MRSA – The Interview

The following is the transcript of a telephone interview on “The Breakfast Showâ€? on Newstalk Radio, broadcast at 7.10 am on 13th September 2007.

The transcript is a free interpretation of what was said and has been subject to Ciceronian editing (in other words I have changed what was said to what might and should have been said). (The interview ended abruptly and prematurely, leaving the impression that the interviewer had to answer a call of nature).(I have had time, too, to change out of my pyjamas).

INTERVIEWER: The Ryan family of Cork have issued proceedings in respect of the death of Mr. Ryan in a Cork hospital in 2002. An inquest held last November found he had died from MRSA. Does this indicate there will be a flood of such cases coming before the courts?

SELF: I don’t think so. The point about the Ryan case is that the inquest made a finding that the deceased died of a particular form of MRSA – MRSA bacteraemia, which is a form of blood poisoning. That’s a notifiable disease; other forms of MRSA are not. The Ryan family, like all Plaintiffs must prove negligence against the defendants.

INTERVIEWER: The newspaper report confirms that there will be many such cases taken?

SELF: The newspaper report also states that the case “alleges the pensioner died after contracting the superbug through contributory negligence”. Contributory negligence is what a Plaintiff is found to be guilty of, not a defendant.

I would like to re-capitulate about MRSA. MRSA is a variant of a relatively common bacterium. It is overwhelmingly a nosocomial infection; that is, it is contracted in a health care setting. It is a hospital hygiene issue. Hygiene is a management issue, not a medical issue. That means that the wrongful infection of a person by MRSA in a hospital setting is a matter of ordinary negligence and not a matter of medical negligence. The standard is different in each case.

INTERVIEWER: Are there other difficulties facing the Plaintiffs in the action?

SELF: Proof of ordinary negligence is easier than proof of medical negligence. A potential difficulty, I think, is the effect of the Statute of Limitations. Under the Civil Liability and Courts Act 2004 (brought in by Mr. McDowell) the period within which proceedings must be issued for personal injuries was reduced from three years to two years. The Plaintiffs, in the instant case, may argue that time did not begin to run until they got the result of the inquest; that is, that they did not know who had caused the death of Mr. Ryan until then.

INTERVIEWER: Do they have any advantages?

SELF: Not particularly. Every Plaintiff suing in respect of MRSA infection faces a number of irrational distinctions. There is the, to my mind, irrelevant distinction between MRSA infection of the blood and other locations for the infection. On the point of dangers from biological agents; the staff of a hospital are specifically protected by Statutory Instrument from biological agents at work. There is no such provision made to protect patients. Arguably Section 30 of the Health Act 1947 is a protection to patients, but arguably it is not. It reads as follows:

30. —(1) A person who knows that he is a probable source of infection with an infectious disease shall, in addition to taking the precautions specifically provided for by or under this Part of this Act, take every other reasonable precaution to prevent his infecting others with such disease by his presence or conduct or by means of any article with which he has been in contact.

(2) A person having the care of another person and knowing that such other person is a probable source of infection with an infectious disease shall, in addition to the precautions specifically provided for by or under this Part of this Act, take every other reasonable precaution to prevent such other person from infecting others with such disease by his presence or conduct or by means of any article with which he has been in contact.

(3) A person who contravenes subsection (1) or (2) of this section shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding fifty pounds,

In any event, if it applies, it applies to staff as well as patients. So, staff are more protected than patients.