MATERNITY-WARD ISSUES: Assembly Bill Targets Reporting Of Problems
The state Assembly health committee voted 13-7 Tuesday to pass legislation "requiring all [California] hospitals to report maternity ward injuries and develop procedures to correct problems." The Los Angeles Times reports that the bill, sponsored by state Assemblywoman Martha Escutia (D-Huntington Park), would require tracking of maternal and fetal injuries in a database, "as well as a system to ensure that conditions that can lead to malpractice ... are corrected." State health officials would scrutinize "all injuries, deaths or other problems in maternity clinics" and "then monitor individual cases, as well as scout for trends." Additionally, the legislation would require "state oversight of the database and corrective action." Escutia's proposal is modeled after a "program developed by Los Angeles County Supervisor Gloria Molina to combat malpractice at county hospitals."
Addressing A Larger Issue
Escutia's bill is in response to a rise in injury and death to women and infants in Los Angeles County resulting from a policy that attempted to reduce the "number of costly Caesareans at public hospitals in the late 1980s and early 1990s." County hospitals "were at the forefront of a nationwide movement to reduce" Caesareans by having most women, even those at high risk, attempt a trial of labor. The policy led to 49 malpractice claims and "has cost the county at least $25 million in malpractice settlements." The American College of Obstetricians and Gynecologists, which "urges caution about efforts to reduce the number of Caesarean births," supports Escutia's bill. However, state health department officials oppose it, questioning "the quality of information submitted by hospitals" and saying a database would be too expensive.
Enforcing Proper Treatment
State Assemblyman Martin Gallegos (D-Irwindale), chair of the state Assembly health committee, is sponsoring another bill that "would forbid a public agency to require doctors to undertake a particular course of treatment for any class of patients." Gallegos explained that the bill would make it "illegal for a public agency to interfere in the doctor's decision-making with regard to care or treatment of a patient" (Bernstein, 4/23).