Document MG425GxNo187vzGxDNz2Em4zV

4r. rv Interoffice Communication To J. R. Drumwright, M.D. From 0. A. DeBemardi Date May 17, 1982 Subject Medical Records (conoco) Per the attached page of the recently Issued Co Policy and Procedures Guide, I aa requesting the Manager - Medical Division to-allow a complete employees medical van test results be maintained direction of Gordon Monroe, R.N* ' i on - The need for employee access to their medical records Is normally on an emergency basis. This need cannot be satisfied in outlying locations by a normal request procedure. Our most recent.experience is presented to support this situation. On 4/29 a call was made to the Medical Division requesting recent X-rays of a plant employee. A formal request form was filled out and sent by shuttle to Ponca City on 5/3 by the Safety Director. Follow-up calls wre made to Ponca on 5/6, 5/7 and 5/11. On 5/13 a call was received from Ponca indicating the X-rays were put on the shuttle to Lake Charles on 5/13. As a result, the employee was forced to have add itional X-rays taken to satisfy his physician's need In a timely fashion. %^ The overall result of incidents of this.nature can only be to adversely affect the credibility of plant management and the Medical Division with our employees. Although a failure of this nature seemingly affects only I one person, the knowledge of our failure to satisfy one employee's need is ** quickly known by the majority of all employees at a location and the overall effect reaches beyond the one affected employee. I will look forward to your response to my request. 00O007392 vvt MEDICAL AND EXPOSURE RECORDS GENERAL All medical records are confidential and will be kept on file in Medical Division offices. Where required and if confidentiality can be assured, certain field/plant locations employing the services of a full-time nurse may also maintain copies of employee medical records with the concurrence of the Manager--Medical Division. i Corporate guidelines defining storage and maintenance of records will be closely followed. The Manager-- Medical Division, or his designated representative, may release information to authorized persons upon receipt of appropriate written requests or as required by statute or regulation. Any questions regarding an employee's right of access to his/her medical records should be directed to the attention of the Manager--Medical Division. DEFINITIONS (FOR PURPOSES OF THIS GUIDE) 1. Employee Medical Record--The record maintained by Conoco Medical Division contain ing information concerning the health status of an employee of Conoco Inc. or one of its subsidiary companies. This record will usually contain medical and/or employment histories and questionnaires as generated by various workplace requirements, federal guidelines, etc., as well as results of medical examinations (pre-placement, periodic or episodic) and laboratory tests (including x-ray examinations and biological monitoring). In addition, sec tions relative to medical opinions, diagnoses, clinic visits, occupational and nonoccupational injury reports or treatment descriptions and recommendations may be included. 2. Employee Exposure Record--The record maintained by Conoco Medical Division includ ing information from corporate industrial hygiene, toxicology, environmental and safety activities pertaining to harmful or potentially harmful toxic or physical agents to which an employee is exposed to, or potentially exposed to, during his/her course of employment. Specific monitoring data (environmental area, personal) as applicable to individual needs, state/federal regulations and good occupational health practices are included in this defini tion. 10.1-1 vve 000007393 J. R, Drumwright. M.D. Medical Director Chemicals Operations Corporate services June 3, 1982 (conoco) Mr. J. A. DeBernardi Lake Charles VCM Plant Box 605 Westlake, Louisianna 70069 RE: MEDICAL RECORDS Dear Mr. DeBernardi: Your letter of May 17, 1982 to me was reviewed with C. L. Whetstone, M.D., Manager, Conoco Medical Division, and it is my pleasure to let you know that Dr. Whetstone concurs with your request to allow a copy of each LCVCM Plant Employees Medical Van Test Results to be maintained at. the LCCP under the direction of Gordon Monroe, R.N.. The copy which would be kept locally, would of course, be the most recent van examination completed by each employee and would be replaced periodically when a new van examination was completed. This would assure that the most current van examin ation data would be readily available should the need arise for review, etc. All original examinations, including X-rays, must remain on file at the Conoco Medical Division here in Ponca City as this office remains the ''legal11 central repository for medical records for Conoco Inc. Prior to the release of any information from any van examination test results etc. the appropriate written request form must be completed and directed to the Manager - Medical Division (or us required by statute or regu I a t ion) . These requirements are outlined under the Medical Confidentiality and Access to Medical Records section of the Conoco Medical Division's Policy and Procedures Guide. Page 2 Mr. J. A. DeBernardi It is my understandi ng that as soon as the new Conoco Medical Clinic is established at Westlake, that copies of ail appropriate medical records, etc. will be transferred to that facility. There fore, the maintenance of the van test results for LCVCM would then be handled by the medical personnel working at that facility. Although I agree that sometimes an employee requires access to his/her medical records on an emergency basis, it has not been my experience that this is the most common requirement. As you are aware, each employee who participates in the van testing program is provided with a copy of his/her test results and is encouraged to make that data available to his/her personal physician and/or maintain a copy for themselves (All too often this advice is not followed unfortuna tel y) . When the need, for medical test results are required on an emergency basis, appropriate data can be "faxed" from the Conoco Medical Division here in Ponca City to the Westlake area without difficulty. This method of service has worked well for numerous Conoco locutions in the past. Unfort unatel y, our capabilities for "faxing" X-rays has not yet renchi`d this level of sophistication. The situation whico you described in your letter, vividly points out the pit falls of attempting to transfer X-rays - even when the Conoco ..buttle service is utilized. I was not under the impression that the request for the X ray in question was on an emergency basis. In those type situations, Conoco1 s physicians usually communicate with the employee's attending physician directly as the delays encountered in transport i ng X-rays are too common an occurrence. Also, due to the fact that many films are lost, never returned, etc., it hja become a practice to provide copies or duplicate X-rays to avoid the loss o t a n or i g i na 1 - As 1 do no t know what type of additional X-rays this i-inp 1 oyoe ' S physician requ i red, 1 can only state that many times the standard PA chest film that i s taken i n a physician' s v f f i ce or on the mobile van, it not adequate r or va r \ ou S d i agnos t i c procedural needs and other views are required. When looking for potential cases of Tuberculosis, many times un apical lordotic view, as well as obliques, are a necessity for clarification. VVC 00000^395 Page 3 Mr. J.A.DeBernardi June 3, 1982 i do agree that the response time in this case was slower than that usually provided, but at the same time I must point out that it was well within the 15 working day response time. I have discussed the delays connected with this situation with our laboratory staff here in Ponca City and appropriate changes have been worked out to hopefully avoid repeating this in the future. I also concur that the credibility of all involved potentially suffers in situations of this sort. Unfortunatel y it afways seems to be the failures that get all the publicity and not the cases where we are successful in identifying an employee's medical problem early enough to allow for appropriate inter vention. For every "negative" incident, such as this case apparently was, many positive incidents are well-known. I do hope, Mr. DeBernardi, that this response is satisfactory. 1 will be working closely with Gordon Monroe to ascertain what help he may need in obtaining adequate space to maintain these copies (as you may recall, Gordon recently indicated that his office no longer had storage space etc). By the Fall of 1982, it is my understanding that the new Conoco Medical Clinic facility in Westlake should be in operation and should certainly resolve this part of the problem and hopefully improve many other areas of current need as well. Thank you for your request and for your candid remarks. Please let me know if I can be of aditional assistance. J. R. Drumwright, M.D. Medical Director Chemicals Operations & Corporate Services kww vve 000007396