Clinical negligence, litigation and healthcare-associated infections.
BACKGROUND
Litigation costs resulting from clinical negligence claims involving healthcare-associated infections are a significant but underappreciated cost to healthcare organizations. In England these claims are handled on behalf of the National Health Service (NHS) organizations by the NHS Litigation Authority (NHSLA). The total number of claims and the amounts awarded have increased significantly in recent years.


OBJECTIVE
To determine whether the recent significant reductions in meticillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) and Clostridium difficile infections in England have had an effect on the number and value of NHSLA claims relating to these infections.


METHODS
Data obtained from the NHSLA relating to claims mentioning C. difficile or MRSA from 2003 to 2010 were correlated with mandatory surveillance data from the Health Protection Agency for these infections.


RESULTS
The rate of NHSLA claims for MRSA has decreased in line with reductions in BSI for this infection (0.007 per BSI between 2003/4-2006/7 to 0.0017 per BSI between 2007/8 and 2010/11), but there was no significant change in claims relating to C. difficile infection. Overall the amounts awarded for successful claims have decreased significantly from a total of £76,846 for the period 1997/8-2006/7 to £24,821 for the period 2007/8-2010/11.


CONCLUSIONS
The number of litigation claims involving MRSA has recently decreased significantly in line with surveillance data. There was no observed effect on claims involving C. difficile. The amounts awarded for successful claims for both infections have also fallen, although the reasons for this are not clear.
Centre for Clinical Infection and Diagnostics Research, Guy's & St Thomas' NHS Foundation Trust, London, UK. Simon.goldenberg@gstt.nhs.uk
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Goldenberg
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Volpé
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French
D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D016360:Clostridioides difficile; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000382:microbiology; D004739:England; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008318:Malpractice / Q000191:economics / Q000331:legislation & jurisprudence*; D055624:Methicillin-Resistant Staphylococcus aureus; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013222:State Medicine / Q000331:legislation & jurisprudence