Sometimes medical procedure names have commas in them. Instead of text qualifying them, it can be faster to write code that uses a different semi-standard delimiter.
It sucks, but, like, I don't really blame people for being in a hurry to fix a problem.
Or they could be using a legacy system that exports data in that format from times before CSV was invented/standardized.
For example, SCO Unix's Informix SQL's `UNLOAD TO <file> SELECT ...` queries output in a format that's very much like what avs733 describes, only that the values aren't separated by pipes, they're terminated by them, so every record ends with a pipe character.
If that's the case, there's unfortunately no built-in option to get it to include column identifiers in the report. :(
It sucks, but, like, I don't really blame people for being in a hurry to fix a problem.