Iowa hospitals oppose mandatory reporting of major medical errors

A long-running debate over medical transparency in Iowa is resurfacing with the introduction of Senate File 2185, a bill that would mandate reporting of “serious reportable events” – often called “never events” – to the Iowa Department of Inspections, Appeals and Licensing (DIAL). Despite provisions intended to address concerns from the medical community, the bill is already facing opposition from major hospital groups in the state.

The Push for Transparency

Senate File 2185 would require Iowa hospitals, ambulatory surgical centres and birth centres to report specific incidents, including those involving contaminated drugs, medication errors, surgical mistakes (wrong body part or patient), and errors in artificial insemination. The bill stipulates that DIAL would not initiate further investigations once informed of an event, and it includes measures to protect the identities of healthcare professionals involved.

Did You Know? The debate over mandatory reporting of medical errors in Iowa dates back at least 16 years, to 2008, when a proposal to create such a rule was blocked by the Iowa Hospital Licensing Board.

A History of Opposition

This isn’t the first attempt to require this level of reporting. For over 16 years, similar proposals have been considered but ultimately failed to gain approval from state lawmakers. In 2008, Dean Lerner, then head of the state inspections department, publicly criticized the hospital licensing board for refusing to vote on a mandatory reporting rule, stating that “special interests have taken over government.”

Currently, the Iowa Hospital Association, UnityPoint Health, and MercyOne have all registered their opposition to the bill. Requests for comment from executives and lobbyists representing these organizations went unanswered.

What’s at Stake?

Senator Mark Lofgren, the bill’s sponsor, believes increased transparency will empower both consumers and legislators. He argues that Iowans currently lack accessible information about the safety and quality of healthcare facilities, despite routinely researching major purchases like cars and homes. He emphasizes the bill’s focus on quality improvement, not punishment.

Expert Insight: The resistance to mandatory reporting often stems from concerns about potential legal repercussions and reputational damage. However, a lack of transparency can erode public trust and hinder efforts to systematically improve patient safety.

Supporters, including the Iowa Association for Justice, point to a concerning trend in medical errors. Estimates suggest that between 98,000 and 440,000 Americans die each year due to medical errors, and a 2016 report suggested as many as 2,400 Iowans may die annually from preventable medical mistakes. With limited avenues for legal recourse for patients in Iowa, advocates argue that regulatory oversight is crucial.

What Happens Next?

The bill has already passed a subcommittee and moved to the Senate Health and Human Services Committee. However, a hearing date has not yet been scheduled. If the bill does not receive committee approval by the end of the week, it may not be eligible for further debate this session. Should it advance, it would then need to be considered by the full Senate and, if passed, by the Iowa House of Representatives.

Even if passed, the extent to which the reported data will be made public remains unclear. While the bill includes confidentiality provisions for reports from professional licensing boards and corrective action plans, it is uncertain whether the initial reports from hospitals will also be kept confidential.

Frequently Asked Questions

What types of events would be reported under Senate File 2185?

The bill requires reporting of “serious reportable events,” including injuries or deaths related to contaminated drugs, major medication errors, discharging newborns to the wrong patients, surgery on the wrong body part or patient, and errors in artificial insemination.

Which facilities would be required to report these events?

Iowa hospitals, ambulatory surgical centres, and birth centres would be required to report serious reportable events to DIAL.

Does the bill seek to punish healthcare facilities or professionals?

Senator Lofgren stated the purpose of the bill is to facilitate quality improvement in the healthcare system, not to punish facilities. The bill also stipulates that DIAL will not conduct further investigations once informed of an event, and it includes provisions to protect the identities of healthcare professionals.

As Iowa lawmakers consider this legislation, will increased transparency truly lead to safer healthcare for all Iowans?