May 01, 2017

Hospitals fight tooth and nail to avoid producing adverse incident reports. Learn how to craft a motion that will survive their opposition.

Almost all hospitals in the United States have an adverse incident reporting system in which risk managers accumulate documents about events that have injured or killed patients[1]. Congress enacted the Patient Safety Quality Improvement Act of 2005 (PSQIA) to encourage hospitals to maintain this reporting system and to simultaneously protect the confidentiality of the information, also known as “patient safety work product.”[2] 

Seizing on this privilege, defendant hospitals perennially cite the PSQIA as legal authority for withholding documents. But a careful reading of the act, along with recent U.S. Department of Health and Human Services (HHS) guidance, can help you overcome defense objections and obtain vital documents for your medical negligence case.

When requesting documents related to adverse incidents, the exact wording is less important than the substance. Incorporate language broad enough to encompass all relevant documents. For example, I have had success with the following language, notwithstanding the anticipated objection:

Any and all records you made or received regarding the adverse medical incident in question, including but not limited to: records, reports, and investigations required by state or federal law to be reported to any governmental agency or body, and/or that are reported to or that were reported to or reviewed by the facility’s peer review, risk management, quality assurance, credentials, patient safety disciplinary, or any other similar committee or any representative of such committees.


[1] Donna O'Farley et al., Adverse-Event-Reporting Practices by U.S. Hospitals: Results of a National Survey, 17 Quality & Safety in Health Care 416-23 (2008)

[2] Patient Safety and Quality Improvement Act of 2005, Pub. L. No. 109-41, 119 Stat.424 (2005); and see U.S. Dep't of Health and Human Servs., Patient Safety and Quality Improvement Act of 2005 Statute and Rule