Death from healthcare-related infection. Complication or poor health management?

Care-related infections (ICA), acquired in hospitals, clinics and inpatient facilities, are a more widespread phenomenon than is thought, which can even lead to the death of the patient. According to the latest data, these infections affect on average between 5 and 8% of hospitalized patients, especially after surgery, but the most alarming fact is that for one patient out of two, they could have been avoided. In these cases, can we talk about post-operative complications or is it a question of poor health management?

"The issue is quite complex, and each case must be carefully assessed in each of its profiles, before it can be said that the infection was caused or encouraged by inadequate behavior of the health care providers. - The Italian lawyer Gabriele Chiarini affirms. - However, where a cause-and-effect relationship can be verified between the medical operation and the onset of the infection, we are faced with a case of malpractice, and it is therefore appropriate to investigate in order to ascertain the responsibility of the personnel in charge of the care, as in a recent legal case followed by me and my collaborators, which has led to an important compensation for the family of a patient, who died as a result of ICA".

The lawsuit followed by the law firm Chiarini concerns a 77 year old man suffering from steno-valvular insufficiency and aneurysm of the ascending aorta, who was admitted to a private hospital in Rome to undergo surgery to replace the aortic valve and the ascending aorta. After the operation, the man was moved to intensive care, to be then discharged and transferred to a special institute for the management of the subacute phase and cardiological rehabilitation. The same day, however, at the new institute, he was given a swab that tested positive for Staphylococcus epidermidis, and for this reason he was promptly returned to the facility where he had been treated.

Only after eleven days, a chest CT scan, a bronchoscopy with culture of the broncho aspirated material and urinoculture were made, which would have shown, unfortunately after the death of the patient, the massive presence of the bacterium Pseudomonas aeruginosa. In a short time, the general conditions of man worsened, with serious respiratory problems, until the onset of a multiorgan failure, proved fatal. Subsequently, it was found that the hospital had not only failed to take the necessary precautions to prevent infection following such a delicate and invasive intervention, but, once it had occurred, it was underestimated and managed with a therapy not suitable and insufficient to counteract the attack.

"In this specific case, we have established with no doubt the medical responsibility for the incident. - Lawyer Chiarini continues. - The unsuitable cleaning of the surgical wound, the insufficient postoperative monitoring and the deficit of the dressing and treatment procedures, with antibiotic prophylaxis aimed only at Gram positive bacteria and ineffective for Gram negative ones, as well as the late diagnosis and management of the infection, are elements that lead us to define the story not as a sad medical complication, but as a serious case of poor health management, for which the Judge has proposed a total compensation in favor of the family of the deceased equal to € 750.000.00, plus reimbursement of the costs of litigation and C.T.U.".