600.000 € compensation to be paid by Evangelismos hospital in Athens for patient death due to infection in the intensive care unit. The case is very important because 1,000 patients are estimated to die in Greece every year from this cause. This high number ranks Greece in a distinctive negative position within European Union. It is estimated that in European Union 37,000 people die each year due to such causes.
Such infections occur at least 48 hours after hospital admission (if they were not in the incubation stage), up to 5 days after leaving the hospital or 30 days after surgery. When medical devices are implanted (e.g., orthopedic prostheses, cardiac valves, cerebrospinal fluid shunt) the time of occurrence of hospital infections extend up to one year after placement. It is estimated that around 20-30% of the cases could be prevented by measures of infection prevention and control.
Of course the conditions of each case should be considered carefully, including a precise analysis of patient's condition and the exact treatment received by the hospital and the medical personnel.
600.000 € for death of a patient at Evangelismos hospital.
The 48 year old man died due to a nosocomial infection although the operation which he undertook was... successful. 1,000 patients die each year in hospitals from the same cause.
A judicial decision which for the first time hold liable a large hospital of Attica constitutes a slap in the face of the Greek National Health Care System because they did not take the measures, as was required, resulting in a patient having an infection which proved fatal for his life. The decision, which is now presented by "Proto Thema" newspaper, opens the Aeolus sacs for judicial claims, since each year at least 250,000 patients in hospitals suffer from infections connected with hospital treatment.
The 16 pages court decision illustrating the morbid, infectious picture of Greek National Health Care System gives to our country a European negative first to deaths from infections within hospitals. It is not very long ago the approach of the European Centre for Disease Prevention of Infections, putting Greek patients in quarantine when due to be treated in hospitals in Europe. The Greeks patients are considered as "germs exporters" and therefore they must be isolated!
Now, the decision published by the Administrative Court of Appeal of Athens describes exactly this situation, namely the spread of germs in the wards and departments of hospitals, and records the omissions of authorities with regard to addressing them- from nurses obeying the rules of health to means of sterilization. In this case Greek justice is a catapult for Greek National Health Care System's flagship, Evangelismos hospital, in which Intensive Care Unit the 48 years old man lost his life while hospitalized. The unlucky man was entered in June 2005 at the Neurosurgical Clinic of the hospital to undergo a "nerve decompression surgery". The operation was conducted by the Head of the clinic with success, and then the patient was admitted to the Intensive Care Unit, as required to such serious interventions. The first four days after the operation his condition gradually improved and the 48 years old man had full contact with his relatives. On the fifth, however, day of the hospitalization, his health deteriorated rapidly. The patient was intubated, however, he had unexpectedly high fever and within three hours he died from cardiac arrest. The autopsy showed that his death occurred due to meningitis.
Considering that the loss resulted from omissions of medical and nursing staff, the relatives of the unfortunate man went to court claiming compensation. In their lawsuit, they argued that the necessary hygiene measures were not undertaken, before and after the operation, that there was no master seed from the drainage of the wound in order to identify the microbe and that medical staff failed to strengthen or change the antibiotic treatment administered.
Doctors who testified as witnesses in court spoke of a breach the surgical operations, stating inter alia that the 48 years old man died because the microbes " invaded" his organization "from the surrounding operating theatre and surgical tools. Also, witnesses testified that the doctors treating the man did not suspected meningitis, as they should have, resulting to leaving him unprotected through drugs.
Indeed, both scientists who testified as witnesses and experts appointed by the court, have referred to the low dose of antibiotics given to the patient. While bacterial meningitis administers doses of 4 and 6 grams per day, in this case they granted an antibiotic of 1 gram twice a day!
The rationale of the decision
Evaluating the information provided to the Court, as certified by the Head Professor and Surgeon, records of hospitalization and drugs etc., as well as the testimony of scientists, the judges awarded the relatives, his wife, his two children, his mother and his brother a total compensation amounting to € 600,000 for solatium ( mental anguish). The fact that the same amount was awarded by the Court of First Instance is remarkable and rare, as well as the fact that the hospital rushed to pay the amount even before the expiration of the time limits prescribed by law.
In their decision (1239/2015) the judges deem that there are "illegal omissions of the medical and nursing staff". This is because "the emergence of bacterial meningitis after surgery is a presumption of fault as to the compliance with the rules of hygiene and disinfection (sterilization) of hospital sites and proof that even in the case that strict measures had been taken, they have not provided sufficiently safe outcome for the patient, since he ultimately suffered a post-operative wound infection and further generalized infection of his organs from microbial meningitis within the hospital due to not perfect sterilization in their area"
The final decision by levying blame on the medical staff because "in violation of medical science and ethics, did not master seed the fluids of the drainage of the wound that could reveal the kind and sensitivity of the microbe and define the appropriate antimicrobial therapy and dosage, i.e. either to increase the dosage or take another antimicrobial medication".
Greece keeps black scepters in Europe both the indices of nosocomial infections and antibiotic consumption. Three are the microbes responsible for hospital acquired infections: Klebsiella, Acinetobacter and Pseudomonas. These multi-resistant germs cause every year 250,000 infections in hospital patients, of whom 5,000 are very serious, while they have a fatal outcome more than 1,000 patients.