Page 16
proceed as expected, disclosure of information to patients and their families is the right thing to do. Moreover, disclosure increasingly is required by ethical, self-regulatory, and statutory mandates. In Pennsylvania, the MCARE Act’s disclosure requirement provides impetus for improving communication between physicians and patients reconsidering litigious, defensive responses to medical error, and experimenting with non-litigation dispute resolution processes such as mediation. States with laws that protect apologies of responsibility give added support to physicians who want to take responsibility for their actions, and encourage the type of communication which can provide solace to patients. It is too early to measure the impact of the MCARE Act’s disclosure requirement on medical malpractice litigation. If disclosure is made with skill and compassion, includes an appropriate apology, and generates a fair offer of compensation and steps to avoid recurrent harm, we predict that litigation will decrease and patient safety will improve. But old habits are hard to shed. Strong, persistent efforts by hospital leaders will be required to change the institutional and professional response to an error that is made or a claim that is filed. Duty to notify patients: An appropriately trained person designated by each licensed facility shall inform each patient, or an individual identified pursuant to s. 765.401(1), in person about adverse incidents that result in serious harm to the patient. Notification of outcomes of care that result in harm to the patient under this section shall not constitute an acknowledgment or admission of liability, nor can it be introduced as evidence. 1. Each medical facility that is located within this state shall designate a representative for the notification of patients who have been involved in sentinel events at that medical facility. 2. A representative designated pursuant to subsection 1 shall, not later than 7 days after discovering or becoming aware of a sentinel event that occurred at the medical facility, provide notice of that fact to each patient who was involved in that sentinel event. d. A health care facility shall assure that the patient affected by a serious preventable adverse event or an adverse event specifically related to an allergic reaction, or, in the case of a minor or a patient who is incapacitated, the patient's parent or guardian or other family member, as appropriate, is informed of the serious preventable adverse event or adverse event specifically related to an allergic reaction, no later than the end of the episode of care, or, if discovery occurs after the end of the episode of care, in a timely fashion as established by the commissioner by regulation. The time, date, participants and content of the notification shall be documented in the patient's medical record in accordance with rules and regulations adopted by the commissioner. The content of the documentation shall be determined in accordance with the rules and regulations of the commissioner. If the patient's physician determines that the disclosure would seriously and adversely affect the patient's health, then the facility shall assure that the family member, if available, is notified in accordance with rules and regulations adopted by the commissioner. In the event that an adult patient is not informed of the serious preventable adverse event or adverse event specifically related to an allergic reaction, the facility shall assure that the physician includes a statement in the patient's medical record that provides the reason for not informing the patient pursuant to this section. Chris Stern Hyman is a health care lawyer and a mediator. From 1980 until 1995 she was Chief Counsel of the Bureau of Professional Medical Conduct in the New York State Department of Health. In 1998 she formed Medical Mediation Group LLC with Marc Fleisher, JD to conduct trainings and mediate medical malpractice claims and other conflicts arising in health care facilities. In addition to health care disputes, Chris Hyman mediates child visitation and custody cases, pro se cases referred by Civil Court, New York County, civilian complaints against police, and attorney disciplinary cases. She has written on state medical boards' pain management policies and on mediation and health care. She received her undergraduate degree