Hospital-acquired infections – When are hospitals legally liable?
In previous Healthfiles articles, we have highlighted the implications of antibiotic resistance and hospital-acquired infections (HAIs), those which patients acquire during the course of receiving treatment for other conditions.
These issues remain topical. There are around 200,000 HAIs in Australian healthcare facilities each year affecting 1 in 10 hospital admissions. These infections lead to extended hospital stays and an increase in treatment and diagnostics, so amplifying costs.
HAIs have generally been accepted to be a potential risk involved in hospital admissions. However, the landscape has shifted over the last several years, creating the perception that HAIs may be largely preventable when good infection control practices are followed.
An article by Professor David McQuoid-Mason published in the South African Medical Journal suggests that liability for HAIs will depend on whether the hospital:
- Has introduced and implemented best practice infection control measures.
- Is vicariously liable for negligent or intentional failures by staff to comply with the infection control measures.
The Australian National Safety and Quality Health Service Standards require that boards periodically review systems and strategies to prevent the infection of patients. Research has shown that the major route of transmission of HAIs has been determined as the unwashed hands of healthcare workers. Hand Hygiene Australia, responsible for the alcohol-based hand rub across Australian Hospitals, released its June 2015 report from data collected nationally from 860 public and private hospitals. and hygiene compliance by health care workers is at 82.8%, up from 50% in 2009. However, the compliance rate for doctors is 71%, the poorest of all the health professionals.
It remains difficult for a patient, who cannot point to some particular act or omission, to prove that a general lack of infection control procedures caused their infection. There is an increase in individual and class action lawsuits in Canada and the United States. Last year, an Ontario hospital paid a $1.7 million settlement after more than 400 people tested positive for tuberculosis. In Missouri, a 69 year old plaintiff was awarded a $2.58 million verdict after contracting an infection through an IV that was administered in the ambulance following a heart attack.
What does this mean moving forward? Where a patient contracts an HAI, infection control policies and practices are now more likely to be questioned. Hospitals and health care providers therefore need to have in place carefully worded protocols and policies which are widely communicated, easily understood and regularly implemented.
This article is part of our August 2016 edition of HealthFiles. You can read the full version of HealthFiles here.
 Australian Commission on Safety and Quality in Health Care. Guide to the National Safety and Quality Health Service Standards for Health Service Organization Boards. Sydney: ACSQHC, 2015.