Hospitals might face quandaries over when they must report clinicians to the National Practitioner Data Bank (NPDB), but it is important to remember queries to the NPDB also are required.
Under Title IV of the Health Care Quality Improvement Act, the law that governs NPDB reporting and protections from liability, hospitals must query the NPDB when physicians, dentists, and other healthcare practitioners apply for medical staff appointment.1 The same requirement applies when they seek clinical privileges. Additionally, hospitals must query the NPDB every two years on physicians, dentists, and other healthcare practitioners who are part of the medical staff or who hold privileges.
Failing to follow those requirements puts the hospital at risk of liability, says Christopher J. Kutner, JD, partner with Rivkin Radler in Uniondale, NY.
“One reason hospitals can be reluctant to report to the data bank is that they may be afraid to acknowledge that they hired or provided privileges to somebody who really shouldn’t have had them,” he says. “When someone applies for initial privileges at a hospital, the hospital must inquire with the data bank whether they have any history that would prevent granting them privileges. In addition, if a doctor already has privileges and wants to expand on those privileges and do something else, that also triggers the hospital to query the data bank and find out if there is anything in this person’s past that would require us to decline this expansion on privileges.”
Failure to query the NPDB when required can give a plaintiff attorney an opening to claim the hospital is responsible for a patient injury because the physician should not have been privileged.
“If a provider commits malpractice, there is a lawsuit, and the plaintiff’s attorney finds out that this doctor had a history — and also finds out that that the hospital did not query the data bank before granting privileges — there’s another pocket that can be picked for purposes of settlement,” Kutner says. “Hospitals and surgery centers are very cautious about this, putting it on autopilot to check the data bank at the appropriate times. That is good practice.”
REFERENCE
- National Practitioner Data Bank. Title IV of public law 99-660. The Health Care Quality Improvement Act of 1986, as amended 42 USC Sec. 11101 01/26/98.
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