Legal Liability for HAIs
There is a lot of talk about patient safety and the financial side of health-associated infections, HAIs, but what are the legal implications? Becker Hospital Review reports there are 1.7 million HAIs annually in acute care environments. This includes around 99,000 deaths at a cost in excess of 10 billion dollars. Some the financial burden comes in the form litigation. It is critical that all healthcare workers understand the liability issues of HAIs and their role in preventing them.
The Risk Factors of HAIs
The truth is the failure to comply with evidence-based infection control standards is nothing short of medical malpractice. Consider some of the risks that lead to HAIs:
Patients – A patient with a medical problem, whether acute or chronic, may already have a stressed immune system. Admitting them into a critical care environment can introduce pathogens that would otherwise not thrive in that setting.
Care Environments – A facility that fails to adhere to infection protocols is a great risk, as well. Cleanliness of the hospital, air filtration and water quality are elements that affect everyone, not just patients.
Latrogenic Risks – This refers to the staff protocols designed to prevent cross-contamination and covers everything from hand hygiene to urine cauterization procedures.
It is difficult for facilities to monitor the transmission of infections, so they end up taking the brunt of the blame legally. It falls on them to investigate each incidence, as well.
- How was the pathogen introduced into the environment?
- Why did treatment fail to stop it?
- Could it have been prevented?
In most cases, all eyes turn to the physician in charge of that patient’s care. Doctors that work as independent contractors for a healthcare facility may end up as scapegoats, especially when there are sepsis and patient death.
The Legal Side of HAIs
In cases where a lawsuit ensues, a third party may take charge of the investigation and look specifically at the care standards in order to determine liability. This expert will look at the treatment scenario, whether both the facility and physician were in compliance with medical standards of care and if the infection was preventable.
In order for someone to initiate a lawsuit, they must prove:
- They have an interest protected by law
- Show the defendant had a duty to act
- Prove the defendant failed in that duty
- Show there was an injury or damage as a result of that failure
The burden of proof lies entirely with the plaintiff. If the plaintiff succeeds in establishing the case based on a preponderance of the evidence, the burden shifts to the defendant. If liability is established, then the plaintiff has to prove there were damages.
When a person sues a hospital or medical professional because of an HAI, they believe there was malpractice, but legally, the two issues are separate. The law defines medical malpractice as professional negligence by act or omission where the treatment falls below the accepted standard. An HAI may fall into this category, but that litigation is usually aimed at the facility, not the practitioner, as a wrongful tort action.
In 2009, a Texas jury awarded 17.5 million dollars to a patient who required an amputation due to a healthcare-acquired infection. Many of the cases like this one that involves nosocomial infections relate to failure to diagnose and treat the infection.
In the healthcare industry, infection control experts are often seen as the bad guys, policing staff and environments, but they serve a real purpose – one that protects both patient and staff medically and legally.