Article

Clostridium difficile - Maidstone

In October 2007 the Health Care Commission published a highly critical report following an investigation into the management of Clostridium difficile (C diff) at Maidstone and Tunbridge Wells NHS Trust.

The commission found that there was a serious failure to identify an outbreak of C diff in late 2005 and further inadequacies in management of another outbreak in 2006. The 120 page report highlighted numerous failings including insufficiently clear guidelines for the management of C diff, a failure by the trust to review its antibiotic policy following letters from the Chief Medical Officer and Chief Nursing Officer in December 2005, poor hygiene standards, unacceptable delays in isolating infected patients, inadequate staff awareness. The commission reviewed the case notes of a sample of 50 patients and found that management and monitoring of the C diff was unsatisfactory in 80%.

The report received widespread coverage in the press which tended to focus on the headline figures. Between April 2004 and September 2006 345 patients who had been infected with C difficile died. For approximately 90 patients C difficile was probably the main cause of death. What was not highlighted was the fact that the commission emphasised that "it is not, however, correct to conclude that these patients died because of the care they received". In fact the mortality rate only modestly exceeded what would have been predicted on the basis of research in the United States.

Comment

The C diff outbreaks received widespread press coverage both because of the number of alleged deaths and also because the trust's chief executive resigned shortly before the report was published with a severance payment of £250,000.

Patients who caught C difficile in hospital, or relatives of patients who have died, would not have an automatic right to compensation unless the government agreed to a special compensation scheme given the exceptional circumstances. Pursuant to ordinary principles of law compensation would only be payable if it could be shown that a patient contracted C diff as a result of unacceptable failures on the part of the hospital or there were unacceptable delays in diagnosis or treatment. The merits of and the potential value of compensation claims would need to be assessed on an individual basis.

A full copy of the report can be found on the Healthcare Commission website.

Further information on infection claims can be found in the August 2007 edition of Your Health Law.

 

For further enquiries please contact Nicola Mooney (view full profile) on 01892 701381 or email nicola.mooney@ts-p.co.uk.

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