4% Got Disabling Injury in N.Y. Hospitals, Study Finds : Health: The results indicate that such cases are under-reported. Harvard researchers say one-fourth of the incidents were caused by negligence.

A major Harvard University study of medical malpractice has found that almost 4% of patients sustained an injury resulting in disability while hospitalized in New York state, and more than one-quarter of the injuries were caused by negligence.

The study, made public Wednesday, analyzed what happened to 30,121 patients admitted to 51 hospitals during 1984. It suggested that--among the 2.7 million patients actually hospitalized in New York that year--thousands of deaths were caused by in-hospital injuries.

It found that the risk of suffering an injury in a hospital increased with a patient’s age, that negligence was 50% higher in government hospitals and that, although nearly half of all injuries occur in operating rooms, malpractice during surgery is less than in other areas of hospitals.

The results of the project also indicated that hospital administrators continue to under-report incidents, including life-threatening events, to state authorities.

“I think there is significant under-reporting today,” New York state’s health commissioner, Dr. David Axelrod, told a tumultuous news conference in Manhattan during which he was frequently interrupted by patients who asserted that they had suffered malpractice while being treated by physicians.

” . . . I do not believe there is a code of silence. I believe there is concern with the way the current malpractice system functions.”

Drug complications were the most common type of injury, accounting for 19% of the problems reported in the study. Antibiotics and anti-tumor drugs were the most likely to cause difficulties for patients, including allergic reactions, kidney damage, diarrhea, depletion of white blood cells or infection.

The team of Harvard physicians, lawyers, administrators, nurses and statisticians who conducted the four-year-long, $3.1-million study said the results had implications for patients and health care providers in other states.

“This will have important implications for society as a whole,” said Dr. Howard H. Hiatt, professor of medicine at Harvard and former dean of the university’s School of Public Health who participated in the study along with investigators from the Maxwell School of Syracuse University. “We can’t undo what happened in 1984. Our goal is prevention.”

The study was commissioned by the state’s Department of Health as an offshoot of major reform in 1986 of the state’s malpractice insurance act.

The study found that 3.7% of patients who were hospitalized in 1984 received an injury in the hospital resulting in a measurable disability. Statisticians said this translated into 99,000 injuries among the 2.7 million patients who entered hospitals.

Among those who were disabled, 28% of the injuries were caused by negligence, for a total of 27,000 patients, the study concluded. Most injuries were relatively minor--57% of patients recovered completely within a month, and a total of 70% recovered within six months.

However, the study estimated that 14% of the medical injuries were fatal, and almost half of the fatalities were caused by negligence. The researchers said this percentage suggested that there were 13,451 deaths and 2,550 cases of permanent total disability resulting from medical injury in New York hospitals during the study year. They estimated that 6,985 deaths were caused by negligence.

Age clearly was a risk factor. Patients over 65 years old, who often suffer complex medical problems, were judged to have twice the chance of being injured as patients 16 to 44.