|California has tied penalties against hospitals for their failure to timely report adverse events, trying to drive increased compliance and more reliable data. Despite the fines, however, the hospitals have not shown much improvement in their reporting based upon the California database, and fines from July 1, 2007 through December 31, 2009 have been assessed in the amount of $956,900 for failure to report 247 events.
The state law took effect July 1, 2007 and assesses the hospitals $100 for every day after five days from the date the event occurred or within 24 hours if the adverse event represented an emergent threat to the safety of a patient, visitor or personnel. One fourth of the 450 acute care hospitals have been fined and one hospital received five fines totaling more than $130,000.
Adverse events which must be reported to public health officials include wrong surgery, blood or transplant organ incompatibility, transmission of infectious agent to a patient, administration of an incorrect medication or dosage, in-hospital falls or burns, pressure ulcers, catheter-acquired infections and surgical site infections. The most common adverse event reported was Stage 3 or 4 decubitis ulcers acquired during admission, with 2,446 events reported in the 2 ½ years. The second largest adverse event was retention of a foreign object in a patient (350) and there were 62 deaths or serious disability associated with a medication error.
California is one of the few states, however, that is actively enforcing its reporting policy and other states and groups are looking to California to model their own programs.
(This program is complementary to the fines for medical mistakes which involve immediate jeopardy of harm, set up to capture another $5 million.)