In recent years, the use of nondisclosure agreements (NDAs) has faced criticism for shielding bad actors and enabling misconduct to persist. While these agreements are commonly employed by major corporations and wealthy celebrities, their persistent use in taxpayer-funded institutions, including public hospitals, has largely escaped scrutiny. Confidentiality clauses have been employed by the University of Washington (UW) Medical Center, Washington's largest taxpayer-funded hospital system, to hide allegations of malpractice and serious misconduct.

According to public records obtained by NBC News, 70 out of 89 settlement agreements involving the University of Washington Medical Center and other UW-affiliated hospitals and clinics from 2015 to early 2023 included confidentiality clauses. These clauses required victims and their families to remain silent about their claims, the amounts they were paid, or both, as a condition of settlement. The payments in these cases ranged from as low as $2,000 to as high as $14 million.

The settlement agreements reviewed for this article revealed that the university imposed secrecy in cases involving grave harm, such as a newborn who suffered severe brain damage due to alleged negligence during childbirth ($14 million), a man who died after a misdiagnosed cancerous mass in his face and neck went untreated ($6 million), and a girl left with permanent cognitive disabilities after a doctor allegedly left bone fragments in her skull ($11 million).

Critics argue that the use of NDAs to conceal allegations of wrongdoing at taxpayer-funded institutions raises concerns, particularly since these institutions receive public funds and should be subject to transparency laws. Paul Luvera, a retired trial lawyer in Washington state, describes such clauses as "an intimidation clause" that prevents victims from revealing public information. The University of Washington Medical Center defended the practice, stating that confidentiality clauses are a standard industry practice and provide finality and certainty when claims conclude.

However, the use of confidentiality clauses to conceal alleged malpractice is not limited to the University of Washington. Other hospitals subject to public records laws, including the University of Kansas Hospital Authority and the University of Texas-MD Anderson Cancer Center, also employ similar secrecy tactics to keep malpractice cases hidden. In some states, government-run hospitals cannot legally withhold key details that they require claimants to keep secret.

NDAs not only maintain secrecy but also hinder regulatory complaints and prevent public scrutiny, impeding investigations into potential misconduct. By stifling accountability, these agreements raise concerns about patient safety and transparency within the healthcare system.

In March 2023, a settlement was reached in the lawsuit filed by Hana Hooper, who alleged a prominent cardiac surgeon, Dr. Nahush Mokadam, hindered her chances of receiving a life-saving heart transplant. The $12 million settlement included a confidentiality clause, preventing the public from learning about the details of the case.

The prevalence of confidentiality clauses in settlements at taxpayer-funded hospitals highlights the need for increased transparency and accountability. The use of NDAs in these institutions prevents the public from fully understanding the extent of alleged wrongdoing and raises questions about the protection of patient rights and safety.