up on abnormal test results Examples of commission of an act include administering the wrong medication to a patient , administering medication to the wrong patient , and performing a procedure without patient or family consent
For a plaintiff to recover damages resulting from a negligent act , Sheridan ( 2024 ) explains , the plaintiff ’ s case must address four elements : Duty ( an obligation to conform to a recognized standard of care ); breach of duty ( a deviation from the recognized standard of care ); causation ( an act or conduct departing from the recognized standard of care that caused injury ); and injury ( the result of the deviation from the recognized standard of care ).
For a case of negligence to be established , the patient who acquires an infection during their hospital stay must establish that they actually
The test for negligence in this example rests on whether the hospital ’ s care or lack of care caused the infection , and whether the hospital and the personnel working with the patient acted in a reasonable and prudent manner to recognize , report , and try to control the infection .” contracted the infection in the hospital , and that the hospital , through an act of negligence , breached its duty to the patient and did not follow recognized standards of care , a policy , or established procedures to prevent the infection . The patient must also establish that the hospital ’ s negligence or the negligence of its employee / agent caused the infection and that the patient ’ s condition worsened because of the infection . As Sheridan ( 2024 ) explains , “ The test for negligence in this example rests on whether the hospital ’ s care or lack of care caused the infection , and whether the hospital and the personnel working with the patient acted in a reasonable and prudent manner to recognize , report , and try to control the infection .”
Sheridan ( 2024 ) adds , “ The plaintiff must prove that the act or omission of the act resulted in the immediate damage without intervention of another party . This legal standard is referred to as the proximate cause , which is an act that causes an injury as a natural , direct , uninterrupted consequence , and without that act , the injury would not have occurred . If the patient ’ s attorney can establish that the plaintiff experienced injury due to an infection caused by the negligence of the hospital or staff , proximate cause is established and the hospital and / or its staff may be liable .”
Standards of Care
A national standard of care assumes evidence-based practice will result in a single prevailing level of care . Governmental and accreditation agencies such as the National Quality Forum , Agency for Healthcare Research and Quality , National Academy of Medicine , and The Joint Commission have helped develop best practice-driven standards for healthcare organizations .
When a person alleges that a healthcare provider fails to meet a standard of care , the person must first establish what the standard is and then prove that the organization and / or individual breached the standard , according to Sheridan ( 2024 ). This proof normally comes from expert testimony but can also be derived from alternative sources such as medical textbooks and journals , state and federal laws , regulations , guidelines , protocols , and practice parameters .
HAI Judgments : A Perspective from the Medical Literature
In
a retrospective review of HAI judgments in the Civil Court of
Rome between 2016 and 2020 , Treglia , et al . ( 2022 ) analyzed the phenomenon of professional liability related to HAIs , examining 140 verdicts issued in which the liability for which compensation was sought was related to the occurrence of healthcare-related infections . Convictions were recognized in 62.8 percent of cases , and most involved the surgical areas of orthopedics , heart surgery , and general surgery . The three most frequently isolated microorganisms were Staphylococcus aureus , Pseudomonas aeruginosa , and Klebsiella pneumoniae . The review showed how the analysis of the juridical and medico-legal aspects of HAIs may represent not only a helpful tool for healthcare performance assessment , but also a data source usable in clinical risk management and in the implementation of patient safety .
The researchers observe , “ in cases of causation-related complications leading to the onset of an infection during hospitalization or healthcare care service provision , they may constitute , under certain circumstances , grounds for professional liability of the healthcare facility in question , leading to compensation for damage to the patient , with rising costs for public and private health facilities and insurance companies . Despite the remarkable increase in the amount of medical malpractice claims around the world , however , it has been a poorly considered and investigated aspect in the scientific literature . Fault-based liability may arise in specific cases , such as non-fulfillment of specific hygiene and aseptic procedures during health service provision ; underestimation of immunocompromised patients or patients with specific pre-existing comorbidities ; poor sanitation of the operating rooms or improper asepsis of surgical instruments ; or , more generally , non-compliant healthcare facility conduct with all the scientifically validated precautions designed to prevent any occurrence of infection .”
In terms of preventability , Treglia , et al . ( 2022 ) found that in medical settings equipped with specific infection control and surveillance protocols managed by expert epidemiologists , the infection rate was 32 percent lower than in healthcare settings lacking these protocols . They note further , “ Even more recent studies have shown that up to 55 percent of HAIs are preventable . Furthermore , it must not be forgotten that , hypothetically , a considerable number of patients might have suffered from permanent damage or even have died from potentially preventable infections . Therefore , considering the multiplicity and variability of the conditions that may facilitate the onset of an infection during hospital stays , and their ascertained partial preventability , forensic evidence of the occurred events on fault-based medical liability following nosocomial infections may be extremely complex , although crucial , in legal proceedings .”
Convictions as proof of the existence of a direct or indirect HAI-related professional liability were recognized in 88 out of 140 litigations . Sentences resulted in 25 out of 47 ( 53.2 percent ) of orthopedics cases , in 10 out of 15 ( 66.6 percent ) of cardiac surgery cases , and in 9 of 14 ( 64.3 percent ) of those relating to general surgery ; and in 6 out of 140 ( 4.3 percent ) of ophthalmology cases , with a litigation / conviction ratio of 83.3 percent .
20 • www . healthcarehygienemagazine . com • september 2024