Munchausen files in Scottish A&E departments: A review of current practice

Our objective was to describe current use of Munchausen files in Scottish A ccident and Emergency Departments. A Postal questionnaire survey was sent t o lead A&E consultant/clinical directors in each department in Summer 1998. A total of 29 departments replied with 27 saying they kept a Munchausen fi le, of which only two were updated regularly. Organisation of information w as variable or absent. Six departments kept data on other groups such as dr ug misusers, violent patients, missing persons or children at risk in the s ame file. Of the 27 replies, only 14 departments would review their own fil es if suspecting a case: only 11 would report a suspected incident, to a va riety of destinations. The majority of Scottish A&E departments do keep a M unchausen file although there appears to be little consistency in the colle ction, use and dissemination of the information therein. An improved data s ystem may lead to more appropriate patient management.