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Despite laws in New Jersey and Pennsylvania requiring hospitals to report major medical errors, unanticipated complications, and near misses to stage agencies for the purpose of reducing medical mistakes, experts say that hospitals in both states are neglecting to report these kinds of incidents.

In 2007, major medical errors in Pennsylvania included accidentally leaving surgical equipment inside two separate patients at Fox Chase Cancer Center. At Abington Memorial Hospital in 2005, a woman recovering from hip surgery developed open bed sores after being left lying on a bedpan for several hours. In a total violation of state law, none of these incidents was reported by the hospitals responsible.

These individual reporting failures are indicative of a larger trend across Pennsylvania and New Jersey. In 2007, 5 out of the 80 hospitals in New Jersey neglected to report a single preventable medical error to state agencies. Similarly, a handful of Pennsylvania hospitals reported no serious events and no near misses that could have hurt patients.

To put this in perspective, James Conway, a quality expert at the Institute for Healthcare Improvement in Cambridge, Mass., says that on average, 100 patient medical charts document about 40 instances of patient harm.

When we compare these statistics to the ones coming in from hospitals, it becomes apparent that underreporting is both pervasive and profound.

"Anybody that is supposed to report close calls and has zero reports is clueless," said James Bagian, head of the Department of Veterans Affairs’ National Center for Patient Safety. "Management is asleep at the switch and just waiting until they kill someone." -Josh Goldstein, Philadelphia Inquirer

On the consumer level, patients have no way of knowing how well local hospitals are performing. State agencies do not release reports from individual hospitals regarding their rate of medical errors. Oftentimes, it is not until the health department cites a hospital for violating state laws that the public even hears of the hospital’s failing.

Since 2003, though the health department has cited four hospitals in Southeastern Pennsylvania for failing to report serious medical errors, none of these hospitals has been fined.

In the current climate of sloppy enforcement, medical malpractice lawsuits may be one of the only ways to make certain that hospitals and doctors are held responsible for serious patient harm.

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