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

Our objective was to describe current use of Munchausen files in Scottish Accident and Emergency Departments. A Postal questionnaire survey was sent to 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 file, of which only two were updated regularly. Organisation of information was variable or absent. Six departments kept data on other groups such as drug misusers, violent patients, missing persons or children at risk in the same file. Of the 27 replies, only 14 departments would review their own files if suspecting a case; only 11 would report a suspected incident, to a variety of destinations. The majority of Scottish A&E departments do keep a Munchausen file although there appears to be little consistency in the collection, use and dissemination of the information therein. An improved data system may lead to more appropriate patient management.