[Nosocomial infections as a cause of liability claims].
The objective of this work is a preliminary analysis of claims concerning nosocomial infections advanced by patients against public inpatient institutions.


METHODS
646 patient claims against medical institutions resulting from their civil liability were analyzed. All the claims included expert opinions issued by the Medical Department of PZU SA between the year 2003 and 2005. In the analyzed material, the majority of claims (85.3%) involved public hospitals. The value of the presented material is high, as PZU SA is practically the only insurance company that insures public hospitals against civil liability for medical procedures. Therefore, conclusions from the present analysis may be used to formulate certain generalized statements in the case of claims made by patients against public hospitals in Poland. Nosocomial infections constituted 32% of all patient claims against public hospitals. The majority of claims indicated Staphylococcus aureus infections (37%). Other common infections associated with patient claims were HBV and HCV infections, with HBV infections predominating at surgical and internal disease wards, while HCV infection claims were more common among gynecology and obstetrics patients. Staphylococcus aureus infections were dominant in orthopedic and traumatology wards. Some objective reasons may hinder formulation of an expert opinion, such as finding the causal association between the infection and the timing of hospitalization, or between the infection and the culpability of medical personnel. Medical opinions passed by doctors of the Medical Department in most cases remained ambiguous. New legal regulations that require obligatory reporting and registration of nosocomial infections provide a chance that some of these difficulties may be overcome in the near future.
Pałka
Janusz
J
Biura Medycznej Obsługi Ubezpieczeń Centrali PZU SA I PZU Zycie SA Al. Jana Pawła II 24; 00-133 Warszawa. jpalka@pzu.pl
Truszkiewicz
Waldemar
W
D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission*; D018562:Disease Transmission, Infectious / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005554:Forensic Medicine / Q000331:legislation & jurisprudence; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence*; D007351:Insurance, Liability / Q000331:legislation & jurisprudence*; D016365:Liability, Legal; D011044:Poland / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence; D024382:Professional Role; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000517:prevention & control / Q000635:transmission