Lincoln Medical And Mental Health Center Fined For Violating Resident Work Hours

Albany, December 10, 1998 – The State Health Department today announced that it has fined Lincoln Medical & Mental Health Center, in the Bronx, $16,000 for allowing physicians in residency training to work hours that far exceed the limits set by the State Health Department as a protection for patients.

To protect patients from medical errors due to sleep–deprived and overworked physicians, the New York State Hospital Code limits the working hours of physicians in hospital residency training programs to no more than 80 hours per week over a four week period and no more than 24 consecutive hours. Close supervision of medical residents by attending physicians also is mandated. Hospitals in New York State have been put on notice that full–compliance with these important quality of care standards is required and that sanctions will be imposed for violations.

Lincoln has cooperated with the Department of Health and has expressed a commitment to fully resolve issues raised by the Department's findings. Lincoln must submit a Plan of Correction to the Department that incorporates previous corrective actions and identifies additional steps that will be taken to prevent a recurrence of the violations cited.

Working hour violations identified at Lincoln by Health Department inspectors during a June 21, 1998 survey, include the following:

  • Six of 10 surgical residents, and one obstetrics/gynecology resident, were working in excess of 85 hours per week;
  • Eight of 10 surgical residents worked 28 to 37 hours straight, and five of ten pediatric residents worked from 29 to 34 hours straight, in violation of the 24–hour maximum shift rule;
  • Residents "on call" during night shift hours are not generally resting due to frequent interruptions for patient care responsibilities;
  • Continuous assignments for residents that include night shift "on call" duty are not followed by a required non–working period;
  • In three of 14 medical records reviewed, documentation of oversight of residents by the supervising attending physician was not evident.

Earlier this year the State Health Department issued a report, based on a survey of 12 teaching hospitals, showing widespread abuse of resident working hour limits, particularly among surgical residents in New York City. This report represents a continuation of unannounced inspections of all teaching hospitals to improve compliance with the residency regulations.

12/10/98–118 OPA