This post originally appeared in ProPublica’s Patient Harm Facebook Group, part of our ongoing look at patient safety.

When patients suffer hospital-acquired injuries, infections or medical errors, Helen Haskell, founder of Mothers Against Medical Error, recommends six action steps.

1. Get a copy of medical records. Every patient has a right to his or her medical records under federal law. These records can provide important information about what happened – and what might have gone wrong.

How: As soon as possible after the incident, contact your doctor’s office or go to the hospital’s medical records department and ask for a complete copy, including doctor and nursing notes, lab results and copies of diagnostic images. (Warning: There may be significant charges for copying, and records can sometimes be altered.)

2. Make sure the incident is reported internally. Accredited hospitals are required to conduct internal investigations of serious medical incidents. And they’re supposed to have procedures in place to deal with incidents that lead to patient harm or could lead to patient harm. But often, the investigation glosses over problems.

How: Ask to be part of the investigation, or at least to have your version of events on record as part of the analysis.

3. If the patient has died, order a forensic autopsy, which includes toxicology tests. Autopsies -- though not always 100 percent accurate -- are the most reliable means of finding out what happened in an unexpected death. Hospitals do not routinely conduct autopsies, but the family always has the right to have one.

How: In some cases, the local coroner or medical examiner is supposed to be called if a patient dies in a medical facility. If the authorities decline to take the case, the family may have to pay an independent pathologist to perform a forensic autopsy. In that case, ask the coroner or medical examiner’s office for a referral to an independent pathologist.

4. Consider calling an attorney. Be aware that the standards for proving medical malpractice are much higher than most patients expect. Attorneys take few cases because they’re expensive to pursue and difficult to win. Even if an attorney does not take your case, however, he or she may help you deal with the hospital.

How: Ask friends or lawyers you know for the name of an experienced malpractice attorney. Or, find one online.

5. Meet with the doctor and hospital officials. Ask them how they will prevent future harm to other patients. If the patient has suffered damages or died, you can also negotiate directly with them to waive medical bills or agree on an amount for compensation. If you can, bring an attorney to help ensure that any agreement you make is in your best interest.

How: The Assertive Patient has some great tips.

6. Report the incident to regulators, who can investigate. While regulatory action is often much milder than patients think is warranted, it creates a paper trail and providers may be cited or fined and required to create a program for improvement.

How: It’s necessary to report to the correct agency:

• State health departmentslicense hospitals and nursing homes
• The Joint Commissionaccredits hospitals
• Doctors are accountable to a medical board
• Nurses answer to a nursing board
• Medicare patients can also complain to Medicare or a Medicare Quality Improvement Organization.

Depending on the circumstances, reports could be filed with one or many agencies.

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