感染性心内膜炎和医疗保健相关感染赔偿诉讼：意大利样本分析

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine Pub Date : 2025-04-04 DOI:10.1016/j.jflm.2025.102861

Livio Pietro Tronconi , Giuseppe Basile , Elisa Mikus , Luca Bianco Prevot , Carlo Savini , Gerardo Vito Lo Russo , Diego Sangiorgi , Vittorio Bolcato

{"title":"感染性心内膜炎和医疗保健相关感染赔偿诉讼：意大利样本分析","authors":"Livio Pietro Tronconi , Giuseppe Basile , Elisa Mikus , Luca Bianco Prevot , Carlo Savini , Gerardo Vito Lo Russo , Diego Sangiorgi , Vittorio Bolcato","doi":"10.1016/j.jflm.2025.102861","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Litigation related to Healthcare-Associated Infections (HAIs) in Italy represent a growing field of interest in establishing the medico-legal link between infection and the healthcare environment and practices for compensation; it is little explored in the cardiovascular surgery regarding infective endocarditis (IE).</div></div><div><h3>Methods</h3><div>We retrospectively analysed the civil judgements on infective endocarditis in the Italian region Emilia-Romagna from 2016 to July 2024 using Ministry of Justice national official database. The search was conducted on the online database on July 31, 2024, using the free word \"endocarditis”. Two authors independently analysed the full-text judgements: , those IE without relevance in the reason for the claim were excluded. Main items were the timeline and outcome, with complaint motivation and liability ascertainment. In-court confirmation of healthcare causal link was reported.</div></div><div><h3>Results</h3><div>Twenty-five judgments were retrieved. After screening for inclusion, nineteen judgements (11 of first instance and 8 of appeal) were included, for overall 15 cases of infective endocarditis. Of the fifteen cases, median age 60.5 years, 73 % males, median time for claim 6 years, for judgement 10 years and, if appealed, 16.5 years. Annual distribution of the claims was linear over time. Eleven (67 %) infective endocarditis were confirmed as healthcare-associated in trial. The prevalent reason for liability was improper or delayed diagnosis and/or treatment of the IE. Valvular surgery resulted in 40 %, while the more frequent pathogens were <em>Staphylococcus aureus</em> (40 %) and epidermidis (30 %). Of fifteen cases, 73 % was decided in favour of the patient-claimant, with an average cost of €289.872, plus an additional €55.296 in case of appeal. Only in 25 % the appeal's judge changed decision. In all cases, technical advisors were appointed.</div></div><div><h3>Conclusions</h3><div>This sample provides an initial insight into litigation for compensation related to infective endocarditis, highlighting specific characteristics compared to HAIs management in court. Medico-legal reasoning should be integrated into infection prevention and control policies and overall clinical risk management strategies.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"113 ","pages":"Article 102861"},"PeriodicalIF":1.2000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Infective endocarditis and litigation for compensation on healthcare-associated infections: An Italian sample analysis\",\"authors\":\"Livio Pietro Tronconi , Giuseppe Basile , Elisa Mikus , Luca Bianco Prevot , Carlo Savini , Gerardo Vito Lo Russo , Diego Sangiorgi , Vittorio Bolcato\",\"doi\":\"10.1016/j.jflm.2025.102861\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Litigation related to Healthcare-Associated Infections (HAIs) in Italy represent a growing field of interest in establishing the medico-legal link between infection and the healthcare environment and practices for compensation; it is little explored in the cardiovascular surgery regarding infective endocarditis (IE).</div></div><div><h3>Methods</h3><div>We retrospectively analysed the civil judgements on infective endocarditis in the Italian region Emilia-Romagna from 2016 to July 2024 using Ministry of Justice national official database. The search was conducted on the online database on July 31, 2024, using the free word \\\"endocarditis”. Two authors independently analysed the full-text judgements: , those IE without relevance in the reason for the claim were excluded. Main items were the timeline and outcome, with complaint motivation and liability ascertainment. In-court confirmation of healthcare causal link was reported.</div></div><div><h3>Results</h3><div>Twenty-five judgments were retrieved. After screening for inclusion, nineteen judgements (11 of first instance and 8 of appeal) were included, for overall 15 cases of infective endocarditis. Of the fifteen cases, median age 60.5 years, 73 % males, median time for claim 6 years, for judgement 10 years and, if appealed, 16.5 years. Annual distribution of the claims was linear over time. Eleven (67 %) infective endocarditis were confirmed as healthcare-associated in trial. The prevalent reason for liability was improper or delayed diagnosis and/or treatment of the IE. Valvular surgery resulted in 40 %, while the more frequent pathogens were <em>Staphylococcus aureus</em> (40 %) and epidermidis (30 %). Of fifteen cases, 73 % was decided in favour of the patient-claimant, with an average cost of €289.872, plus an additional €55.296 in case of appeal. Only in 25 % the appeal's judge changed decision. In all cases, technical advisors were appointed.</div></div><div><h3>Conclusions</h3><div>This sample provides an initial insight into litigation for compensation related to infective endocarditis, highlighting specific characteristics compared to HAIs management in court. Medico-legal reasoning should be integrated into infection prevention and control policies and overall clinical risk management strategies.</div></div>\",\"PeriodicalId\":16098,\"journal\":{\"name\":\"Journal of forensic and legal medicine\",\"volume\":\"113 \",\"pages\":\"Article 102861\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-04-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of forensic and legal medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1752928X25000629\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, LEGAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of forensic and legal medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1752928X25000629","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, LEGAL","Score":null,"Total":0}

引用次数: 0

摘要

背景：在意大利，与医疗保健相关感染（HAIs）相关的诉讼在建立感染与医疗保健环境和赔偿做法之间的医学-法律联系方面日益受到关注；关于感染性心内膜炎（IE）的心血管外科研究很少。方法回顾性分析2016年至2024年7月意大利艾米利亚-罗马涅地区感染性心内膜炎民事判决书。搜索于2024年7月31日在在线数据库上进行，使用自由词“心内膜炎”。两位作者独立分析了全文判决：那些与索赔理由无关的IE被排除在外。主要项目是时间和结果，投诉动机和责任确定。法庭确认了医疗保健因果关系。结果共检索裁判文书25份。经筛选纳入，共纳入15例感染性心内膜炎19例判决（一审11例，上诉8例）。在这15起案件中，年龄中位数为60.5岁，73%为男性，索赔时间中位数为6年，判决时间中位数为10年，上诉时间中位数为16.5年。索赔的年度分布随时间呈线性。在试验中，11例（67%）感染性心内膜炎被确认为与医疗保健相关。造成责任的主要原因是IE的诊断和/或治疗不当或延误。瓣膜手术导致40%，而更常见的病原体是金黄色葡萄球菌（40%）和表皮球菌（30%）。在15起案件中，73%的判决有利于患者索赔人，平均费用为289.872欧元，再加上上诉的额外费用55.296欧元。只有25%的上诉法官改变了判决。在所有情况下都任命了技术顾问。结论：该样本提供了与感染性心内膜炎相关的赔偿诉讼的初步见解，突出了与HAIs在法庭上管理相比的具体特点。应将医学-法律推理纳入感染防控政策和临床整体风险管理战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Infective endocarditis and litigation for compensation on healthcare-associated infections: An Italian sample analysis

查看原文本刊更多论文

Infective endocarditis and litigation for compensation on healthcare-associated infections: An Italian sample analysis

Background

Litigation related to Healthcare-Associated Infections (HAIs) in Italy represent a growing field of interest in establishing the medico-legal link between infection and the healthcare environment and practices for compensation; it is little explored in the cardiovascular surgery regarding infective endocarditis (IE).

Methods

We retrospectively analysed the civil judgements on infective endocarditis in the Italian region Emilia-Romagna from 2016 to July 2024 using Ministry of Justice national official database. The search was conducted on the online database on July 31, 2024, using the free word "endocarditis”. Two authors independently analysed the full-text judgements: , those IE without relevance in the reason for the claim were excluded. Main items were the timeline and outcome, with complaint motivation and liability ascertainment. In-court confirmation of healthcare causal link was reported.

Results

Twenty-five judgments were retrieved. After screening for inclusion, nineteen judgements (11 of first instance and 8 of appeal) were included, for overall 15 cases of infective endocarditis. Of the fifteen cases, median age 60.5 years, 73 % males, median time for claim 6 years, for judgement 10 years and, if appealed, 16.5 years. Annual distribution of the claims was linear over time. Eleven (67 %) infective endocarditis were confirmed as healthcare-associated in trial. The prevalent reason for liability was improper or delayed diagnosis and/or treatment of the IE. Valvular surgery resulted in 40 %, while the more frequent pathogens were Staphylococcus aureus (40 %) and epidermidis (30 %). Of fifteen cases, 73 % was decided in favour of the patient-claimant, with an average cost of €289.872, plus an additional €55.296 in case of appeal. Only in 25 % the appeal's judge changed decision. In all cases, technical advisors were appointed.

Conclusions

This sample provides an initial insight into litigation for compensation related to infective endocarditis, highlighting specific characteristics compared to HAIs management in court. Medico-legal reasoning should be integrated into infection prevention and control policies and overall clinical risk management strategies.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of forensic and legal medicine MEDICINE, LEGAL-

CiteScore

2.70

自引率

6.70%

发文量

106

审稿时长

57 days

期刊介绍： The Journal of Forensic and Legal Medicine publishes topical articles on aspects of forensic and legal medicine. Specifically the Journal supports research that explores the medical principles of care and forensic assessment of individuals, whether adult or child, in contact with the judicial system. It is a fully peer-review hybrid journal with a broad international perspective. The Journal accepts submissions of original research, review articles, and pertinent case studies, editorials, and commentaries in relevant areas of Forensic and Legal Medicine, Context of Practice, and Education and Training. The Journal adheres to strict publication ethical guidelines, and actively supports a culture of inclusive and representative publication.