Avoidable MRSA infection

The claimant was referred to hospital to investigate rectal bleeding which revealed a small colonic polyp. This was removed and the pathology confirmed an adenocarcinoma so the claimant was advised to undergo a sigmoid colectomy.

When the claimant was admitted to hospital for the elective sigmoid colectomy, he was advised by admitting staff that an earlier ear swab taken at his GP surgery for otitis externa had been reported as being MRSA positive. Further swabs were taken of his nose and groin area and the claimant was reassured. Instead of following the Trust’s own infection control department policy and MRSA protocols, surgery went ahead even though it was non-urgent and postponing it would not have affected the claimant’s underlying condition.

The surgery itself was uneventful. However, a couple of days after the operation, the claimant began to deteriorate. Blood cultures grew staphylococcus and the microbiologist advised treatment for MRSA. Subsequent cultures confirmed the growth of MRSA and IV therapy for 1 to 2 weeks was recommended. Ten days after his initial surgery the claimant was returned to theatre for a laparotomy and wound wash out which was performed under epidural anaesthesia. The claimant was discharged from hospital one month after his original procedure.

Unfortunately, the claimant was re-admitted a month later as an emergency, experiencing fever and vomiting. A spinal abscess was diagnosed. He had neurological signs, an unsteady gait and some signs of renal failure caused by the antibiotic therapy required. The claimant was responding well to conservative therapy and the neurosurgeons advised that no operative intervention was necessary. He was then placed on a prolonged course of antibiotics. He was ultimately discharged from hospital wearing a spinal brace. He made good progress and ultimately was advised that he no longer needed the brace and was discharged from follow-up.

On a balance of probability, if the surgical team had sought advice from the medical microbiology department once the positive MRSA swab was noted, the claimant’s elective procedure would have been deferred for MRSA decolonisation/clearance treatment regime. There would have been a successful decolonisation of the MRSA from the nose and skin and the MRSA septicaemia together with the complication of the spinal epidural abscess and the claimant’s stormy course of recovery would have been avoided.

The defendant denied liability so proceedings were issued and served. The defendant subsequently admitted that steps should have been taken to clear the claimant’s MRSA prior to surgery. Shortly after this, the claim settled.

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