2002 SPECIAL SESSION (18th) A AB1 1
ASSEMBLY ACTION Initial and Date |SENATE ACTION Initial and Date
Adopted Lost | Adopted Lost
Concurred In Not |Concurred In Not
Receded Not | Receded Not
Amend sec. 3, page 3, by deleting line 10, and inserting:
“treatment, care or custody, loss of earnings and loss of earning capacity.”.
Amend sec. 5, page 3, by deleting lines 14 through 43 and inserting:
“Sec. 5. 1. Except as otherwise provided in subsection 2 and except as further limited in subsection 3, in an action for damages for medical malpractice or dental malpractice, the noneconomic damages awarded to each plaintiff from each defendant must not exceed $350,000.
2. In an action for damages for medical malpractice or dental malpractice, the limitation on noneconomic damages set forth in subsection 1 does not apply in the following circumstances and types of cases:
(a) Organic brain damage;
(b) Hemiplegia, paraplegia or quadraplegia;
(c) Death of a parent, spouse or child;
(d) Total blindness;
(e) Actual physical loss of a limb, including a foot or hand;
(f) Permanent loss or damage to a reproductive organ resulting in sterility;
(g) A case in which the conduct of the defendant is determined to constitute gross malpractice; or
(h) A case in which, following return of a verdict by the jury or a finding of damages in a bench trial, the court determines, by clear and convincing evidence admitted at trial, that an award in excess of $350,000 for noneconomic damages is justified because of exceptional circumstances.
3. In an action for damages for medical malpractice or dental malpractice, in the circumstances and types of cases described in subsections 1 and 2, the noneconomic damages awarded to each plaintiff from each defendant must not exceed the amount of money remaining under the professional liability insurance policy limit covering the defendant after subtracting the economic damages awarded to that plaintiff. Irrespective of the number of plaintiffs in the action, in no event may any single defendant be liable to the plaintiffs in the aggregate in excess of the professional liability insurance policy limit covering that defendant.
4. This section is not intended to limit the responsibility of any defendant for the total economic damages awarded.
5. For the purposes of this section:”.
Amend section 9, page 4, by deleting lines 37 and 38 and inserting:
“malpractice, all of the parties to the action, the insurers of the respective parties and the attorneys of the respective parties shall attend”.
Amend sec. 14, page 9, line 18, by deleting “30” and inserting “64”.
Amend the bill as a whole by renumbering sections 18 through 26 as sections 50 through 58 and adding new sections, designated sections 18 through 49, following section 17, to read as follows:
“Sec. 18. Chapter 439 of NRS is hereby amended by adding thereto the provisions set forth as sections 19 to 43, inclusive, of this act.
Sec. 19. As used in sections 19 to 43, inclusive, of this act, unless the context otherwise requires, the words and terms defined in sections 20 to 28, inclusive, of this act have the meanings ascribed to them in those sections.
Sec. 20. “Incident” means an event, occurrence or situation involving the treatment of a patient that potentially could have injured the patient but did not actually cause the patient to suffer an unanticipated injury or require the patient to receive additional treatment.
Sec. 21. “Medical facility” means:
1. A hospital, as that term is defined in NRS 449.012;
2. An obstetric center, as that term is defined in NRS 449.0155; and
3. A surgical center for ambulatory patients, as that term is defined in NRS 449.019.
Sec. 22. “Patient” means a person who:
1. Is admitted to a medical facility for the purpose of receiving treatment; or
2. Receives treatment at a medical facility from a provider of health care.
Sec. 23. “Patient safety officer” means a person who is designated as such by a medical facility pursuant to section 39 of this act.
Sec. 24. “Provider of health care” means a person who is licensed, certified or otherwise authorized by the law of this state to administer health care in the ordinary course of the business or practice of a profession.
Sec. 25. “Repository” means the repository for health care quality assurance created pursuant to section 29 of this act.
Sec. 26. “Serious event” means an event, occurrence or situation involving the treatment of a patient that:
1. Causes the death of the patient; or
2. Compromises the safety of the patient and causes the patient to suffer an unanticipated injury which requires the patient to receive additional treatment.
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The term does not
include an incident.
Sec. 27. “Treatment” means any medication, drug, test or procedure conducted or administered to diagnose or remedy a physical or mental illness or condition.
Sec. 28. “Unanticipated injury” means an injury suffered by a patient as a result of treatment, where the injury:
1. Is not an intended or anticipated consequence of the treatment; or
2. Is of a manner, nature or type that does not occur ordinarily in the absence of a negligent or wrongful act or omission.
Sec. 29. 1. The repository for health care quality assurance is hereby created within the health division.
2. The health division shall, to the extent of legislative appropriation and authorization:
(a) Hire such staff as it determines to be necessary to carry out the provisions of sections 19 to 43, inclusive, of this act.
(b) Contract with persons and entities to carry out the provisions of section 32 of this act.
Sec. 30. 1. Except as otherwise provided in subsection 2:
(a) A person who is employed by a medical facility shall, within 6 hours after becoming aware of an incident or serious event that occurred at the medical facility, notify the patient safety officer of the facility of the incident or serious event; and
(b) The patient safety officer shall, within 18 hours after receiving notification pursuant to paragraph (a), report the incident or serious event to:
(1) The repository; and
(2) The representative designated pursuant to section 35 of this act, if that person is different from the patient safety officer.
2. If the patient safety officer of a medical facility personally discovers or becomes aware, in the absence of notification by another employee, of an incident or serious event that occurred at the medical facility, the patient safety officer shall, within 24 hours after discovering or becoming aware of the incident or serious event, report the incident or serious event to:
(a) The repository; and
(b) The representative designated pursuant to section 35 of this act, if that person is different from the patient safety officer.
3. The administrator shall prescribe the manner in which reports of incidents and serious events must be made pursuant to this section.
4. The administrator shall prescribe the form of a survey to be sent to each employee who makes a report pursuant to subsection 1. The survey must be in a form designed to obtain a confidential response from the employee as to whether:
(a) It is the opinion of the employee that the employee experienced any retaliation from a medical facility or provider of health care as a direct result of the reporting;
(b) If applicable, the employee was the subject of disciplinary action by a professional regulatory body as a direct result of the reporting or of the incident or serious event that led to the submission of the report; and
(c) To the extent of the employee’s knowledge, any remediation or other corrective action occurred in response to the reported incident or serious event to correct the situation or circumstances that caused or contributed to the incident or serious event.
5. The administrator shall cause the repository to send a copy of the survey to each such employee not earlier than 90 days nor later than 120 days after the report was submitted pursuant to subsection 1. The administrator shall direct that the responses to the survey be returned to the repository. The administrator shall take such actions as are necessary to ensure the confidentiality of these responses and to ensure that the responses are used solely to prepare aggregate data regarding the effects of the reporting required pursuant to subsection 1.
Sec. 31. The repository shall:
1. Collect and maintain reports received pursuant to subsections 1 and 2 of section 30 of this act;
2. Collect and maintain the responses received pursuant to subsection 5 of section 30 of this act; and
3. Ensure that such reports and responses and any additional documents created therefrom are protected adequately from fire, theft, loss, destruction and other hazards and from unauthorized access.
Sec. 32. The health division shall contract with one or more persons or entities, other than a provider of health care, to carry out the following functions:
1. Collection, analysis and evaluation of data regarding reports of incidents and serious events, including, without limitation, the identification of indicators of performance and patterns of frequency and severity at individual medical facilities and in individual geographic regions of this state;
2. Analysis and evaluation of data received on the responses submitted pursuant to subsection 5 of section 30 of this act;
3. Preparation and transmission to the repository of written recommendations for changes in health care practices and procedures to be instituted at individual medical facilities or on a statewide basis to reduce the number and severity of incidents and serious events in this state; and
4. Provision of any additional services that the administrator determines to be necessary or advisable.
Sec. 33. 1. Within 30 days after receiving a recommendation for a change in a health care practice or procedure transmitted pursuant to subsection 3 of section 32 of this act, the repository shall:
(a) Conduct an evaluation of the recommendation using the factors set forth in subsection 3; and
(b) Submit to the administrator the recommendation and its evaluation of the recommendation.
2. Within 30 days after receiving a recommendation and evaluation from the repository pursuant to subsection 1, the administrator shall approve or disapprove the recommendation using the factors set forth in subsection 3. If the administrator:
(a) Approves a recommendation, the administrator shall, within 30 days after the date of approval, notify the repository in writing that the recommendation has been approved.
(b) Disapproves a recommendation, the administrator shall, within 30 days after the date of disapproval, set forth in writing and transmit to the repository the reason for the disapproval.
3. When the repository evaluates a recommendation pursuant to subsection 1 and the administrator determines whether to approve or disapprove a recommendation pursuant to subsection 2, the following factors, without limitation, must be considered:
(a) Whether the recommendation may reasonably be expected to improve the quality of treatment administered to patients in this state;
(b) The feasibility of carrying out the recommendation;
(c) The cost of carrying out the recommendation, evaluated with respect to the probable financial burden that the recommendation will cause to be incurred by patients, insurers and medical facilities; and
(d) Any other factor that the repository or the administrator, as applicable, determines to be relevant.
Sec. 34. 1. Within 30 days after receiving notification from the administrator that a recommendation has been approved, the repository shall:
(a) If the recommendation pertains to a change in a health care practice or procedure at one or more individual medical facilities, cause a copy of the recommendation to be sent to those medical facilities.
(b) If the recommendation pertains to a change in a health care practice or procedure at medical facilities within a particular geographic area of this state, cause a copy of the recommendation to be sent to each medical facility located within that geographic area.
(c) If the recommendation pertains to a change in a health care practice or procedure at medical facilities on a statewide basis, cause a copy of the recommendation to be sent to all medical facilities.
2. All copies of recommendations required to be sent to medical facilities pursuant to this section must be sent in a manner pursuant to which receipt of the recommendations may be verified.
Sec. 35. 1. Each medical facility that is located within this state shall designate a representative for the notification of patients who have been involved in serious events at that medical facility.
2. A representative designated pursuant to subsection 1 shall, not later than 7 days after discovering or becoming aware of a serious event that occurred at the medical facility, provide notice of that fact to each patient who was involved in that serious event.
3. The provision of notice to a patient pursuant to subsection 2 must not, in any action or proceeding, be considered an acknowledgment or admission of liability.
4. A representative designated pursuant to subsection 1 may or may not be the same person who serves as the facility’s patient safety officer.
5. The administrator shall prescribe the manner in which patients must be notified pursuant to this section.
Sec. 36. 1. The repository shall compile the aggregate information pertaining to serious events contained in the reports that it receives pursuant to section 30 of this act and organize that information in several different manners that will be usable by any person or entity that may require that information, including, without limitation, by:
(a) Aggregating the information on a regional and a statewide basis;
(b) Organizing the information by applicability to a particular type of serious event; and
(c) Aggregating or organizing the information in any combination of possibilities described in this subsection.
2. The repository shall compile the aggregate information pertaining to the responses to the survey received pursuant to subsection 5 of section 30 of this act.
3. Any interested person or entity may request a copy of a report or information described in this section. The repository shall:
(a) Make such reports and information available at its place of business in accordance with chapter 239 of NRS; and
(b) Ensure that any report or information described in this section is made available only in an aggregated format and does not reveal the identity of a specific person or medical facility.
Sec. 37. Any report, document, recommendation and any other information compiled or disseminated pursuant to the provisions of sections 19 to 43, inclusive, of this act is not admissible in evidence in any administrative or legal proceeding conducted in this state.
Sec. 38. 1. Each medical facility that is located within this state shall develop, in consultation with the providers of health care who provide treatment to patients at the medical facility, an internal patient safety plan to improve the health and safety of patients who are treated at that medical facility. The plan must be approved by the repository.
2. The administrator shall, by regulation, prescribe the contents of a patient safety plan.
3. A medical facility shall submit its patient safety plan to the repository for approval in accordance with the requirements of this section. If the repository does not approve or disapprove the plan within 90 days after receiving the plan from the medical facility, the plan shall be deemed approved.
4. After a medical facility’s patient safety plan is approved, the medical facility shall notify all providers of health care who provide treatment to patients at the medical facility of the existence of the plan and of the requirements of the plan. A medical facility shall require that compliance with its patient safety plan is a condition of employment for all providers of health care who provide treatment to patients at that medical facility.
Sec. 39. 1. A medical facility shall designate an officer or employee of the facility to serve as the patient safety officer of the medical facility.
2. The person who is designated as the patient safety officer of a medical facility shall:
(a) Serve on the patient safety committee.
(b) Investigate and supervise the reporting of all incidents and serious events alleged to have occurred at the medical facility, including, without limitation, performing the duties required pursuant to section 30 of this act.
(c) Take such action as he determines to be necessary to ensure the safety of patients as a result of the investigation of any incident or serious event alleged to have occurred at the medical facility.
(d) Report to the patient safety committee regarding any action taken in accordance with paragraph (c).
Sec. 40. 1. A medical facility shall establish a patient safety committee.
2. Except as otherwise provided in subsection 3:
(a) A patient safety committee established pursuant to subsection 1 must be composed of:
(1) The patient safety officer of the medical facility.
(2) At least three providers of health care who provide treatment to patients at the medical facility.
(3) Two members of the public who reside in the community served by the medical facility. The members described in this subparagraph must not be agents, employees or contractors of the medical facility.
(b) A patient safety committee:
(1) Must not include more than one member of the executive or governing body of the medical facility.
(2) Must include members of the medical, nursing and pharmaceutical staff of the medical facility.
(c) A patient safety committee shall meet at least once each month.
3. The administrator shall adopt regulations prescribing the composition and frequency of meeting of patient safety committees at medical facilities having fewer than 25 employees and contractors.
4. A patient safety committee shall:
(a) Receive reports from the patient safety officer pursuant to section 39 of this act.
(b) Evaluate investigations and actions of the patient safety officer in connection with all reports of incidents and serious events alleged to have occurred at the medical facility.
(c) Review and evaluate the quality of measures carried out by the medical facility to improve the safety of patients who receive treatment at the medical facility. The review and evaluation described in this paragraph must include, without limitation, review and evaluation of any recommendations received pursuant to section 34 of this act
(d) Make recommendations to the executive or governing body of the medical facility to reduce the number and severity of incidents and serious events that occur at the medical facility.
(e) At least once each calendar quarter, report to the executive or governing body of the medical facility regarding:
(1) The number of incidents and serious events that occurred at the medical facility during the preceding calendar quarter; and
(2) Any recommendations to reduce the number and severity of incidents and serious events that occur at the medical facility.
Sec. 41. No person is subject to any criminal penalty or civil liability for libel, slander or any similar cause of action in tort if he, without malice:
1. Reports an incident or serious event;
2. Notifies another person of an incident or serious event;
3. Transmits information regarding an incident or serious event;
4. Compiles, prepares or disseminates information regarding an incident or serious event; or
5. Performs any other act authorized pursuant to sections 19 to 43, inclusive, of this act.
Sec. 42. 1. The administrator may impose a fine of not more than $1,000 against:
(a) Any medical facility that violates any of the provisions of sections 19 to 43, inclusive, of this act.
(b) An employee or officer of a medical facility who violates any of the provisions of sections 19 to 43, inclusive, of this act.
2. The administrator shall, before imposing the fine, notify the medical facility by certified mail that he will impose a fine for the violation unless the medical facility requests a hearing within 20 days after the notice is mailed.
3. If a hearing is requested, the administrator shall hold a hearing pursuant to the provisions of NRS 233B.121 to 233B.150, inclusive.
4. If a hearing is not requested within the prescribed period and the matter is not otherwise resolved, the administrator shall impose the fine and notify the medical facility by certified mail.
5. The decision of the administrator to impose a fine pursuant to this section is a final decision for the purposes of judicial review.
Sec. 43. The administrator shall adopt such regulations as the administrator determines to be necessary or advisable to carry out the provisions of sections 19 to 43, inclusive, of this act.
Sec. 44. Chapter 449 of NRS is hereby amended by adding thereto the provisions set forth as sections 45 and 46 of this act.
Sec. 45. 1. A medical facility or any agent or employee thereof shall not retaliate or discriminate in any manner against an employee of the medical facility or a person acting on behalf of the employee who in good faith:
(a) Reports to the board of medical examiners or the state board of osteopathic medicine, as applicable, information relating to the conduct of a physician which may constitute grounds for initiating disciplinary action against the physician or which otherwise raises a reasonable question regarding the competence of the physician to practice medicine with reasonable skill and safety to patients;
(b) Reports an incident or serious event to the repository for health care quality assurance created pursuant to section 29 of this act; or
(c) Cooperates or otherwise participates in an investigation or proceeding conducted by the board of medical examiners, the state board of osteopathic medicine or another governmental entity relating to conduct described in paragraph (a) or (b).
2. A medical facility or any agent or employee thereof shall not retaliate or discriminate in any manner against an employee of the medical facility because the employee has attempted to or intends to take an action described in subsection 1.
3. A medical facility or any agent or employee thereof shall not prohibit, restrict or attempt to prohibit or restrict by contract, policy, procedure or any other manner the right of an employee of the medical facility to take an action described in subsection 1.
4. As used in this section:
(a) “Physician” means a person licensed to practice medicine pursuant to chapter 630 or 633 of NRS.
(b) “Retaliate or discriminate” includes, without limitation:
(1) Frequent or undesirable changes in the location where the employee works;
(2) Frequent or undesirable transfers or reassignments;
(3) The issuance of letters of reprimand, letters of admonition or evaluations of poor performance;
(4) A demotion;
(5) A reduction in pay;
(6) The denial of a promotion;
(7) A suspension;
(8) A dismissal;
(9) A transfer; or
(10) Frequent changes in working hours or workdays,
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if such action is
taken, in whole or in part, because the employee took, attempted to take or
intended to take an action described in subsection 1.
Sec. 46. 1. An employee of a medical facility who believes that he has been retaliated or discriminated against in violation of section 45 of this act may file an action in a court of competent jurisdiction.
2. If a court determines that a violation of section 45 of this act has occurred, the court shall award such damages as it determines to have resulted from the violation, including, without limitation:
(a) Compensatory damages;
(b) Reinstatement;
(c) Reimbursement of any wages, salary, employment benefits or other compensation denied to or lost by the employee as a result of the violation;
(d) Attorney’s fees and costs, including, without limitation, fees for expert witnesses; and
(e) Punitive damages, if the facts warrant the imposition of such damages.
3. In addition to any damages awarded pursuant to subsection 2, the court shall award interest on those damages at the prevailing rate.
4. The court may grant any equitable relief it considers appropriate, including, without limitation, issuing temporary, preliminary or permanent injunctive relief.
5. An action must be brought pursuant to this section within 2 years after the date of the last event constituting the alleged violation for which the action is brought.
6. A medical facility or any agent or employee thereof that violates the provisions of section 45 of this act is subject to a civil penalty of not more than $10,000 for each violation.
Sec. 47. Chapter 630 of NRS is hereby amended by adding thereto the provisions set forth as sections 48, 49 and 50 of this act.
Sec. 48. 1. A physician or any agent or employee thereof shall not retaliate or discriminate in any manner against an employee of the physician or a person acting on behalf of the employee who in good faith:
(a) Reports to the board information relating to the conduct of the physician which may constitute grounds for initiating disciplinary action against the physician or which otherwise raises a reasonable question regarding the competence of the physician to practice medicine with reasonable skill and safety to patients;
(b) Reports an incident or serious event to the repository for health care quality assurance created pursuant to section 29 of this act; or
(c) Cooperates or otherwise participates in an investigation or proceeding conducted by the board or another governmental entity relating to conduct described in paragraph (a) or (b).
2. A physician or any agent or employee thereof shall not retaliate or discriminate in any manner against an employee of the physician because the employee has attempted to or intends to take an action described in subsection 1.
3. A physician or any agent or employee thereof shall not prohibit, restrict or attempt to prohibit or restrict by contract, policy, procedure or any other manner the right of an employee of the physician to take an action described in subsection 1.
4. As used in this section, “retaliate or discriminate” includes, without limitation:
(a) Frequent or undesirable changes in the location where the employee works;
(b) Frequent or undesirable transfers or reassignments;
(c) The issuance of letters of reprimand, letters of admonition or evaluations of poor performance;
(d) A demotion;
(e) A reduction in pay;
(f) The denial of a promotion;
(g) A suspension;
(h) A dismissal;
(i) A transfer; or
(j) Frequent changes in working hours or workdays,
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if such action is
taken, in whole or in part, because the employee took, attempted to take or
intended to take an action described in subsection 1.
Sec. 49. 1. An employee of a physician who believes that he has been retaliated or discriminated against in violation of section 48 of this act may file an action in a court of competent jurisdiction.
2. If a court determines that a violation of section 48 of this act has occurred, the court shall award such damages as it determines to have resulted from the violation, including, without limitation:
(a) Compensatory damages;
(b) Reinstatement;
(c) Reimbursement of any wages, salary, employment benefits or other compensation denied to or lost by the employee as a result of the violation;
(d) Attorney’s fees and costs, including, without limitation, fees for expert witnesses; and
(e) Punitive damages, if the facts warrant the imposition of such damages.
3. In addition to any damages awarded pursuant to subsection 2, the court shall award interest on the amount of damages at the prevailing rate.
4. The court may grant any equitable relief it considers appropriate, including, without limitation, issuing temporary, preliminary or permanent injunctive relief.
5. An action must be brought pursuant to this section within 2 years after the date of the last event constituting the alleged violation for which the action is brought.
6. A physician who violates the provisions of section 48 of this act is subject to a civil penalty of not more than $10,000 for each violation.”.
Amend sec. 18, page 10, by deleting lines 20 through 26, and inserting:
“Sec. 50. A physician licensed pursuant to this chapter shall not practice medicine in this state unless he maintains professional liability insurance in an amount of:
1. Not less than $1,000,000 per occurrence; and
2. Not less than $3,000,000 in the aggregate.”.
Amend sec. 25, page 13, line 40, by deleting “person;” and inserting “occurrence;”.
Amend sec. 25, page 13, line 41, by deleting “per occurrence.” and inserting:
“in the aggregate.”.
Amend sec. 26, page 13, line 43, by deleting:
“27 to 30,” and inserting:
“59 to 64,”.
Amend the bill as a whole by renumbering sections 27 through 39 as sections 61 through 73 and adding new sections designated sections 59 and 60, following sec. 26, to read as follows:
“Sec. 59. 1. An osteopathic physician or any agent or employee thereof shall not retaliate or discriminate in any manner against an employee of the osteopathic physician or a person acting on behalf of the employee who in good faith:
(a) Reports to the board information relating to the conduct of the osteopathic physician which may constitute grounds for initiating disciplinary action against the osteopathic physician or which otherwise raises a reasonable question regarding the competence of the osteopathic physician to practice medicine with reasonable skill and safety to patients;
(b) Reports an incident or serious event to the repository for health care quality assurance created pursuant to section 29 of this act; or
(c) Cooperates or otherwise participates in an investigation or proceeding conducted by the board or another governmental entity relating to conduct described in paragraph (a) or (b).
2. An osteopathic physician or any agent or employee thereof shall not retaliate or discriminate in any manner against an employee of the osteopathic physician because the employee has attempted to or intends to take an action described in subsection 1.
3. An osteopathic physician or any agent or employee thereof shall not prohibit, restrict or attempt to prohibit or restrict by contract, policy, procedure or any other manner the right of an employee of the osteopathic physician to take an action described in subsection 1.
4. As used in this section, “retaliate or discriminate” includes, without limitation:
(a) Frequent or undesirable changes in the location where the employee works;
(b) Frequent or undesirable transfers or reassignments;
(c) The issuance of letters of reprimand, letters of admonition or evaluations of poor performance;
(d) A demotion;
(e) A reduction in pay;
(f) The denial of a promotion;
(g) A suspension;
(h) A dismissal;
(i) A transfer; or
(j) Frequent changes in working hours or workdays,
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if such action is
taken, in whole or in part, because the employee took, attempted to take or
intended to take an action described in subsection 1.
Sec. 60. 1. An employee of an osteopathic physician who believes that he has been retaliated or discriminated against in violation of section 59 of this act may file an action in a court of competent jurisdiction.
2. If a court determines that a violation of section 59 of this act has occurred, the court shall award such damages as it determines to have resulted from the violation, including, without limitation:
(a) Compensatory damages;
(b) Reinstatement;
(c) Reimbursement of any wages, salary, employment benefits or other compensation denied to or lost by the employee as a result of the violation;
(d) Attorney’s fees and costs, including, without limitation, fees for expert witnesses; and
(e) Punitive damages, if the facts warrant the imposition of such damages.
3. In addition to any damages awarded pursuant to subsection 2, the court shall award interest on the amount of damages at the prevailing rate.
4. The court may grant any equitable relief it considers appropriate, including, without limitation, issuing temporary, preliminary or permanent injunctive relief.
5. An action must be brought pursuant to this section within 2 years after the date of the last event constituting the alleged violation for which the action is brought.
6. An osteopathic physician who violates the provisions of section 59 of this act is subject to a civil penalty of not more than $10,000 for each violation.”.
Amend sec. 27, page 13, line 47, by deleting “person;” and inserting “occurrence;”.
Amend sec. 27, page 13, line 48, by deleting “per occurrence.” and inserting:
“in the aggregate.”.
Amend sec. 28, page 14, line 9, by deleting “29” and inserting “63”.
Amend sec. 28, page 14, line 10, by deleting “30” and inserting “64”.
Amend sec. 32, page 16, line 14, by deleting “29” and inserting “63”.
Amend sec. 33, page 16, line 17, by deleting “29” and inserting “63”.
Amend the bill as a whole by renumbering sec. 40 as sec. 75 and adding a new section designated sec. 74, following sec. 39, to read as follows:
“Sec. 74. 1. With respect to the duty set forth in subsection 3 of section 38 of this act, a medical facility shall submit its patient safety plan to the repository:
(a) Not later than August 31, 2003, if the medical facility was licensed pursuant to chapter 449 of NRS on or before July 1, 2003.
(b) Within 60 days after the date of licensure, if the medical facility was licensed pursuant to chapter 449 of NRS after July 1, 2003.
2. As used in this section:
(a) “Medical facility” has the meaning ascribed to it in section 21 of this act.
(b) “Repository” has the meaning ascribed to it in section 25 of this act.”.
Amend sec. 40, page 18, line 7, to read as follows:
“Sec. 75. 1. This section and sections 1 to 17, inclusive, 50 to 58, inclusive, and 61 to 73, inclusive, of this act become effective on October 1, 2002.
2. Sections 18 to 49, inclusive, and sections 59, 60 and 74 of this act become effective July 1, 2003.”.
Amend the preamble of the bill, page 1, by deleting line 7 and inserting:
“of Nevada; and
Whereas, Medical errors cause preventable injuries to be suffered by as many as one out of every 25 hospital patients in the United States; and
Whereas, Errors in the provision of health care have been estimated to cost more than $2,000,000 per year in a large teaching hospital, and preventable injuries related to the provision of health care cost the economy of the United States from $17,000,000,000 to $29,000,000,000 each year; and
Whereas, A report promulgated by the Institute of Medicine estimates that at least 44,000 persons and as many as 98,000 persons die each year as a result of medical errors, which is higher than the annual mortality rate attributable to motor vehicle accidents, breast cancer or acquired immune deficiency syndrome, thus making medical error the eighth leading cause of death in the United States; now, therefore,”.