I have long been amazed by the rate of hospital injuries from preventable bloodstream infections. While there have been a few lawsuits, hospitals appear to have avoided liability for these preventable illnesses. Now, a study in the American Journal of Medical Quality suggests that the situation may be worse than anticipated. Not only is that not a strong litigation deterrent (my view), but this study says that hospitals are actually making a killing by making patients sick. Researchers found that an ICU patient who develops an avoidable central line-associated bloodstream infection (CLABSI) costs nearly three times more to care for than a similar infection-free patient. Here is the most amazing fact: hospitals earn nearly nine times more for treating infected patients.
It is insurance companies who end up getting hit with the bill as well as patients, of course. This is not to mention those patients who become gravely ill or die from this preventable illness.
Private insurers pay the most for patient stays complicated by CLABSIs — roughly $400,000 per hospital stay. That fact could add pressure to hospitals to act reasonably in avoidance of such illness. Currently, there is a surprisingly high economic incentive not to avoid such illness, even if the doctors are morally bound to do so.
The CLABSI infections occur when thin plastic tubes, or central lines, are placed in ICU patients. Each year roughly 80,000 patients with central lines become infected. Now consider that hospital’s average profit margin for treating an infected patient was $54,906 in comparison to an uninfected patient of just $6,506. You do the math. That is a huge amount of income.
Worse yet, the failure to avoid the contamination kills 28,000 people a year. Simple checklists at hospitals have been shown to sharply decrease such contamination. In torts, we often use the Hand formula to determine negligence: B < PL. B stands for burden; P stands for probability, and L stands for loss. When the B is lower than the PL, negligence is generally present. In this case, the B would seem low while both the P and L are high. Normally, that would result in not just negligence but potential punitive damages.
Tens of thousands of people are dying from this preventable illness but relatively little has been done by the government to force new measures or accountability. This is why litigation is sometimes the most direct way to deterring negligence and giving an incentive to take precautionary measures in environments like hospitals.