Changes made five years ago to a Connecticut law aimed at revealing medical mistakes at hospitals have allowed the facilities to keep more errors secret, according to a <i>Hartford Courant</i> analysis.
After examining state health department records, death certificates, medical examiner reports and lawsuits, the newspaper found that narrower reporting requirements in the revised law have allowed hospitals to keep more mistakes from being revealed to the public.
“Do we know more? No,” Jean Rexford, executive director of the nonprofit Connecticut Center for Patient Safety, tells the Courant. “The health care industry is as secretive as any you can imagine. And it doesn’t serve the public well.”
State public health officials, however, maintain the revised law has encouraged hospitals to be more forthcoming about medical errors.
According to the Courant, the state has investigated dramatically fewer adverse-event cases since the law was changed. Of the more than 1,200 adverse-event reports filed by state hospitals since 2004, including at least 116 involving the death of a patient, about three out of four were closed without a formal investigation.
That’s down from half of cases that were being investigated before the law was changed.
Details of at least 30 cases in which sponges and other objects were left in patients’ bodies after surgery are concealed in Department of Public Health records, according to the Courant. Also, details of more than a dozen sexual assaults, hundreds of serious falls and at least half a dozen cases where newborn babies died or were seriously injured have been kept under wraps.
The General Assembly in 2002 ordered hospitals to disclose all serious patient injuries that were “associated with medical management.” But that law was later changed in 2004 to limit the types of adverse events that must be revealed. Reports would be kept secret unless they led to an investigation.
Wendy Furniss, health care systems chief for the public health department, said the agency is closing more cases without investigating because the revised law has required hospitals to provide clearer explanations of adverse events and how hospital officials plan to address problems. Keeping the reports secret, she said, has encouraged hospitals to report more honestly.
“The confidentiality piece has made all the difference,” she said.
The revised 2004 law was partially prompted by underreporting by hospitals.
DPH investigates cases that indicate there are systemic problems at a hospital or inadequate standards of care. Furniss said the more clear, initial reporting by the hospitals makes it easier to rule out such problems without having to conduct an independent investigation.
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