By Keith L. Alexander
Washington Post Staff Writer
Wednesday, March 14, 2007
Infant mortality rates in the District have been adjusted upward after the discovery that some hospitals failed to document newborn deaths for several consecutive years.
The addition of 13 such deaths in the period from 2001 to 2004 did not dramatically alter the rates; city officials said the increases were "not significant."
For 2004, three deaths were added, and the infant mortality rate rose from 11.8 deaths per 1,000 live births to 12.2. For 2003, heralded for having the fewest infant deaths in city history, five more deaths were counted, and the rate was revised from 10.2 to 10.9.
The District's infant mortality rate is one of the worst among large American cities. But it has significantly improved since peaking in 1989 at 23.1. The national average is 6.6.
The recalculated rate results from the disclosure that some hospitals had maintained fetal and newborn remains in their morgues beyond the 30-day limit set by city law.
The city fined Howard University Hospital $7,000 for having 25 sets of fetal and newborn remains in its morgue dating to 2003. In January, health officials fined Washington Hospital Center $8,000 for keeping the remains of 95 newborns and fetuses too long; some had been held since 2001.
Washington Hospital has blamed the problems on a new policy giving grieving parents more time to decide funeral arrangements and the departure of two key employees. Howard officials have declined to say publicly why they had so many sets of remains and asked the Department of Health for more time to respond.
Separately, according to information obtained through the Freedom of Information Act, city health investigators earlier this year found five adult bodies stored in Howard's morgue from 60 to 103 days; the 30-day limit on keeping remains also applies to adults. According to their report, Howard officials had no policy about unclaimed bodies and "failed to identify that there were unclaimed decedents in the morgue."
In an e-mail, Howard spokeswoman J.J. Pryor said the hospital has since established a "multidisciplinary team" to make changes.
"The hospital will exercise on-going oversight and monitoring to prevent future deficiencies," Pryor wrote, adding that the hospital was "committed to making all efforts to ensure that they are consistently dealt with in the proper manner."
In January, District health officials began a citywide canvass after Washington Hospital administrators notified them that they had only recently discovered the 95 sets of remains, which were stored in a box in the hospital morgue.
In addition, $2,000 fines were levied against Greater Southeast Community Hospital, which had the remains of one infant from June, and Children's Hospital, which had two.
The Health Department has decided to reduce the time hospitals, nursing homes and funeral homes have to report all deaths for city records from five days to 24 hours.
The city has received a $490,000 grant from the Social Security Administration to develop a Web-based electronic death reporting system.
The 2005 figures will not be released until late spring.
"The goal here is to increase our oversight, which we take very seriously," said Health Department Director Gregg A. Pane. "We have put these institutions on notice."
Mortality rates help determine the health of the population, with comparisons made among cities, states and nations.
Baltimore and Detroit are among the large U.S. cities with infant mortality rates markedly higher than the District's. In 2003, Baltimore's rate was 13.2, and Detroit had a rate of 16.3. Other cities do much better. In 2005, for example, New York's rate was 6.0.
The Department of Health and the National Institutes of Health have begun an initiative to improve the District's rate, particularly in Wards 5, 7 and 8, which have had the highest rates in recent years.