BALTIMORE _ Johns Hopkins touts itself as a national leader in patient safety.
Its doctors invented a simple checklist credited with saving thousands of lives. They developed a system to reduce medical mistakes through teamwork and communication. They wrote one rule to follow above all: Listen to the frontline staff.
But the renowned Johns Hopkins Hospital in Baltimore and its five sister hospitals haven't always followed those principles, the Tampa Bay Times has found.
In at least nine recent cases, the hospitals have been accused of making preventable errors or setting aside basic safety rules. Some serious problems continued long after frontline workers brought them to the attention of high-ranking executives.
In Bethesda, Md., doctors at Suburban Hospital kept performing surgeries even though Johns Hopkins had learned the operating rooms weren't being properly cleaned, according to federal inspectors.
In the heart of Baltimore, a pediatric burn unit continued treating patients after its leader begged administrators to shut it down, saying the unit had made mistakes that left children disfigured, court records show.
And in St. Petersburg, at least eight employees warned supervisors about issues with a pair of heart surgeons at Johns Hopkins All Children's Hospital, the Times reported in November.
By late 2017, when the hospital stopped the first of those surgeons from operating, the mortality rate in its Heart Institute had tripled, and at least 11 children had died.
Every hospital makes mistakes; federal inspection reports show safety problems at many top institutions. And Johns Hopkins continues to be a leader in health care. The flagship Johns Hopkins Hospital spent more than 20 years atop U.S. News and World Reports' rankings. It is now No. 3.
But some of the incidents at Johns Hopkins hospitals stand out for their severity. Taken together, they illustrate the $6 billion health system's struggle to consistently follow the principles its experts preach.
Johns Hopkins' efforts to reduce harm have brought "great fame to the system," said Sara Singer, a Stanford University professor who studies how hospital culture affects patient safety.
When told about some of the incidents, Singer said, "I see a problem in the culture here. I think there are real lapses."
Johns Hopkins did not make an executive available for an interview to discuss the cases. In a statement, it described medical errors as a "tragic fact" that occur in all health organizations. But it also said "we can and will do better" and that it would take steps to prioritize safety.
"The Tampa Bay Times has identified occasions where it is apparent that as an organization we failed to act quickly enough, we failed to listen closely enough and, in some instances, we failed to deliver the care our patients and their families deserve. This is unacceptable," the statement said.
The system said it would remind employees "that they have options for reporting their concerns outside of the direct reporting chain."
"Anyone who demonstrates that they are unwilling or unable to maintain our rigorous and exacting safety culture will not be a welcome member of our caregiving community," the statement said.
In the burn unit case, however, the program's director said he took his concerns higher and higher, ultimately writing an urgent letter to the health system's chief executive.
The director, Dr. Stephen Milner, said he presented "incontrovertible proof of children that were being mutilated in that department, and they did nothing but cover it up," court records show.
Asked why under oath, Milner responded bluntly.
"I think that they care more about the reputation of the hospital than they do the care of patients," he said.
