Incident Reporting Guide

Who Must Report
What Must Be Reported
When and How to Report
Why It Is Important to Report

Who Must Report

As an employee or agent of a participating entity, you have an individual responsibility to report to your Self-Insurance Program any occurrence that you reasonably believe may have caused or resulted in an injury to a patient.

NOTE: You may also have other additional reporting responsibilities and should be familiar with the policy for reporting events and near misses at the facilities where you practice.

What Must Be Reported

In ADDITION to any facility and/or university-related reporting requirements, the following are TYPES OF INCIDENTS THAT YOU SHOULD REPORT TO YOUR SIP.

Any event that results in an unexpected patient or fetal death
Any event that results in brain or spinal damage, or the loss of a limb or use of a limb
Any event that results in a procedure on the wrong site or the wrong patient, or a wrong procedure
Any event that results in a disability or impairment of any organ (including reproductive and sensory)
Any procedure resulting in a retained foreign body
Misdiagnosis of a patient’s condition resulting in mortality or increased morbidity
Medication errors leading to injury, death, or transfer to a higher level of care
Any assertion by a patient of sexual assault/abuse or sexual misconduct
Any assertion by a patient that no consent for treatment was given
Any assertion by a patient or patient’s family that he/she has been medically injured or is seeking attorney representation related to care
Any injury to a part of the body not undergoing treatment
Any other unexpected adverse condition or outcome that could result in a claim

Occurrence

An Occurrence is:

any event that has produced an actual, potential, or perceived injury.
a practice, situation, premises, or product defect that may produce an injury if left uncorrected.
any other unexpected or untoward outcome or event where established policy or procedure was not followed.
any other conditions you feel may give rise to a claim.

Allegation

Allegations are written or verbal statements alleging negligence and asserted claims. These include any assertion by a patient or patient’s family:

that an injury has occurred.
that proper consent was not given for treatment.
that there has been sexual misconduct.

These also include any legal or regulatory agency communications, including:

Notices of Intent to Initiate Litigation for Medical Negligence.
Summons and Complaints.
Letters or phone calls from the Agency for Health Care Administration (AHCA) or the Department of Health (DOH).
Letters or phone calls from an attorney.

When and How to Report

Immediately upon the occurrence of a potentially reportable event (as soon as the patient’s needs are addressed), notify your Self-Insurance Program by calling:

1-352-273-7006
1-904-244-9070
1-844-MY FL SIP (1-844-693-5747)

When you receive licensure investigation letters from the DOH or licensing board
When you receive Notices of Intent to Initiate Litigation for Medical Negligence (NOI)
When you need assistance with deposition/subpoena requests
When you are in need of medical malpractice defense education
When you are in need of continuing education
When you need insurance coverage certifications

PLEASE DO NOT USE E-MAIL TO MAKE REPORTS!!

Information we will need to know:

Name, sex, and age of patient
Medical record number
Date of admission and admission diagnosis
Date, time, and location (e.g., inpatient facility, outpatient clinic) of the occurrence
Brief description of the occurrence with the names of the involved individuals and witnesses
Description of the injury, the treatment provided, and the name(s) of the physician(s) notified

NOTE: Residents must also notify their Attending and department residency program director. Students/Other Staff members must notify their supervisors.

Why It Is Important To Report

Patient Safety and Loss Prevention

Timely reporting allows for the identification of patient safety initiatives and provides insight into opportunities to improve the provision of healthcare.

Claim Management

Prompt reporting permits timely investigation of unexpected clinical occurrences and/or allegations, enabling SIP to meet the immediate needs of patients with meritorious claims and aggressively and effectively defend those claims that lack merit.