President Urges U.S. Hospitals to Report Their Deadly Mistakes

By Anne Gearan;The Assoc.Press( 22/02/00)

WASHINGTON - President Clinton, responding to findings that as many as 98,000 people are killed annually because of medical mix ups, wants hospitals to agree to routine reporting of serious and deadly mistakes.

Although the president can*t require such reporting unless Congress acts, the White House said Clinton today will unveil a program that urges increased reporting, would require increased reporting at veterans hospitals and call for new error-reduction plans at 6,000 hospitals participating in Medicare.

Hospitals would not have to report less serious mistakes or close calls, although the White House hopes they would do so voluntarily, a senior White House official said Monday.

The administration*s program is a compromise between patient advocates who want mandatory full disclosure of all medical mistakes and the medical community that fears such disclosure would bring more lawsuits.

The proposed reporting system would be administered by the states, which would collect information about preventable deaths and major injuries by hospital and type of problem. Names of individual doctors or other health-care workers would not be public.

While the White House would like all hospitals within three years to develop a system of reporting fatal errors, administration officials acknowledged the government cannot force compliance without legislation from Congress.

However, there are already plans in Congress requiring more comprehensive reporting. Sen. Edward Kennedy, D-Mass., predicted a bipartisan medical error bill will pass this year. Two Senate committees have scheduled hearings.

Eighteen states already have some kind of mandatory reporting system.

CRITICAL STUDY: The intense interest in additional hospital reporting stems from a report in November by the independent Institute of Medicine

misunderstandings over dosages and effects of prescription drugs.

"The whole idea here is to not blame people," said the White House official, who spoke on condition of anonymity.

"Obviously we have a problem in medical errors, and we have to acknowledge it. Acknowledging it is the first step, but we can*t make it punitive."

Dr. Sidney Wolfe, head of the Washington-based Public Citizen*s Health Research Group, said the Clinton plan does not go far enough. Hospitals can still mask the true level of mistakes by failing to perform enough autopsies, and patients deserve a full accounting, Wolfe said.

But Dr. Nancy Dickey, immediate past president of the American Medical Association, said there is no evidence that hospitals are safer in states with reporting Systems in place and, "We are opposed to mandatory reporting. "THE NEXT STEP: Clinton already announced some federal Steps that did not require congressional approval, and plans to add more today.

Among the new proposals are:

' An immediate mandatory reporting requirement for military hospitals. The 500 Pentagon administered hospitals serve an estimated 8 million people.

' The Food and Drug Administration within a year would develop new standards to help prevent medical mistakes caused by sound-alike drug names or look-alike Products. The agency will also come up with new labeling standards to reduce errors.

' The Health Care Financing Administration would require error reduction plans in all 6,000 hospitals that participate in Medicare.

The President*s proposed budget for next year includes $33 million to improve the reporting system for medical mistakes at the FDA. It also includes $20 million for new research on reducing medical errors and calls for the creation of a new patient safety clearinghouse.