Legislators are considering passing a law requiring New Hampshire's 26 hospitals to publicly report their "never events" to the state.

According to the National Quality Forum, never events are "errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients, and that indicate a real problem in the safety and credibility of a health-care facility."

Rep. Peter Batula, R-Merrimack, spearheaded the law requiring hospitals to publicly report hospital-acquired infections, which is expected to be fully implemented next year. Batula said he plans to propose legislation regarding hospital never events in the next session.

"I have been in some heavy discussions on medical errors. It hasn't been on the front page, but it is one of my priorities," Batula said.

Lori Nerbonne, a co-founder of NH Patient Voices, a new group advocating health-care reform in New Hampshire, said never events should be reported because "it's the right thing to do morally and ethically. It is a basic patient right to have this information disclosed to the patient/family."

She described public reporting as "a checks and balance system like any other audit."

"Tracking harmful and deadly errors at the state level and through public reporting gets it out of the closet so it can be adequately dealt with as a patient safety issue," Nerbonne said. "We pay for this care, and as consumers, have a basic right to know if we or our family has been harmed or died as a result of it."

The Institute of Medicine estimates hospital deaths from never events at 44,000 to 98,000 people a year nationally, but no one keeps track of the deaths in New Hampshire.

"Even using the lower estimate, preventable medical errors in hospitals exceed attributable deaths to such feared threats as motor-vehicle wrecks, breast cancer, and AIDS," according to the institute's landmark 1999 study, "To Err is Human."

"Among the problems that commonly occur during the course of providing health care are adverse drug events and improper transfusions, surgical injuries and wrong-site surgery, suicides, restraint-related injuries or death, falls, burns, pressure ulcers, and mistaken patient identities," the report said.

Twenty-six states plus the District of Columbia have reportable medical error systems in place, according to the National Academy of State Health Policies.

New Hampshire is the only New England state without such a system.

Many states use some version of the National Quality Forum's list of 28 preventable never events.

"What we need to do in the future is to sit down and work this out with hospitals and the (New Hampshire Hospital Association)," said Batula. "I don't want to fight them. I want us to come to an understanding about letting the public know what is going on with never events."

First, Batula wants to form an oversight committee on infections and injuries that occur in hospitals.

"That's in the future. It's a subject I think the public is going to be interested in and eventually demand," Batula said. "This whole thing needs a good review."

He said he would also like to meet with the New Hampshire Medical Society, an idea welcomed by Palmer Jones, the society's executive vice president.

"I'm sure we would sit down and work with him on it," Jones said.

The New Hampshire Union Leader published an Associated Press story Saturday about the Rhode Island Health Department finding that a surgical team operated on the wrong knee of a patient at The Miriam Hospital last month. After discovering the error, the surgeon operated on the correct knee.

That mistake would not have been be reported to the state if it had occurred in New Hampshire because hospitals are not required to do so; the error would have not become public information.

Hospitals in New Hampshire may voluntarily report serious medical errors to patients and their families, but are not legally required to do so.

Michael Quinlan, a Bedford respiratory therapist and former member of the board of Catholic Medical Center in Manchester, helped push lawmakers to follow through on the hospital-acquired infection reporting legislation and plans to do the same for never events.

"The public is blissfully unaware of the pitfalls of health care until ... something happens," Quinlan said.

Quinlan, who helped form the advocacy group NH Patient Voices, said patients and families see the good will and the caring that comes with health care and generally don't believe a hospital would try to hide a mistake -- "until that happens to you."

Rep. David Hess, the acting Republican leader who pushed the state to move on the hospital infection law, said it's time to take a look at public reporting for never events.

"We need to look at what other states have done and work off their experience," Hess said.

Andrea Alley, communications director for New Hampshire Hospital Association, said her association supports transparency.

As for publicly reporting never events, Alley said, "If we were asked to do that, our hospitals would comply."