What to Do if a Hospital Makes You Sick

Hospitals are completely sterile environments, right? Wrong. According to a new study, over 12 percent of hospital liability claims are associated with infections, injuries and other conditions that patients contracted – in the hospital itself.

Details of the Study

The 2008 Hospital Professional Liability and Physician Liability Benchmark Analysis, conducted by the Aon Corporation and the American Society for Healthcare Risk Management, looked at nearly 78,000 claims from over 1,200 medical facilities that resulted in $9.3 billion in losses. It concentrated on four areas, 1) hospital-acquired infections, 2) injuries, 3) pressure ulcers and 4) foreign objects left in the body, and concluded that these areas constituted 12.2 percent of hospital liability costs. In other words, the hospital you go to for treatment may actually be making you sick.

When Insurers & Medicare Won't Pay

As an unfortunate result of increasing hospital liability claims, more and more insurers are refusing to cover them. In fact, according to news reports, Aetna, Blue Cross Blue Shield, CIGNA and WellPoint Inc. have already said as much. Known as "never claims," because they should never occur in a hospital setting, insurers aren’t the only ones who are refusing to pay. As of October 1 2008, Medicare will no longer pay for these types of claims that it says are “reasonably preventable" conditions. These include medication errors, incompatible blood transfusions, post operative infections, bedsores, urinary tract infections and others.

Who Is Responsible?

If the hospital made you sick, who’s responsible for your injuries? Let’s say you’re admitted to the hospital for surgery. While recuperating, you develop an infection and additional medical attention. If the hospital says the infection was not the result of hospital conditions, but your insurer or Medicare says that it was, where does that leave you? More likely than not – in the middle.

If you find yourself in this position – with unpaid medical bills threatening your budget and potentially your credit score – and can’t get either side to budge, you may want to contact an attorney to discuss your situation. In addition to the possibility that the hospital may be responsible for hospital malpractice – hospitals, insurance companies and Medicare have specific guidelines regarding these situations. An experienced attorney will be able to obtain these guidelines, determine who might be responsible and assess your options. Click here to contact a medical malpractice lawyer near you. Consultations are free, without obligation and are strictly confidential.