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Submitting a Narrative

Clearly describing the events that led to the reportable action is an important step in submitting a report to the NPDB. The narrative description must include sufficient detail to ensure that future queriers have a clear understanding of what the subject of the report is alleged to have done, and the nature of/reasons for the event upon which the report is based.

Narrative descriptions should:

  • Be limited to statements of fact
  • Summarize the official findings of the action taken
  • State the facts of the case
  • Include a description of the circumstances that led to the action taken
  • Be no longer than 4,000 characters

Narrative descriptions must not include:

  • URLs or references to external websites
  • The proper names of or identifying information about any individual except the subject of the report. Individuals may be characterized in general terms (such as "the patient," "the chief of staff," etc.)

Entities may wish to consult with their legal counsel regarding the wording of the narrative before submitting reports to the NPDB.


Examples of Factually-Sufficient Narratives


Action Basis for Action Narrative
Reduction in Privileges Substandard or inadequate care After reviewing Dr. Doe's cases, the Peer Review panel determined he was not fit to perform laparoscopies and revoked his laparoscopic privileges. Dr. Doe retained all other privileges.
Suspension of Clinical Privileges Immediate threat to health or safety The physician received a 3-month privileges suspension and 2 years of probation for failing to maintain sterile conditions in the operating room and neglecting to follow required operating room protocols.
Suspension of Clinical Privileges Substandard or inadequate care, Other unprofessional conduct After concerns about conduct, competency, and judgment, the Board suspended the practitioner's privileges. He repeatedly failed to complete medical records and patient charts, and a medical error occurred due to him not completing medical records on time. The hearing committee upheld the decision to suspend his privileges. The executive committee accepted the recommendation and finalized the decision to suspend his privileges. It concluded that his conduct adversely affected patient care.
Voluntary Surrender of Clinical Privileges while under or to avoid investigation relating to professional conduct or competence Sexual misconduct, Other unprofessional conduct A nurse filed a complaint with her supervisor, alleging that the physician made unwanted sexual advances toward her. The Chief of Medical Staff formed an ad hoc committee to investigate the allegations. A few hours before the committee was supposed to meet, the physician submitted a written resignation to the Chief of Medical Staff.

State Licensure or Certification Action Taken Basis for Action Narrative
Publicly Available Negative Action or Finding Failure to comply with continuing education or competency requirements, Other unprofessional conduct The state licensing board found that the practitioner violated state code section 432(b): Failure to meet continuing education requirements. The state code considers this "unprofessional conduct."
Voluntary Surrender of License Unable to practice safely by reason of alcohol or other substance abuse, Diversion of controlled substances During the state licensing board's investigation of the practitioner for allegedly diverting drugs for personal use, the practitioner agreed to a voluntary surrender of her license to avoid further investigation. She also agreed to surrender her right to reapply for a license for at least 2 years.
Suspension of License

Publicly Available Fine/Monetary Penalty 

Publicly Available Negative Action or Finding 		Criminal Conviction (19); Violation of Federal or State Statutes, Regulations, or Rule (A6); Other - Not Classified, Specify (99); Other, as Specified: Unethical or Unprofessional Conduct Effective 11/28/2021, the state licensing board suspended the practitioner's medical license for a minimum of 1 year, after which he may seek reinstatement. The board also issued the subject a citation and warning and ordered him to pay a $1,000 civil penalty and complete a board-approved professional ethics program. The board filed a statement of charges against the subject, alleging that he engaged in unprofessional conduct before receiving a conviction of a felony in violation with the laws and rules governing the practice of medicine in the state.
Summary or Emergency Suspension of License Unable to Practice Safely by Reason of Alcohol or Other Substance Abuse (F2) Due to drug use, there is an allegation of the practitioner being unable to practice nursing with reasonable skill. Staff found the subject unresponsive in the staff break room. The employer order an immediate drug screen, and the practitioner tested positive for opiates while not under a physician's care and did not have a lawful prescription or legitimate medical reason for using the drug. The practitioner's license was immediately suspended pending further investigations by the state licensing board.

Example 1

Narrative Question Narrative Description
Description of Settlement and Any Conditions, Including Terms of Payment: Full and final settlement on behalf of the practitioner.
Description of the Medical Condition with Which the Patient Presented for Treatment: On September 6, 2021, a male patient arrived at the emergency room complaining of pain in the right lower back and right leg.
Description of the Procedure Performed: The report subject was the emergency physician on duty when the patient arrived for care. The subject spoke with the patient regarding symptoms. The subject administered the patient an injection of pain medication meant to help reduce pain. While still in the emergency room, the patient requested another dose of the pain medication. The subject gave an additional injection of pain medical and discharged the patient.
Description of the Allegations and Injuries or Illnesses upon Which the Action or Claim Was Based: The patient alleges the subject failed to properly diagnose and treat disc herniation of L3, L4, and L5 and failed to order diagnostic tests such as an MRI, CT, or X-ray imaging, causing a delay in the diagnosis of herniated discs. The subject’s alleged failure to properly diagnose and treat the patient resulted in the need for an emergency micro-discectomy with a subsequent permanent injury, including the loss of muscle strength and range of motion. The patient alleges the loss of the ability to perform daily tasks without help.

Example 2

Narrative Question Narrative Description
Description of Settlement and Any Conditions, Including Terms of Payment: A compromised settlement in the amount of $30,000.00. Deviation from standard of care could not be proven. The practitioner does not admit any wrongdoing or liability. The claim was settled as nuisance.
Description of the Medical Condition with Which the Patient Presented for Treatment: A patient was transferred from outside the facility to the insured’s care for cough, wheezing, and respiratory distress. A CT scan before the transfer read as normal. A later reading of an EEG suggested encephalitis. The patient received an immediate transfer to a specialized facility for the treatment of syndrome of inappropriate antidiuretic hormone secretion (SIADH), where the patient stayed for 30 days.
Description of the Procedure Performed: The insured ordered an MRI and EEG and failed to properly review the reports of each in a timely manner.
Description of the Allegation and Injuries of Illnesses upon Which the Action of Claim Was Based: The claimant alleges a delay in diagnosing SIADH, which caused neurological impairment requiring lifelong care.

Example 3

Narrative Question Narrative Description
Description of Settlement and Any Conditions, Including Terms of Payment: Pre-trial settlement agreement
Description of the Medical Condition with Which the Patient Presented for Treatment: The patient received treatment by other physicians before obtaining a referral to our insured physician for a work-related back injury. The patient saw the insured physician four times. The insured physician prescribed the patient Opana and the patient allegedly had a drug overdose and died.
Description of the Procedure Performed: The patient received treatment for chronic back pain with Diazepam and opiates and an Opana prescription. The patient was previously diagnosed with sleep apnea and the prescribed opiates contraindicated.
Description of the Allegations and Injuries or Illnesses upon Which the Action or Claim Was Based: The patient allegedly had a drug overdose from over-prescribed opiates for chronic back pain in combination with other respiratory depressant drugs. The prescribed opiates contraindicated. The patient needed monitoring for the effects of the medication.

Example 4

Narrative Question Narrative Description
Description of Settlement and Any Conditions, Including Terms of Payment: Liability was disputed and the settlement was based only on a business decision to avoid the inherent and unpredictable risks of litigation. There was no admission of liability or wrongdoing in the settlement. The practitioner remained prepared to defend his care with strong support from board certified experts. The plaintiff’s settlement demand was so reasonable that the insured accepted the offer to avoid costs and risks associated with the trial.
Description of Medical Condition with Which the Patient Presented for Treatment: Alleged failure to perform additional testing in patient presenting for a yearly screening of a well woman visit.
Description of the Procedure Performed: The physician evaluated the patient and performed procedures.
Description of the Allegations and Injuries or Illnesses upon Which the Action or Claim Was Based: The patient alleged that the physician failed to diagnose cervical cancer and failed to properly obtain a PAP smear and additional tests.

Action Basis for Action Narrative
Criminal Conviction (Guilty Plea or Trial) Billing For Services Not Rendered/Supplies Not Provided The psychologist billed patients for more therapy sessions than scheduled; i.e., billing for the scheduled appoinment and then billing an additional four or five times per week for the same patient and not providing the service.

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