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How do Hospitals Police Themselves When Medical Errors are Committed?

By Josh Silverman on August 04, 2014


This morning the Richmond Times Dispatch published an interesting article about hospital quality assurance committees (also called Quality Improvement (QI)).  When there is an adverse event in a hospital, like unusual blood loss during surgery, medication errors, falls, retained objects, etc,. a private committee reviews the evidence and can make recommended changes and occasionally discipline the provider.  These committees operate in almost complete secrecy.  The patient does not even know of the committee review in most cases.  If there is a malpractice case the facts discovered by the committee may never make the light of day.  The purpose of the secrecy is to promote full and frank discussions by the committee and to encourage hospitals to self-police themselves which hopefully will result in better care for the patients. 

Obviously, that is how it is ideally supposed to work and I'm sure in many cases that is exactly how it works.  The problem is that the ethical component appears to be limited.  If the hospital acts ethically, then the hospital has an obligation to do right by the patient.  That would include a sincere apology and taking steps to rectify the problem not just taking steps to prevent it from happening to another patient.  Rectifying the problem could range from canceling the patient's bill, providing free treatment for the injury, and for serious injuries making a voluntary offer to compensate the patient.  

In 16 years of medical malpractice litigation, I can recall only one occasion where a hospital admitted the mistake to the patient and make a voluntary settlement offer.  In that case the patient had a sponge left in her during a hysterectomy.  While the hospital made an offer, it was an insultingly low offer of $10,000 for a patient who had to go through a second surgery and a lengthy recovery.  The patient and her family knew that the hospital was not treating her properly and hired my former practice group to represent her.  The case ultimately settled for a confidential amount. 

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