Hi bigkido1
I would have to watch what you are doing, because that shouldn't happen. I rarely use ImportedItems, but I have never had an issue deleting a file. You are correct, that you simply right-click on the file, enter the password in the Login window for Admin (make sure it is your admin password and not the one you use to log in to AC, although mine is the same anyway. Once you identify yourself as the admin, which is really what you are doing, you should be able to delete it easily. It still takes another step (window), but then it deletes. After that, you can continue to delete files without entering the admin password.
You can try rebooting AC or Windows, but it really should work with no problem.
Alternatively, you can do it manually. Make a note of the ID# of the wrong patient, say 2233. Now go to the Amazing Charts folder on the main computer, go to ImportItems folder. There will be a sub-folder there called 2233. Open it and delete the file or move it out of the folder.
Once this is done, you should clean things up by going into the Administrative Options and at the top left choosing Tools. From the drop down box, select Imported Items: Repair missing files and links. This will open a new window with three options on the right. I find it is always a good idea to do all of them in order. This will fix the "broken link" between AC and the file you deleted. It's a good idea to run this every so often anyway.
As to your last question, I am not the one to ask, but I believe it has been brought up at least 50 times, and I think the answer is no.
If you continue to have issues deleting files the standard way, I would talk to support. I imagine if they were to remote into your computer and watch how you were doing it, they may identify the issue.
HTH.