If Attorney General Richard Blumenthal LAW ’73 has his way, patient injuries resulting from medical mistakes will be harder for Connecticut hospitals to keep under wraps.
Blumenthal announced Monday his intention to revise a 2004 law that did not require the Connecticut Department of Public Health to publicly disclose all the malpractice incidents hospitals reported. Blumenthal said because of the revisions made in 2004 state authorities failed to adequately investigate instances of malpractice at Connecticut hospitals. Since mid-2004, the Connecticut Department of Public Health has investigated 35 cases of medical error at Yale-New Haven Hospital, the most of any hospital in the state.
Currently, health care consumers cannot obtain information about the number of possible malpractice cases an individual hospital has reported to the state health department. Instead, the only data on medical errors currently available to the public about the number of medical errors the state department of public health has investigated at a particular hospital.
In 2004 Connecticut legislators changed a 2002 law requiring the state health department to make public all the “adverse events” hospitals reported. Under the revised law, the department only has to disclose the malpractice cases it is investigating. At the time, hospital lobbyists said the increased confidentiality would encourage hospitals to fully comply with the reporting requirements, but Blumenthal said the redrafted law has been a disaster for patients.
“This secrecy doesn’t protect patients, it protects the least competent hospitals,” he said in an interview with the News Wednesday. “Keeping most of the specifics on medical mistakes secret has hurt patients’ ability to make informed choices on health care.”
Blumenthal said he intends to meet with state legislators to push for reforms to the 2004 law, including expanding public access to the department’s records and increasing the frequency of investigations.
He said patients should be allowed to view hospital-specific data on medical mistakes so that they can more informed choices about which hospitals to go to for care.
Responding to the charge that Connecticut hospitals are underreporting instances of medical malpractice, Vin Petrini, Yale-New Haven’s senior vice president for public affairs, said in an e-mail Wednesday that it can be difficult for a hospital to decide whether a medical error caused a patient injury or death. As a result, the mistake may not need to be reported, he said.
But William Quinn, director of the New Haven’s Department of Public Health, said he does not believe reporting practices have been problematic at the city’s two major hospitals, St. Raphael and Yale-New Haven.
Since the 2004 revision there was a 50 percent decrease in malpractice cases reported to the health department, an investigative report compiled by the Hartford Courant published Sunday found, and the health department is investigating fewer adverse events — now only about one in four.
“They’re doing the documentation, but they’re not telling the public what the real story is,” Jean Rexford, executive director of the Connecticut Center for Patient Safety, on-profit, patient advocacy group , said of the department’s investigations of reported cases.
Kevin Lembo, a consumers’ healthcare insurance advocate, said the decrease in investigations is partially the result of state budget cuts. The department is also not set up to regularly audit hospitals to ensure all adverse events are reported, he said.
Rexford said she believes if the public is able to access hospitals’ adverse events reports, there will greater competition among hospitals which will lead to better outcomes for patients.
Lisa McGiffert, director of the Safe Patient Project, a national consumer advocacy group, said hospitals would benefit from comparing their performance to that of other hospitals.
“Public reporting would be a tremendous motivation for hospitals to implement more preventive measures, so that they don’t stick out in the public eye,” McGiffert said.
Blumenthal said supporters of the 2004 revision have also argued that confidentiality encourages the development of innovative but potentially riskier techniques and procedures. He said he did not seek to stunt such development and that public records of hospitals’ errors would only include cases of clear violations of medical standards.
“We’re talking about wrong-site surgeries, sponges left inside patients, ulcers, falls, and hospital-acquired infections,” he said. “This secrecy, rather than protecting patients, protects the least competent hospitals.”
Blumenthal said he was confident that lawmakers would be receptive to his recommendations, and that he expected reforms to be discussed at the state’s next legislative session, which begins Jan. 12. He also said that several hospital leaders with whom he has spoken have indicated they may be open to supporting his proposal, despite the continued opposition of the Connecticut Hospital Association.
“We have a huge, historic opportunity to be at the forefront of a national movement,” he said. “I think a lot of hospitals will break ranks with the association on this.”
Only about half of states nationwide have mandatory adverse event reporting systems, and like Connecticut, almost none require public disclosure for the vast majority of incidents.