Boxes of medical records.
Photo: Screen capture from Report
After an audit of the Medical Licensing and Discipline Board, attached to the Department of Health (DS), the Office of the Comptroller in Puerto Rico found that there were hundreds of medical malpractice cases unresolved for years and that, in addition, the way the physicians' records were kept was not adequate.
The situation that seems to have led the Board to fail in its duty is common and happens in other agencies: lack of adequate resources and of leaders who delve into the situation to seek solutions.
According to the audit report prepared by the Office of the Comptroller, the findings regarding the medical malpractice cases were two:
– As of August 30, 2021, according to the legal secretary -who was not identified-, there were 160 unprofessional conduct cases pending resolution. The oldest case was from 2001, so between 1 and 20 years had elapsed without their being resolved.
– As of the same date, but according to the administrator of System III -who was also not identified-, there were 408 unresolved medical malpractice cases. The oldest case was from 2003, so between 1 and 18 years had elapsed without their being resolved.
What caused this situation?
The staff “is not sufficient. The Board's legal division had the services of only one attorney to work on the unprofessional conduct cases. In October 2020 the investigating officer assigned to the Board submitted his letter of resignation. Then, the process to find a replacement began. However, once the Board had chosen a candidate, the Department of Health, then headed by Lorenzo González, reported that the contract did not proceed.
“The Office of the Secretary of Health ordered the cancellation of the contract,” reads the report, which elaborates that as a replacement, they assigned an attorney from the Department of Justice “part-time” to handle these malpractice cases.
Added to that, the Board also had only one attorney assigned to unprofessional conduct cases.
See also: Office of the Comptroller reveals that there are 408 unresolved medical malpractice cases
The Board claims that it communicated with the then secretary of Justice since 2019, but that she indicated that the cuts in the agency made it difficult to send more resources. Although not identified in the report, Wanda Vázquez Garced served as secretary of Justice during much of the time that the Board claims to have asked Justice for help. Vázquez Garced was secretary of Justice until August 7, 2019, when she was sworn in as governor of Puerto Rico following the resignation of Ricardo A. Rosselló Nevares.
Vázquez Garced was succeeded by Dennise N. Longo Quiñones, who was also in power during the period in which the Board requested additional resources.
Former secretary González has not responded to a communication issued by the Office of the Comptroller about these situations, some of which occurred during his tenure, according to the report.
Following a request from this digital newspaper, the Department of Justice confirmed that on September 10 the agency approved an administrative assignment of an attorney to provide full-time services at the Medical Licensing and Discipline Board.
The approval occurred following a request made by the current secretary of Health, Carlos Mellado López.
Medical records:
The Board must maintain an archive of physicians' records in Puerto Rico, which must be divided among general records, permanent licenses, telemedicine, among others. However, a visit by the Office of the Comptroller to the archive concluded that “the Board does not have an inventory or a retention plan for the medical records.”
“It was observed that… the facilities did not have sufficient shelving for filing the physicians' records. These were placed in boxes on the floor, one on top of another, which makes it difficult to identify documents,” the report also says.
Act 38 of 2017 establishes that every case subject to an administrative process must be resolved within six months from its filing, except in exceptional circumstances.
In addition, the law establishes that the Board, as soon as it receives information about actions that constitute professional malpractice, whether or not a case is finally adjudicated, must initiate an investigation and render a report within the first 90 days thereafter. In that report it must recommend whether the imposition of disciplinary sanctions on the physician is warranted.
The Office of the Comptroller recommended that the Board ensure that the law is complied with and that an inventory and retention plan for the physicians' records be prepared.
To view the report click here.
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