LAS VEGAS (AP) - Nevada's top health administrator wants hospitals to review medical records from 2009 and see if they failed to report so-called "sentinel events" involving injury or risk of injury to patients.
State Health Division chief Richard Whitley issued a letter Wednesday with state data that patients suffered 342 preventable injuries or infections during the second half of 2009, while facilities reported just 44.
"We are asking that you reconcile the differences," Whitley wrote.
Officials say each of the 342 cases might fit Nevada's definition of "sentinel events" that hospitals are legally required to review and report to the state and affected patients.
Whitely calls sentinel-event reporting important to determine the circumstances that led to injury and to protect future patients.
The Las Vegas Sun reported Friday the state tally of preventable injuries and infections in Nevada hospitals mirrored its analysis of hospital billing records showing a discrepancy between the number of incidents and the number of cases of patient harm reported to the state.
The Sun found that in 2008 and 2009 patients suffered 1,363
cases of preventable harm in Nevada acute-care hospitals, but that hospitals reported 402 sentinel events during that time.
The data included 21 cases of foreign objects left in patients' bodies after surgery, 79 cases of advanced-stage pressure sores, 475 cases of bloodstream infections and 248 cases of postoperative falls or other trauma.
Hospitals did not dispute the newspaper findings, but argued that many of the incidents don't meet the definition of a sentinel event. They called them "adverse" events.
The health division licenses and investigates complaints against hospitals. Regulators can impose sanctions against hospitals that fail to report sentinel events. The maximum fine is $100 per event, per day an incident goes unreported.
If all the incidents of hospital harm were considered sentinel events, and the maximum fines were assessed, the newspaper said Nevada hospitals could face combined fines totaling $10.8 million.
Whitley called big fines unlikely and told the Sun he intended to give hospitals a "reasonable" period to review their records from the second half of 2009 and respond.
Meanwhile, health division surveyors will begin pulling medical records for each hospital-acquired condition identified by the state billing record analysis and determine whether incidents should have been reported as sentinel events, he said.
Some hospital officials said they had no qualms about the state reviewing medical records to determine whether a sentinel event report should have been filed.
Kathy Silver, chief executive at University Medical Center in Las Vegas, called it a good opportunity to compare clinical medical records and non-clinical billing files to clear up questions.
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