Maryland Hospitals Reported 808 Serious Adverse Events in One Year: What Injured Patients and Families Should Know

Every year the Maryland Department of Health, through its Office of Health Care Quality (OHCQ), publishes a Maryland Hospital Patient Safety Program report. It compiles de-identified data that hospitals are required by state law to submit about adverse events, the serious things that go wrong during a patient's care. The most recent report, covering fiscal year 2023, counted more than 950 adverse events of all severities reported by Maryland hospitals.

Of those, 808 were Level 1 events, the most serious category the state tracks. More than 100 of the Level 1 events involved a patient death. The 808 figure was about 5 percent higher than the year before, and it continued a run that has now climbed for four straight years. The state recorded 212 of these most serious events in 2019, roughly 264 in fiscal 2020, 517 in fiscal 2021, and 769 in fiscal 2022 before reaching 808. That is nearly four times the 2019 total.

News coverage from WYPR, WTOP, the Washington Post, and Fox Baltimore has tracked this trend as the numbers came out. The underlying document is a public state record, not a lawsuit and not a set of allegations. It is the regulator's own count of how often Maryland hospital patients were killed or seriously harmed by something that went wrong in their care.

The report defines an adverse event as, in the state's words, "an unexpected occurrence related to an individual's medical treatment and not related to the natural course of the patient's illness or underlying disease condition." In plain terms, it is harm that came from the care, not from the disease the patient already had. A cancer that progresses despite good treatment is not an adverse event. A patient who develops a deep bedsore because no one repositioned them is.

Maryland sorts these events by severity. A Level 1 event is the most serious tier, meaning the event led to a patient's death or serious disability. Less severe harm falls into lower tiers. The 808 number that draws headlines is the count of Level 1 events specifically, the deaths and the permanent, life-changing injuries, not every minor mishap in a Maryland hospital.

That distinction cuts both ways. It means the reported figure understates the full volume of hospital harm, because the lower tiers and the events that go unreported are not in the 808. It also means the number should not be read as 808 deaths. The larger share of Level 1 events are serious disabilities rather than deaths, and the state itself has been careful to note that not every death counted in a Level 1 event was necessarily caused by the underlying error. When you see the figure quoted as deaths, that is a simplification worth correcting.

The report identifies the same three categories at the top of the list year after year. Hospital-acquired pressure injuries, the wounds most people call bedsores, are the single most frequently reported adverse event. Falls are second, with reported falls rising about 22 percent in the latest year. Delays in treatment are third, up about 16 percent. Each of these is a recognizable injury with a known cause, and each raises a specific question about whether the standard of care was met.

Pressure injuries develop when a patient who cannot move themselves is left in one position too long. The prevention is not mysterious: regular repositioning, pressure-relieving surfaces, skin assessment, and nutrition and moisture management. When a patient who was admitted with intact skin leaves with a stage 3 or stage 4 wound, the chart usually shows whether the repositioning and skin checks the care plan called for were actually done. A deep pressure injury acquired in the hospital is one of the more provable failures in this area precisely because the prevention is so well established.

Falls turn on assessment and response. Hospitals are expected to screen patients for fall risk, put interventions in place for high-risk patients such as bed alarms, closer monitoring, or assistance to the bathroom, and reassess after any change. A fall that causes a hip fracture or a head bleed in a patient flagged as high risk, where the ordered precautions were never carried out, is the pattern that supports a claim. Delayed treatment covers a wide range, from a worsening infection that no one escalated to a critical lab result that sat unread. Our article on emergency room negligence walks through how these timing failures are reconstructed from the record, and our article on hospital-acquired infections covers the prevention bundles that determine whether an infection was avoidable.

The Maryland Department of Health has attributed the rising counts to a mix of causes: workforce and staffing shortages, supply chain disruptions, and hospitals caring for sicker patients with more conditions at once. Officials have described the pattern as an after effect of the COVID-19 pandemic, a healthcare system still strained years after the acute crisis passed. Understaffing runs through all of it, because bedsores, falls, and missed warning signs are exactly the harms that become more likely when there are too few nurses on a shift.

Part of the increase also reflects better reporting rather than worse care alone. The state has said hospitals have gotten more consistent about reporting events they are legally required to disclose, so some of the climb is harm that was always happening finally being counted. A 2021 cyberattack on the state's systems disrupted data collection and forced the program to cut the number of data points it tracked per event, which makes clean year-over-year comparisons harder. An honest reading is that the true amount of hospital harm is high and rising, and the exact slope is blurred by how the data is gathered.

For a patient, the reason behind a number matters less than the fact behind an injury. Whether a hospital was short-staffed because of a national labor market or because of its own budget choices, the legal question is the same: did the care fall below the accepted standard, and did that failure cause the harm.

This is the point a law firm has an obligation to make plainly. The fact that a hospital reported an event to the state, and the fact that an event counted as Level 1, does not by itself establish that anyone was negligent or that a patient has a case. Medicine carries real risk, some bad outcomes happen despite competent care, and the reporting system is designed to capture events for safety review, not to assign legal blame.

A malpractice claim requires more than a bad result. It requires evidence that a specific provider or facility failed to meet the accepted standard of care, and that the failure caused or worsened the injury. That is a medical judgment, and in Maryland as in most states it has to be supported by a qualified medical expert before a case can go forward. The report tells you that serious harm is common in Maryland hospitals. It does not tell you whether any one patient's harm crossed the line into negligence. That answer comes from the individual record.

The flip side is also true. Many patients and families never learn that an adverse event in their care was reported to the state at all, because those reports are de-identified and are not released patient by patient. A family may sense that something went wrong without ever seeing it named. The way to close that gap is not the state report. It is the patient's own medical record, read by someone who knows what the standard required.

If you or a family member suffered a serious injury during a hospital stay, the medical record is where the answer lives, and you have the right to it. Request the complete chart, not the discharge summary alone. That means the physician and nursing notes, the medication administration record, vital signs and flow sheets, lab and imaging results, the care plan, any wound care or fall risk assessments, and the order history. For a pressure injury, the repositioning and skin assessment documentation is central. For a fall, the fall risk score and the precautions ordered are central.

Electronic records also carry a hidden layer. The system's audit trail logs who accessed the chart and when, when entries were made or changed, and whether critical results were viewed. A pattern of copy-forwarded notes claiming a wound was clean while the patient's condition worsened is the kind of thing an audit trail exposes. Our article on EMR audit trails as malpractice evidence explains how that metadata is obtained and why it often matters more than the narrative notes.

Keep your own timeline as well. Note the dates of visits, what you observed, what staff told you, and any changes in your loved one's condition. Photographs of a wound or a visible injury, taken consistently, are hard to dispute later. If medications were involved, our article on medication errors and prescription mistakes describes the records that show how a dosing or administration error happened. Gathering these materials early, before memories fade and before a chart is archived, protects the case whether or not you ultimately pursue it.

Maryland does not treat a medical malpractice claim like an ordinary injury case, and the extra steps take time you may not realize you are spending. Before most malpractice claims can proceed, they generally must be filed with the Health Care Alternative Dispute Resolution Office (HCADRO), and the claimant generally must file a Certificate of a Qualified Expert, a signed statement from a qualified medical professional that the standard of care was breached and that the breach caused the injury. That certificate is typically due within 90 days of filing. Lining up the right expert and getting the certificate signed is not something that happens overnight.

The deadline itself is unforgiving. In Maryland, a medical malpractice claim generally must be brought within the earlier of five years from the date of the injury or three years from the date the injury was discovered, under Maryland's statute of limitations for health care claims. Wrongful death claims carry their own separate deadline. Special rules can apply for injuries to minors and in other situations. Because the exact deadline depends on facts specific to your case, and because the certificate and HCADRO steps eat into the time you have, the safe assumption is that the clock is shorter than it looks. Our article on the statute of limitations for medical malpractice explains how these deadlines work and the traps that quietly shorten them.

Waiting is the expensive mistake here. Evidence is easiest to preserve when a lawyer sends a preservation letter early, while the chart, the staffing records, and the audit trail are all still intact. The clock is already running from the day of the injury or the day it should have been discovered, and no one gets that time back. If you think a Maryland hospital seriously harmed someone you love, the right time to get an answer is now, while the answer can still help.

A hospital harm case is built by matching the injury to the record. An experienced malpractice firm collects the complete chart, has the right specialists review it, and identifies whether the accepted standard was met at each step: was the patient assessed, was the risk acted on, was the deterioration caught and escalated. The state report tells you the harm is common. Only the record tells you whether a particular case is one the law can do something about, and that review is what separates a bad outcome from a viable claim. Our article on choosing a medical malpractice attorney describes what to look for in a firm that handles this work.

National Malpractice Lawyers works these cases across the country, with deep roots in the DMV region, Maryland, Virginia, and the District of Columbia, where OHCQ, the same office that publishes this report, is also the agency families can complain to about a hospital or facility. Our Hospital Negligence practice area covers the range of hospital harm claims, from pressure injuries and falls to infections and treatment delays.

A conversation costs nothing and carries no obligation. If a serious injury happened during a hospital stay and you are not sure whether it was avoidable, a review of the record can tell you. The sooner that review happens, the more evidence survives and the more of Maryland's short timeline you keep.