President to Target Health Errors

WASHINGTON —  President Clinton, responding to findings that as many as 98,000 people are killed annually because of medical mix-ups, wants hospitals to agree to routine reporting of serious and deadly mistakes.

Although the president can’t require such reporting unless Congress acts, the White House said Clinton will unveil a program today urging it. He would require increased reporting at veterans hospitals and call for new error-reduction plans at 6,000 hospitals participating in Medicare.

Hospitals would not have to report less serious mistakes or close calls, although the White House hopes they would do so voluntarily, a senior White House official said Monday.

The administration’s program is a compromise between patient advocates, who want mandatory full disclosure of all medical mistakes, and the medical community, which fears that such disclosures would bring more lawsuits.

The proposed reporting system would be administered by the states, which would collect information about preventable deaths and major injuries by hospital and type of problem. Names of individual doctors or other health-care workers would not be made public.

Although the White House would like all hospitals within three years to develop a system of reporting serious and fatal errors, administration officials acknowledged that the government cannot force compliance without legislation from Congress.

But there are already plans in Congress requiring more comprehensive reporting. Sen. Edward M. Kennedy (D-Mass.) predicted that a bipartisan medical-error bill will pass this year. Two Senate committees have scheduled hearings.

Eighteen states already have some kind of mandatory reporting system. The intense interest in additional hospital reporting stems from a report in November by the independent Institute of Medicine that an estimated 98,000 Americans are killed each year because of hospital mistakes, ranging from botched surgeries to misunderstandings over dosages and effects of prescription drugs.

Clinton already announced some federal steps that did not require congressional approval and plans to add more today. His new proposals include:

* An immediate mandatory reporting requirement for military hospitals. The 500 Pentagon-administered hospitals serve an estimated 8 million people.

* The Food and Drug Administration would develop within a year new standards to help prevent medical mistakes caused by sound-alike drug names or look-alike products.

* The Health Care Financing Administration would require error-reduction plans in all 6,000 hospitals participating in Medicare.