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How to report SREs to the Department of Public Health

Note: If the SRE occurred at another hospital or ambulatory surgery center, use this form to report by fax within 7 days, instead of electronically. You would not need to provide a 30-day follow-up report.

1. Immediately

If the SRE involved any of the following*, call DPH and complete steps 2 and 3:

  • Unanticipated death,
  • Suicide, or
  • A serious criminal act

(See contact information below).

If not, skip this step and go to step 2

2. Within 7 days [of discovering the event]

Submit an initial report using the Virtual Gateway - Healthcare Facility Reporting System (HCFRS)

3. Within 30 days [of making the initial electronic report]

Submit a follow-up report through HCFRS that reflects the findings of your investigation of the event.

*This is a partial list of immediately reportable events. For the full list, see 105 CMR § 130.331(A) or § 140.307.


Not familiar with DPH’s online reporting system? You can get enrollment help, training materials, and more from DPH.

Remember that there are also specific requirements to notify patients and third-party payers about the event.

When filling your 30-day report be sure to include in your preventability determination narrative: identification and analysis of root causes; any updates to the incident narrative; and description of any corrective measures taken.


Related DPH forms and instructions

Laws: 105 §§ CMR 132.332, 140.308


Department of Public Health, Bureau of Health Care Safety and Quality

Business hours:

Non-business hours:
617-363-0755 or 617-469-1111

Fax: 617-753-8165


We hope these instructions helped you meet this reporting requirement. Be aware that this action may not fulfill all applicable reporting requirements associated with the event.

This document is intended for informational purposes only and does not constitute regulatory guidance or legal advice. Links and information in this document may be outdated. The Betsy Lehman Center does not represent or warrant that this information is accurate, complete, or current. For further terms and conditions, see the Terms of Use.