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– MAINE –
Public and Private Policy
Medical Errors and Patient Safety

Definitions

For Maine's Sentinel Event Reporting program, the definition of ‘Sentinel Event’ is provided in Title 22, Chapter 1684, §8752(4) of Maine's Statutes. The definition is also available in multiple areas of the Code of Maine Rules (CMR) for the Department of Human Services (DHHS) in Chapters 112, 125, and 126. For Acute Care and Critical Access hospitals, the CMR is provided under the title of Chapter VI, §T – Mandatory Reporting of Sentinel Events (DHHS CMR Ch. 112-VI-T) .

While Maine does not provide a definition of ‘sentinel event’ according to JCAHO's definition, Maine adopted JCAHO's ‘Definition of Occurrences that are Subject to Review’ as the ‘Reportable Sentinel Events’ for the State's reporting program. As such, Maine is the only state that has restricted the reportable events to the occurrences defined by the core of JCAHO's 2003 reporting standards. The 10 definitions for sentinel event include:

Definition Text of Definition
0. Sentinel Event Defined by Statute 22 MRSA §8752.4, all events listed #1 through #10 below are defined as ‘sentinel events.’
1. Unnatural Death A.  One of the following that is determined to be unrelated to the natural course of the patient's illness or underlying condition or proper treatment of that illness or underlying condition . . .:
  • (1)  An unanticipated death;
  • - -
2. Major Permanent loss of function A.  One of the following that is determined to be unrelated to the natural course of the patient's illness or underlying condition or proper treatment of that illness or underlying condition . . . :
  • - -
  • (2)  A major permanent loss of function that is not present when the patient is admitted to the health care facility;
3. Elopement A.  One of the following . . . that results from the elopement of a hospitalized inpatient who lacks the capacity, as defined in Title 18-A, section 5-801, subsection (c), to make decisions:
  • (1)  An unanticipated death; or
  • (2)  A major permanent loss of function that is not present when the patient is admitted to the health care facility;
4. Wrong Patient B.  Surgery on the wrong patient . . .
5. Wrong Body Part B.  Surgery on the . . . wrong body part
6. Transfusion Reaction C.  Hemolytic transfusion reaction involving administration of blood or blood products having major blood group incompatibilities
7. Suicide D.  Suicide of a patient in a health care facility where the patient receives inpatient care
8. Infant Abduction E.  Infant abduction . . .
9. Infant Discharge to wrong family E.  Infant . . . discharge to the wrong family
10. Rape F.  Rape of a patient
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