## Hospital-acquired infection claims in District of Columbia **Hospital-acquired infections (HAIs)** affect ~1 in 31 hospital patients + cause 100,000+ US deaths annually. Many are preventable through proper infection control. District of Columbia HAI cases combine medical malpractice + negligence theories. ## Common hospital-acquired infections **Bacterial:** - **MRSA** (Methicillin-resistant Staphylococcus aureus) - **C. difficile** (C. diff) - **CRE** (Carbapenem-resistant Enterobacteriaceae) - **VRE** (Vancomycin-resistant Enterococcus) - **Pseudomonas** - **Klebsiella** - **E. coli** **Sepsis:** - Life-threatening response to infection - Often hospital-acquired - Major cause of HAI deaths - Specific procedures **Surgical site infections:** - Post-operative - Specific procedures - Specific to surgery - Common HAI **Catheter-related:** - Central line infections - Catheter-associated UTIs - Specific procedures - Common HAI **Pneumonia:** - Ventilator-associated - Specific to ICU - Specific procedures - Major HAI **Specific viruses:** - Norovirus outbreaks - COVID-19 hospital transmission - Specific procedures - Specific to circumstances ## Liability theories **Multiple potential claims:** **Medical malpractice:** - Negligent care - Specific procedures violated - Specific standards - Specific to provider **Hospital negligence:** - Inadequate infection control - Specific procedures - Inadequate staffing - Specific systemic issues **Product liability:** - Defective devices (catheters, etc.) - Specific procedures - Specific manufacturers - Specific issues **Negligent hiring / retention:** - Inadequate staff training - Specific to systemic issues - Specific procedures - Specific evidence ## Causation challenges **Difficult to prove:** **Requirements:** - Patient developed infection - Infection caused by hospital practices - Hospital practices below standard - Damages caused by infection **Common challenges:** - Pre-existing colonization - Specific to patient factors - Specific to circumstances - Causation issues **Strong evidence:** - Negative culture at admission - Specific to acquisition - Specific to timing - Specific evidence ## Standard of care **Key elements:** **Infection control protocols:** - Hand hygiene - PPE use - Specific procedures - Specific to facility - CDC + WHO standards **Staffing requirements:** - Adequate ratios - Specific to acuity - Specific procedures - Specific to ${s.name} **Equipment standards:** - Specific to maintenance - Specific cleaning - Specific procedures - Specific to types **Specific protocols:** - Surgical site preparation - Catheter insertion + care - Ventilator care - Specific procedures - Specific to type **Reporting + tracking:** - Internal reporting - CDC reporting (NHSN) - Specific procedures - Specific to types - Public reporting in some states ## Critical evidence **Medical records:** - Complete hospital records - Specific to admission - Specific procedures - Lab results - Treatment records **Cultures:** - Admission cultures - During-stay cultures - Discharge cultures - Specific to evidence - Specific to causation **Hospital infection control:** - Policies + procedures - Specific to compliance - Training records - Specific to staff - Specific to circumstances **Staff records:** - Specific to assignments - Specific to training - Specific to compliance - Specific to procedures **Reportable infections:** - Internal reporting - External reporting - Specific to procedures - Specific to types **Expert witnesses:** - Infectious disease specialist - Infection control expert - Hospital administration expert - Specific to circumstances - Standard of care expert ## Damages **Compensatory:** **Past + future medical:** - Specific to infection treatment - Specific to long-term care - Specific to amputations sometimes - Specific to permanent damage - Specific procedures **Past + future lost wages:** - Specific to time off - Specific to disability - Specific to circumstances - Specific to earning capacity **Pain & suffering:** - Specific to infection course - Specific to ongoing effects - Specific to permanent damage - Specific to circumstances **Wrongful death** (when killed): - Specific to family losses - Specific procedures - Specific to ${s.name} - Specific damages **Specific to circumstances:** - Disfigurement (amputations sometimes) - Specific to long-term effects - Specific to mental anguish - Specific to PTSD ## Sepsis cases **Particularly serious:** **Severity:** - 30%+ mortality rate (severe sepsis) - Permanent organ damage often - Long-term effects - Specific to circumstances **Liability theories:** - Failure to recognize - Failure to treat promptly - Specific to delay - Specific to procedures **Damages typical:** - Significant amounts - Specific to severity - Specific to permanent damage - Specific to wrongful death ## Surgical site infections **Specific category:** **Common issues:** - Inadequate prep - Specific to procedures - Specific to staff - Specific to compliance **Standard of care:** - Specific protocols - Specific to procedures - Specific to environment - Specific procedures **Evidence:** - Operating room records - Specific to staff - Specific to procedures - Specific to compliance ## Statute of limitations **${s.name}-specific:** - Generally 1-3 years - Discovery rule applications - Specific to medical malpractice - Different from general PI **Discovery rule:** - From discovery of infection cause - Specific to circumstances - Specific procedures - Specific to ${s.name} **Specific:** - ${s.name} medical malpractice rules - Specific procedures - Specific to circumstances - Specific deadlines ## Pre-suit requirements **${s.name} medical malpractice:** - Pre-suit notice - Specific procedures - Affidavit of merit - Expert review - Specific to ${s.name} **Specific to circumstances:** - Specific procedures - Specific to claims - Specific deadlines - Strict enforcement ## Common defenses **Hospital defenses:** **1. Pre-existing infection:** - Patient brought infection - Specific to colonization - Specific evidence - Strong defense if established **2. Standard of care met:** - Followed protocols - Specific procedures - Specific compliance - Specific evidence **3. Causation:** - Patient factors - Specific to circumstances - Specific to evidence - Specific to outcomes **4. Inevitable infection:** - Some infections occur despite proper care - Specific to circumstances - Specific to evidence - Limited defense **5. Patient non-compliance:** - Specific to circumstances - Specific to procedures - Specific to behavior - Specific evidence **6. Acceptable risk:** - Some procedures inherently risky - Specific to circumstances - Informed consent - Specific to procedures ## Strategic considerations **For plaintiffs:** - Get medical records immediately - Preserve cultures + samples - Document all symptoms + treatment - Specific to admission + discharge - Hire experienced medical malpractice attorney - Specific to HAIs - Strong expert witnesses - Strong causation evidence **For hospitals:** - Strong infection control policies - Specific procedures - Compliance documentation - Specific to staff - Adequate staffing - Specific to circumstances ## Insurance considerations **Hospital insurance:** - Generally substantial coverage - Specific to claims - Specific procedures - Strong incentive to settle **Health insurance subrogation:** - Patient's insurance pays initially - Subrogation rights - Specific procedures - Specific to recovery **Medicare / Medicaid:** - Specific subrogation - Significant for elderly patients - Specific procedures - Specific to ${s.name} ## Recent developments **Issues + trends:** **COVID-19 impact:** - Hospital-acquired COVID - Specific to circumstances - Specific to nursing homes - Specific procedures **Antibiotic resistance:** - More resistant infections - Specific to MRSA + CRE - Specific to procedures - Treatment challenges **Public reporting:** - More states require - Specific to data - Specific to procedures - Strategic implications **CMS pay-for-performance:** - Hospital reimbursement reduced for HAIs - Specific to procedures - Specific to incentives - Major financial implications ## What you should do If you (or family member) suffered hospital-acquired infection in District of Columbia: get all medical records immediately, preserve evidence, hire experienced medical malpractice attorney with HAI experience. Most District of Columbia medical malpractice attorneys work on contingency. Free consultations standard. Causation key issue. Strong expert witnesses essential. --- *This guide is general information about District of Columbia law as of mid-2026 and is not legal advice. HAI cases are technical + medical-evidence dependent. Talk to a licensed District of Columbia medical malpractice attorney about your specific situation.*