Relying on out-of-country test results

March 19, 2008

I have a large Latino population that often travels to Mexico for healthcare. They then come to me with lab results, EKGs, and ultrasound results that were done there. Some of these patients don?t have health insurance, so to repeat those tests here would be financially prohibitive for them. Do I incur any risk in relying on tests results from these out-of-country health care facilities?

Q. I have a large Latino population that often travels to Mexico for healthcare. They then come to me with lab results, EKGs, and ultrasound results that were done there. Some of these patients don’t have health insurance, so to repeat those tests here would be financially prohibitive for them. Do I incur any risk in relying on tests results from these out-of-country health care facilities?

A. Whenever you act on the results of lab or imaging studies, you’re essentially making two statements. First, you’re stating that you’re familiar with the source of the results and have a reasonable belief that they’re accurate. Second, you’re accepting their applicability to your patient’s condition. The second is the case no matter where the results are obtained, and is part of every physician’s practice. The first, however, is open to argument. If you’re familiar with the laboratory or imaging center where the tests are done, and you know (or have reason to believe) that its standards are equivalent to those of US facilities of the same type, there shouldn’t be a problem.

On the other hand, if the test results are from perhaps a neighborhood lab that may not have the highest standards, you have a duty to question both the accuracy and consistency of the results. In other words, the results themselves may be inaccurate or the lab’s quality control may be poor enough that you shouldn’t base dosing or other therapy on those results.

Perhaps the safest thing you can do, besides repeating the tests at your own reference lab, is to take a proactive approach. Obtain certification data for the lab(s) you’re receiving reports from in Mexico, and keep them on file. That way, if your decision to accept them is ever questioned, you can at least demonstrate that you did your “due diligence” in investigating the labs and have a reasonable belief that they’re equivalent to results from your own lab. If the results are coming from a large, well known lab (e.g. a university lab), this would probably not be necessary, but remember, the one-time effort of obtaining an out-or-country lab’s certification data may save you endless hours of worry and defense expense down the road.

Eric E. Shore, DO, JD

Eric Shore, an attorney concentrating in healthcare law, is a founding member and partner in the law firm of Kane & Shore, LLC in Philadelphia. Before entering the full-time practice of law, he practiced internal medicine for more than 25 years and earned an MBA in healthcare management. He has been medical director at several long term care facilities, a hospital chief of service, and a medical staff officer, as well as being a fellow of the American College of Legal Medicine, the American Academy of Family Physicians, and the American College of Medical Quality. He can be reached at eshore@KaneShore.com, or 610-664-4182.

The answers to these queries are general opinions and are not intended as substitutes for legal advice. You should not rely on these replies in making decisions involving questions of law, but should instead consult with competent legal counsel.