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Audit finds widespread violation of NY’s mandatory reporting law

Quality Improvement Monitor, October 8, 2004

New York hospitals routinely violate a state law that requires them to promptly report medical errors that harm patients, according to a September 29 report in The New York Times.

The hospitals either never report the information or sit on it for months before submitting critical information about patient deaths or wrong site surgeries that could help investigators, the newspaper reported, citing a state audit conducted by State Comptroller, Alan G. Hevesi.

In addition, the State Health Department has punished only a handful of the detractors and has yet to develop rules that detail how the law will be enforced, according to the Times.

State law has required hospitals and health clinics tell the state whenever their actions harm patients since the 1980s. The Institute of Medicine in its landmark 1999 report, XX, highlighted the New York law as an example that other states should follow.

The state audit reviewed 66,000 mistakes that were reported, nearly all of them by hospitals. Although there were thousands of violations, the state comptroller fined only two hospitals and issued citations against 37 others.

In addition, auditors covered more than 5,000 cases that should have been reported to the state within 24 hours. They found instead that 84% of the errors were reported an average of 40 days late. One was reported more than two years late.

Many other errors could have been detected, auditors surmised, if the health department were more aggressive. They criticized the department for failing to uncover the most serious cases that hospitals may be covering up or mismanaging, according to the Times report.

State Health Commissioner Antonia C. Novello pledged to correct some of the problems uncovered in the audit, including by drafting an enforcement policy that will result in more penalties.

However, Jeannie Cross, a spokeswoman for the Healthcare Association of New York State, a statewide hospital group, rejected the notion that hospitals are persistent violators of the law.

"But we agree that improvements have been needed to clarify definitions and requirements," she told a Times reporter. "A central reporting mechanism is a good thing, and we want to make it work, but it really should not be punitive."

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