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Hospitals fined more than $1 million for failing to report errors

California regulators have fined hospitals just over $1 million for failing to report incidents such as leaving a foreign object in a patient after a surgery or operating on the wrong person, according to data released to California Watch by the California Department of Public Health.

The state has issued more than 260 such fines under a 2006 law that mandated $100-a-day penalties for failing to report such incidents, data show.

Flickr photo by the U.S. Army

The law was passed in recognition of the human and financial cost of preventable medical errors, which are estimated to take 10,000 lives in California each year. The enhanced reporting was mandated with the hope that increased scrutiny would inspire change.

“Hospitals are in the business of healing patients,” said Jan Emerson, spokeswoman for the California Hospital Association. “We do believe that public reporting will make patient care safer.”

The penalties in the spreadsheets below range from $100 to more than $50,000 and were issued between July 2007 and November 2009, the latest data that's been released. More particulars on the law, SB 1301, are here.

One hospital, Tri-City Medical Center in Oceanside, was twice fined more than $40,000 for failing to report that an object was left in a patient. The hospital was also fined more than $30,000 over an unreported patient death during or within 24 hours of a surgery. A spokesman from the facility, which appealed both fines related to leaving an object in a patient, did not return a call Friday.

In these spreadsheets, you can see which types of incidents the state Department of Public Health fined your local hospital for failing to report in each of the three years of reporting (although the most recent year is not complete). Note that some hospitals appealed the fines.

Regulators issued most fines for failing to report serious bed sores that were obseved after a patient's admission to a hospital. The same violation is also the most common among the nearly 2,500 “adverse events” that hospitals came forward to report during the first two full years of mandated medical error disclosure.

Since mid-2007, hospitals have appealed 22 of the failure-to-report fines. The state has collected more than $830,000 of the $1 million that it's assessed.

The track record is a bright spot in the state’s enforcement of a package of laws meant to improve patient safety, said Lisa McGiffert, director of Consumers Union’s Safe Patient Project, which issued a report earlier this month on the department’s failures to carry out parts of some patient safety laws. 

“Quite frankly, I think it’s a really good model,” McGiffert said. “Our patient safety campaign works across the country and I think attaching a penalty to not filing a report is a really effective tool to encourage reporting.”

 Here’s a breakdown of some of the most serious incidents that hospitals did not report within timelines laid out in the 2006 law:

  • Three hospitals performed a surgery on the wrong patient
  • Four performed surgery on the wrong body part
  • Three reported sexual assault on a patient
  • One hospital reported a death during the delivery of a baby and two reported deaths within 24 hours of a surgery

Emerson, of the hospital association, did not comment specifically about the data since her organization had not thoroughly reviewed it Friday. In general, she said, hospitals and state regulators have been refining definitions for the 28 errors hospitals are supposed to report.

Earlier this year, public health officials released a report on problems that hospitals took initiative to report. Bed sores were the most reported problem, accounting for 1,585 reports. Coming in second? Leaving a foreign object, like a sponge, inside a patient after a surgery. More details here.

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