Electronic Records Systems Have Not Reduced Health Costs, Report Says

The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.

Jim Wilson/The New York Times

Dr. Alvin Rajkomar tracks patient data on a Samsung Galaxy Note. A new report questions whether electronic records reduce health care costs.

Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.

“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.

RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.

The report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. The study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems.

“RAND got a lot of attention and a lot of buzz with the original analysis,” said Dr. Kellermann, who was not involved in the 2005 study. “The industry quickly embraced it.”

But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services.

Health care spending has risen $800 billion since the first report was issued, according to federal figures. The reasons are many, from the aging of the baby boomer population, to the cost of medical advances, to higher usage of medical services over all.

Officials at RAND said their new analysis did not try to put a dollar figure on how much electronic record-keeping had helped or hurt efforts to reduce costs. But the firm’s acknowledgment that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted.

The recent analysis was sharply critical of the commercial systems now in place, many of which are hard to use and do not allow doctors and patients to share medical information across systems. “We could be getting much more if we could take the time to do a little more planning and to set more standards,” said Marc Probst, chief information officer for Intermountain Healthcare, a large health system in Salt Lake City that developed its own electronic records system and is cited by RAND as an example of how the technology can help improve care and reduce costs.

The RAND researchers pointed to a number of other reasons the expected savings had not materialized. The rate of adoption has been slow, they said, and electronic records do not address the fact that doctors and hospitals reap the benefits of high volumes of care.

Many experts say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money. Federal regulators are investigating whether electronic records make it easier for hospitals and doctors to bill for services they did not provide and whether Medicare and other federal agencies are adequately monitoring the use of electronic records.

Technology “is only a tool,” said Dr. David Blumenthal, who helped oversee the federal push for the adoption of electronic records under President Obama and is now president of the Commonwealth Fund, a nonprofit health group. “Like any tool, it can be used well or poorly.” While there is strong evidence that electronic records can contribute to better care and more efficiency, Dr. Blumenthal said, the systems in place do not always work in ways that help achieve those benefits.

Federal officials say they are drafting new rules to address many of the concerns about the current systems.

This article has been revised to reflect the following correction:

Correction: January 14, 2013

An article on Friday about a new RAND Corporation study that found few savings from electronic health records misstated, in some copies, the name of the city in Florida that is home to a physician practice that is suing a health care technology firm that stopped supporting a system it sold to doctors in the practice. It is in Panama City, not Panama.

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IHT Rendezvous: IHT Quick Read: Jan. 14

NEWS French fighter jets struck deep inside Islamist strongholds in northern Mali on Sunday, shoving aside months of international hesitation about storming the region after every other effort by the United States and its allies to thwart the extremists had failed. Adam Nossiter, Eric Schmitt and and Mark Mazzetti report.

An Egyptian appeals court on Sunday threw out the guilty verdict and life sentence against former President Hosni Mubarak on charges that he allowed the killing of protesters. The court ordered a new trial, which would once again send the ailing autocrat rolling on a stretcher into the steel defendant’s cage in an Egyptian criminal court. David D. Kirkpatrick reports from Cairo.

For many Greeks, new mining operations are a symbol of their country’s willingness to accept any economic development, regardless of the environmental cost. Suzanne Daley reports from Ierissos, Greece.

Cubans will be allowed to spend more time overseas before they forfeit their residency, a concession that reflects the government’s desire for closer ties with Cubans living abroad. Victoria Burnett reports from Havana.

An outspoken former prime minister and the current foreign minister will face each other in the Czech Republic’s presidential runoff in two weeks, according to the results of the first round of voting released Saturday. This is the first direct popular vote for a head of state in the Czech Republic.The winner will succeed President Vaclav Klaus, a vociferous critic of the European Union who has dominated Czech politics for decades. Dan Bilefsky reports.

ARTS Hundreds of organizations have chosen the name Bauhaus: from a Hong Kong furniture store and a solar energy conference in Frankfurt, to a Madrid investment bank and a hostel in the Belgian city of Bruges. What’s in a name? Alice Rawsthorn on design.

FASHION It should have been the kickoff celebration of 60 years in fashion. Instead, there was a pall of sadness over the Missoni show Sunday as the search continued for the small plane that disappeared Jan. 7 in Venezuela with Vittorio Missoni, the son who always wore the brightest and cuddliest of the family’s iconic knits. Suzy Menkes writes from Milan.

SPORTS Wu Di is the first Chinese man to play singles in any Grand Slam tournament in the 45-year-old Open era. Christopher Clarey reports from the Australian Open in Melbourne.

Real’s coach, José Mourinho, virtually conceded the title following his team’s goalless draw Saturday in Pamplona, against the club at the bottom of the standings, Osasuna. Rob Hughes on soccer.

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Treasury Will Not Mint $1 Trillion Coin to Raise Debt Ceiling

WASHINGTON — The Treasury Department said Saturday that it will not mint a trillion-dollar platinum coin to head off an imminent battle with Congress over raising the government’s borrowing limit.

“Neither the Treasury Department nor the Federal Reserve believes that the law can or should be used to facilitate the production of platinum coins for the purpose of avoiding an increase in the debt limit,” Anthony Coley, a Treasury spokesman, said in a written statement.

The Obama administration has indicated that the only way for the country to avoid a cash-management crisis as soon as next month is for Congress to raise the “debt ceiling,” which is the statutory limit on government borrowing. The cap is $16.4 trillion.

“There are only two options to deal with the debt limit: Congress can pay its bills, or it can fail to act and put the nation into default,” Jay Carney, the White House press secretary, said in a statement. “Congress needs to do its job.”

In recent weeks, some Republicans have indicated that they would not agree to raise the debt limit unless Democrats agreed to make cuts to entitlement programs like Social Security.

The White House has said it would not negotiate spending cuts in exchange for Congressional authority to borrow more, and it has insisted that Congress raise the ceiling as a matter of course, to cover expenses already authorized by Congress. In broader fiscal negotiations, it has said it would not agree to spending cuts without commensurate tax increases.

The idea of minting a trillion-dollar coin drew wide if puzzling attention recently after some bloggers and economic commentators had suggested it as an alternative to involving Congress.

By virtue of an obscure law meant to apply to commemorative coins, the Treasury secretary could order the production of a high-denomination platinum coin and deposit it at the Federal Reserve, where it would count as a government asset and give the country more breathing room under its debt ceiling. Once Congress raised the debt ceiling, the Treasury secretary could then order the coin destroyed.

Mr. Carney, the press secretary, fielded questions about the theoretical tactic at a news conference last week. But the idea is now formally off the table.

The White House has also rejected the idea that it could mount a challenge to the debt ceiling itself, on the strength of the Fourteenth Amendment to the Constitution, which holds that the “validity of the public debt” of the United States “shall not be questioned.”

The Washington Post earlier published a report that the Obama administration had rejected the platinum-coin idea.

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City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

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City Room: Cuomo Declares Public Health Emergency Over Flu Outbreak

With the nation in the grip of a severe influenza outbreak that has seen deaths reach epidemic levels, New York State declared a public health emergency on Saturday, making access to vaccines more easily available.

There have been nearly 20,000 cases of flu reported across the state so far this season, officials said. Last season, 4,400 positive laboratory tests were reported.

“We are experiencing the worst flu season since at least 2009, and influenza activity in New York State is widespread, with cases reported in all 57 counties and all five boroughs of New York City,” Gov. Andrew M. Cuomo said in a statement.

Under the order, pharmacists will be allowed to administer flu vaccinations to patients between 6 months and 18 years old, temporarily suspending a state law that prohibits pharmacists from administering immunizations to children.

While children and older people tend to be the most likely to become seriously ill from the flu, Mr. Cuomo urged all New Yorkers to get vaccinated.

On Friday, the Centers for Disease Control and Prevention in Atlanta said that deaths from the flu had reached epidemic levels, with at least 20 children having died nationwide. Officials cautioned that deaths from pneumonia and the flu typically reach epidemic levels for a week or two every year. The severity of the outbreak will be determined by how long the death toll remains high or if it climbs higher.

There was some evidence that caseloads may be peaking, federal officials said on Friday.

In New York City, public health officials announced on Thursday that flu-related illnesses had reached epidemic levels, and they joined the chorus of authorities urging people to get vaccinated.

“It’s a bad year,” the city’s health commissioner, Dr. Thomas A. Farley, told reporters on Thursday. “We’ve got lots of flu, it’s mainly type AH3N2, which tends to be a little more severe. So we’re seeing plenty of cases of flu and plenty of people sick with flu. Our message for any people who are listening to this is it’s still not too late to get your flu shot.”

There has been a spike in the number of people going to emergency rooms over the past two weeks with flulike symptoms – including fever, fatigue and coughing – Dr. Farley said.

Mayor Michael R. Bloomberg and Mr. Cuomo made a public display of getting shots this past week.

In a briefing with reporters on Friday, officials from the C.D.C. said that this year’s vaccine was effective in 62 percent of cases.

As officials have stepped up their efforts encouraging vaccinations, there have been scattered reports of shortages. But officials said plenty of the vaccine was available.

According to the C.D.C., makers of the flu vaccine produced about 135 million doses for this year. As of early this month, 128 million doses had been distributed. While that would not be enough for every American, only 37 percent of the population get a flu shot each year.

Federal health officials said they would be happy if that number rose to 50 percent, which would mean that there would be more than enough vaccine for anyone who wanted to be immunized.

Two other diseases – norovirus and whooping cough – are also widespread this winter and are contributing to the number of people getting sick.

The flu can resemble a cold, though the symptoms come on more rapidly and are more severe.

Read More..

Aaron Swartz, Internet Activist, Dies at 26

Aaron Swartz, a wizardly programmer who as a teenager helped develop code that delivered ever-changing Web content to users and who later became a steadfast crusader to make that information freely available, was found dead on Friday in his New York apartment.

An uncle, Michael Wolf, said that Mr. Swartz, 26, had apparently hanged himself, and that a friend of Mr. Swartz’s had discovered the body.

At 14, Mr. Swartz helped create RSS, the nearly ubiquitous tool that allows users to subscribe to online information. He later became an Internet folk hero, pushing to make many Web files free and open to the public. But in July 2011, he was indicted on federal charges of gaining illegal access to JSTOR, a subscription-only service for distributing scientific and literary journals, and downloading 4.8 million articles and documents, nearly the entire library.

Charges in the case, including wire fraud and computer fraud, were pending at the time of Mr. Swartz’s death, carrying potential penalties of up to 35 years in prison and $1 million in fines.

“Aaron built surprising new things that changed the flow of information around the world,” said Susan Crawford, a professor at the Cardozo School of Law in New York who served in the Obama administration as a technology adviser. She called Mr. Swartz “a complicated prodigy” and said “graybeards approached him with awe.”

Mr. Wolf said he would remember his nephew, who had written in the past about battling depression and suicidal thoughts, as a young man who “looked at the world, and had a certain logic in his brain, and the world didn’t necessarily fit in with that logic, and that was sometimes difficult.”

The Tech, a newspaper of the Massachusetts Institute of Technology, reported Mr. Swartz’s death early Saturday.

Mr. Swartz led an often itinerant life that included dropping out of Stanford, forming companies and organizations, and becoming a fellow at Harvard University’s Edmond J. Safra Center for Ethics.

He formed a company that merged with Reddit, the popular news and information site. He also co-founded Demand Progress, a group that promotes online campaigns on social justice issues — including a successful effort, with other groups, to oppose a Hollywood-backed Internet piracy bill.

But he also found trouble when he took part in efforts to release information to the public that he felt should be freely available. In 2008, he took on PACER, or Public Access to Court Electronic Records, the repository for federal judicial documents.

The database charges 10 cents a page for documents; activists like Carl Malamud, the founder of public.resource.org, have long argued that such documents should be free because they are produced at public expense. Joining Mr. Malamud’s efforts to make the documents public by posting legally obtained files to the Internet for free access, Mr. Swartz wrote an elegant little program to download 20 million pages of documents from free library accounts, or roughly 20 percent of the enormous database.

The government shut down the free library program, and Mr. Malamud feared that legal trouble might follow even though he felt they had violated no laws. As he recalled in a newspaper account, “I immediately saw the potential for overreaction by the courts.” He recalled telling Mr. Swartz: “You need to talk to a lawyer. I need to talk to a lawyer.”

Mr. Swartz recalled in a 2009 interview, “I had this vision of the feds crashing down the door, taking everything away.” He said he locked the deadbolt on his door, lay down on the bed for a while and then called his mother.

The federal government investigated but did not prosecute.

In 2011, however, Mr. Swartz went beyond that, according to a federal indictment. In an effort to provide free public access to JSTOR, he broke into computer networks at M.I.T. by means that included gaining entry to a utility closet on campus and leaving a laptop that signed into the university network under a false account, federal officials said.

Mr. Swartz turned over his hard drives with 4.8 million documents, and JSTOR declined to pursue the case. But Carmen M. Ortiz, a United States attorney, pressed on, saying that “stealing is stealing, whether you use a computer command or a crowbar, and whether you take documents, data or dollars.”

Founded in 1995, JSTOR, or Journal Storage, is nonprofit, but institutions can pay tens of thousands of dollars for a subscription that bundles scholarly publications online. JSTOR says it needs the money to collect and to distribute the material and, in some cases, subsidize institutions that cannot afford it. On Wednesday, JSTOR announced that it would open its archives for 1,200 journals to free reading by the public on a limited basis.

Mr. Malamud said that while he did not approve of Mr. Swartz’s actions at M.I.T., “access to knowledge and access to justice have become all about access to money, and Aaron tried to change that. That should never have been considered a criminal activity.”

Mr. Swartz did not talk much about his impending trial, Quinn Norton, a close friend, said on Saturday, but when he did, it was clear that “it pushed him to exhaustion. It pushed him beyond.”

Recent years had been hard for Mr. Swartz, Ms. Norton said, and she characterized him “in turns tough and delicate.” He had “struggled with chronic, painful illness as well as depression,” she said, without specifying the illness, but he was still hopeful “at least about the world.”

Cory Doctorow, a science fiction author and online activist, posted a tribute to Mr. Swartz on BoingBoing.net, a blog he co-edits. In an e-mail, he called Mr. Swartz “uncompromising, principled, smart, flawed, loving, caring, and brilliant.”

 “The world was a better place with him in it,” he said.

Mr. Swartz, he noted, had a habit of turning on those closest to him: “Aaron held the world, his friends, and his mentors to an impossibly high standard — the same standard he set for himself.” Mr. Doctorow added, however, “It’s a testament to his friendship that no one ever seemed to hold it against him (except, maybe, himself).”

In a talk in 2007, Mr. Swartz described having had suicidal thoughts during a low period in his career. He also wrote about his struggle with depression, distinguishing it from sadness.

“Go outside and get some fresh air or cuddle with a loved one and you don’t feel any better, only more upset at being unable to feel the joy that everyone else seems to feel. Everything gets colored by the sadness.”

When the condition gets worse, he wrote, “you feel as if streaks of pain are running through your head, you thrash your body, you search for some escape but find none. And this is one of the more moderate forms.”

Ravi Somaiya contributed reporting.

This article has been revised to reflect the following correction:

Correction: January 12, 2013

An earlier version of this article incorrectly identified the police who arrested Mr. Swartz, and when they did so. The police were from Cambridge, Mass., not the Massachusetts Institute of Technology campus force, and the arrest occurred two years before Mr. Swartz’s suicide, but not two years to the day.

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Egyptian Court Grants Hosni Mubarak a New Trial

CAIRO — The prosecution on former Egyptian leader Hosni Mubarak took another turn Sunday, when a court in Cairo granted his appeal of a life sentence and ordered a retrial on charges that he failed to prevent the killing of hundreds of protesters during the uprising that toppled his government nearly two years ago.

The ruling read by judge Ahmed Ali Abdel-Rahman during the brief court session also overturned the conviction of Mr. Mubarak’s interior minister, Habib el-Adly, who is serving a life sentence after his conviction on the same charges. He will also be retried.

Mr. Mubarak, however, will not be freed; he is being held for investigation on other charges. The defendants were not present in the courtroom. Mr. Mubarak, 84, was reported last year to have been close to death, but the current state of his health is unknown.

His defense lawyers had argued that the former president did not know of the killings, but an Egyptian fact-finding mission has determined that he watched the uprising unfold on television at his palace.

The mission’s report could hold both political opportunities and dangers for Mr. Mubarak’s successor, Mohamed Morsi of the Muslim Brotherhood. A new trial would be popular, since many Egyptians were angered that Mr. Mubarak was convicted of failing to stop the killings, rather than ordering the crackdown.

But the report also implicates the military and security officials in the protesters’ deaths. Any move to prosecute them could spark a backlash from the powerful police and others who still hold positions under Mr. Morsi’s government.

The judge also granted the prosecution’s request to overturn not-guilty verdicts on Mr. Mubarak, his two sons and an associate of the former president, Hussein Salem, on corruption charges. Mr. Salem was tried in absentia and remains at large to this day.

A retrial was also ordered for six of Mr. el-Adly’s aides who were acquitted in the same trial. Five of them were found not guilty of involvement in the killing of the protesters, while one was acquitted of “gross negligence.”

No date has been set for the start of the retrial of the 11 and it was not immediately clear if all of them would be brought before the same court as was the case in their first trial.

Mubarak’s sons, one-time heir apparent Gamal and businessman Alaa, are in prison while on being tried for insider trading and using their influence to buy state land at a fraction of its market price.

Sunday’s ruling came a day after prosecutors questioned Mr. Mubarak about $1 million worth of personal gifts he received from a state news organization over his last six years in office, the organization’s Web site reported.

The investigation, conducted by the office assigned to investigate the misuse of public money, appeared to signal the determination of Mr. Morsi to bring new charges against Mr. Mubarak, the ousted former autocrat.

Mr. Mubarak was questioned about gifts, including gold pens, designer neckties, leather bags, shoes, gold jewelry and expensive watches that Al Ahram, which operates several newspapers and other media outlets, gave him from 2006 to 2011 as demonstrations of loyalty, its Web site reported. Al Ahram said Mr. Mubarak was facing possible new charges, including damaging public funds and improperly profiting from the gifts.

Al Ahram had been run by Mubarak loyalists while he was in office, but its management changed after Egypt‘s uprising.

He was questioned in a military hospital where he is serving a jail sentence for overseeing the police killing of nonviolent protesters.

Mr. Morsi campaigned on a pledge to bring new charges against Mr. Mubarak

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Business Briefing | Retailing: Best Buy Shares Rally on Improved Holiday Sales

The Best Buy Company had better-than-expected holiday sales, setting off a gain of $2, or 16.4 percent, in its stock price, to $14.21 a share on Friday. The holiday quarter accounted for about a third of Best Buy’s revenue last year. The chain said that revenue at stores open at least a year fell 1.4 percent for the nine weeks ended Jan. 5. The company’s performance in the United States was flat. The chief executive, Hubert Joly, said in a statement that the result was better than the last several quarters. A Morningstar analyst, R. J. Hottovy, said the results showed that some of Best Buy’s initiatives, like more employee training and online price matching helped increase sales.

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Former Lab Technician Denies Faulty DNA Work in Rape Cases

A former New York City laboratory technician whose work on rape cases is now being scrutinized for serious mistakes said on Friday that she had been unaware there were problems in her work and, disputing an earlier report, denied she had resigned under pressure.

The former lab technician, Serrita Mitchell, said any problems must have been someone else’s.

“My work?” Ms. Mitchell said. “No, no, no, not my work.”

Earlier, the city medical examiner’s office, where Ms. Mitchell said she was employed from 2000 to 2011, said it was reviewing 843 rape cases handled by a lab technician who might have missed critical evidence.

So far, it has finished looking over about half the cases, and found 26 in which the technician had missed biological evidence and 19 in which evidence was commingled with evidence from other cases. In seven cases where evidence was missed, the medical examiner’s office was able to extract a DNA profile, raising the possibility that detectives could have caught some suspects sooner.

The office declined to identify the technician. Documents said she quit in November 2011 after the office moved to fire her, once supervisors had begun to discover deficiencies in her work. A city official who declined to be identified said Ms. Mitchell was the technician.

However, Ms. Mitchell, reached at her home in the Bronx on Friday, said she had never been told there were problems. “It couldn’t be me because your work gets checked,” she said. “You have supervisors.”

She also said that she had resigned because of a rotator cuff injury that impeded her movement. “I loved the job so much that I stayed a little longer,” she said, explaining that she had not expected to stay with the medical examiner’s office so long. “Then it was time to leave.”

Also on Friday, the Legal Aid Society, which provides criminal defense lawyers for most of the city’s poor defendants, said it was demanding that the city turn over information about the cases under review.

If needed, Legal Aid will sue the city to gain access to identifying information about the cases, its chief lawyer, Steven Banks, said, noting that New York was one of only 14 states that did not require routine disclosure of criminal evidence before trial.

Disclosure of the faulty examination of the evidence is prompting questions about outside review of the medical examiner’s office. The City Council on Friday announced plans for an emergency oversight committee, and its members spoke with outrage about the likelihood that missed semen stains and “false negatives” might have enabled rapists to go unpunished.

“The mishandling of rape cases is making double victims of women who have already suffered an indescribably horrific event,” said Christine C. Quinn, the Council speaker.

A few more details emerged Friday about a 2001 case involving the rape of a minor in Brooklyn, in which the technician missed biological evidence, the review found. The victim accused an 18-year-old acquaintance of forcing himself on her, and he was questioned by the police but not charged, according to a law enforcement official.

Unrelated to the rape, he pleaded guilty in 2005 to third-degree robbery and served two years in prison. The DNA sample he gave in the robbery case was matched with the one belatedly developed from evidence the technician had overlooked in the 2001 rape, law enforcement officials said. He was recently indicted in the 2001 rape.

Especially alarming to defense lawyers was the possibility that DNA samples were cross-contaminated and led to false convictions, or could do so in the future.

“Up to this point,” Mr. Banks said, “they have not made information available to us, as the primary defender in New York City, to determine whether there’s an injustice that’s been done in past cases, pending cases, or allowing us to be on the lookout in future cases.” He added, “If it could happen with one analyst, how does anyone know that it stops there?”

The medical examiner’s office has said that the risk of cross-contamination was extremely low and that it does not appear that anyone was wrongly convicted in the cases that have been reviewed so far. And officials in at least two of the city’s district attorneys’ offices — for Brooklyn and Manhattan — said they had not found any erroneous convictions.

But Mr. Banks said the authorities needed to do more, and that their statements thus far were the equivalent of “trust us.”

“Given what’s happened,” he said, “that’s cold comfort.”

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Former Lab Technician Denies Faulty DNA Work in Rape Cases

A former New York City laboratory technician whose work on rape cases is now being scrutinized for serious mistakes said on Friday that she had been unaware there were problems in her work and, disputing an earlier report, denied she had resigned under pressure.

The former lab technician, Serrita Mitchell, said any problems must have been someone else’s.

“My work?” Ms. Mitchell said. “No, no, no, not my work.”

Earlier, the city medical examiner’s office, where Ms. Mitchell said she was employed from 2000 to 2011, said it was reviewing 843 rape cases handled by a lab technician who might have missed critical evidence.

So far, it has finished looking over about half the cases, and found 26 in which the technician had missed biological evidence and 19 in which evidence was commingled with evidence from other cases. In seven cases where evidence was missed, the medical examiner’s office was able to extract a DNA profile, raising the possibility that detectives could have caught some suspects sooner.

The office declined to identify the technician. Documents said she quit in November 2011 after the office moved to fire her, once supervisors had begun to discover deficiencies in her work. A city official who declined to be identified said Ms. Mitchell was the technician.

However, Ms. Mitchell, reached at her home in the Bronx on Friday, said she had never been told there were problems. “It couldn’t be me because your work gets checked,” she said. “You have supervisors.”

She also said that she had resigned because of a rotator cuff injury that impeded her movement. “I loved the job so much that I stayed a little longer,” she said, explaining that she had not expected to stay with the medical examiner’s office so long. “Then it was time to leave.”

Also on Friday, the Legal Aid Society, which provides criminal defense lawyers for most of the city’s poor defendants, said it was demanding that the city turn over information about the cases under review.

If needed, Legal Aid will sue the city to gain access to identifying information about the cases, its chief lawyer, Steven Banks, said, noting that New York was one of only 14 states that did not require routine disclosure of criminal evidence before trial.

Disclosure of the faulty examination of the evidence is prompting questions about outside review of the medical examiner’s office. The City Council on Friday announced plans for an emergency oversight committee, and its members spoke with outrage about the likelihood that missed semen stains and “false negatives” might have enabled rapists to go unpunished.

“The mishandling of rape cases is making double victims of women who have already suffered an indescribably horrific event,” said Christine C. Quinn, the Council speaker.

A few more details emerged Friday about a 2001 case involving the rape of a minor in Brooklyn, in which the technician missed biological evidence, the review found. The victim accused an 18-year-old acquaintance of forcing himself on her, and he was questioned by the police but not charged, according to a law enforcement official.

Unrelated to the rape, he pleaded guilty in 2005 to third-degree robbery and served two years in prison. The DNA sample he gave in the robbery case was matched with the one belatedly developed from evidence the technician had overlooked in the 2001 rape, law enforcement officials said. He was recently indicted in the 2001 rape.

Especially alarming to defense lawyers was the possibility that DNA samples were cross-contaminated and led to false convictions, or could do so in the future.

“Up to this point,” Mr. Banks said, “they have not made information available to us, as the primary defender in New York City, to determine whether there’s an injustice that’s been done in past cases, pending cases, or allowing us to be on the lookout in future cases.” He added, “If it could happen with one analyst, how does anyone know that it stops there?”

The medical examiner’s office has said that the risk of cross-contamination was extremely low and that it does not appear that anyone was wrongly convicted in the cases that have been reviewed so far. And officials in at least two of the city’s district attorneys’ offices — for Brooklyn and Manhattan — said they had not found any erroneous convictions.

But Mr. Banks said the authorities needed to do more, and that their statements thus far were the equivalent of “trust us.”

“Given what’s happened,” he said, “that’s cold comfort.”

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