Zaami Simona, Montanari Vergallo Gianluca, Napoletano Simona, Signore Fabrizio, Marinelli Enrico
a Department of Anatomical, Histological, Forensic and Orthopaedic Sciences , Sapienza University of Rome , Rome , Italy.
b Department of Obstetrics and Gyneacology , San Camillo Hospital , Rome , Italy.
J Matern Fetal Neonatal Med. 2018 Jan;31(2):223-227. doi: 10.1080/14767058.2017.1281243. Epub 2017 Jan 31.
Delivery room infections are frequent, and many of them could be avoided through higher standards of care. The authors examine this issue by comparing it to English and French reality. Unlike England, in Italy and France the relationship established between health facility, physician and patient is outlined in a contract. In England, the judges' decisions converge toward a better and higher protection of the patient-the actor-and facilitate the probative task. In case of infections, including those occurring in the delivery room, three issues are evaluated: the hospital's negligent conduct, damages if any and causal nexus. Therefore, the hospital must demonstrate to have taken the appropriate asepsis measures according to current scientific knowledge concerning not only treatment, but also diagnosis, previous activities, surgery and post-surgery. In order to avoid a negative sentence, both physicians and hospital have to demonstrate their correct behavior and that the infection was caused by an unforeseeable event. The authors examine the most significant rulings by the Courts and the Supreme Court. They show that hospitals can avoid being accused of negligence and recklessness only if they can demonstrate to have implemented all the preventive measures provided for in the guidelines or protocols.
产房感染很常见，其中许多感染可以通过更高的护理标准来避免。作者通过将其与英国和法国的实际情况进行比较来研究这个问题。与英国不同，在意大利和法国，医疗机构、医生和患者之间建立的关系在一份合同中有所概述。在英国，法官的裁决趋向于更好、更高程度地保护患者——即行为主体——并便于进行举证工作。在发生感染的情况下，包括在产房发生的感染，要评估三个问题：医院的过失行为、如有损害以及因果关系。因此，医院必须证明其已根据当前关于治疗、诊断、先前活动、手术及术后的科学知识采取了适当的无菌措施。为了避免不利判决，医生和医院都必须证明自己行为正确，且感染是由不可预见的事件引起的。作者研究了法院和最高法院的最重要裁决。他们表明，医院只有在能够证明已实施指南或协议中规定的所有预防措施时，才能避免被指控疏忽和鲁莽行事。
