Medico-legal limits in healthcare-associated infections

01 / Abstract

Context and purpose.

This paper examines the capabilities and limitations of forensic physicians when assessing infections suspected or confirmed to be associated with healthcare. It distinguishes evidence of infection and its contribution to death from epidemiological classification, identification of the source and assessment of possible shortcomings in care.

The review considers autopsy, histology and post-mortem microbiology, the roles of clinical specialties and public health bodies, and practice in Romania, the United Kingdom, the United States, Germany, France and Italy. It proposes a staged reasoning model separating infection, healthcare association, departure from the standard of care and two causal relationships: departure–infection and infection–death.

02 / Key findings

Conclusions to retain.

1. 01Autopsy can document the focus and effects of infection, but cannot alone identify its place of acquisition or chain of transmission.
2. 02Post-mortem microbiology requires correlation with clinical and histological findings and the risks of contamination.
3. 03Medico-legal assessment integrates epidemiological evidence and specialist input; it does not replace an outbreak investigation or sanitary inspection.
4. 04The paper distinguishes healthcare association from preventability, departure from the standard of care and causal attribution of harm.

03 / Structure

What the paper examines.

1. 01Purpose, methodology and terminology
2. 02Clinical diagnosis, epidemiological surveillance and medico-legal conclusions
3. 03Romanian institutions and professional responsibilities
4. 04Autopsy, post-mortem microbiology and sepsis
5. 05Origin of infection, reporting and limits of hospital inspection
6. 06International comparison and the first summary table
7. 07Device- and procedure-associated infections; clinical scenarios
8. 08Causal reasoning and the second comparative table
9. 09Individual and institutional shortcomings; levels of certainty
10. 10Suggested expert wording, conclusions and unified references

04 / Full paper

Read or download.

The complete scientific paper, including its tables, conclusions and references, is available in Romanian.

05 / Citation and use

Suggested reference.

Chiriac S. Limitele medico-legale în infecțiile asociate asistenței medicale [Medico-legal limits in healthcare-associated infections]. Critical medico-legal review. September 2026. Romanian original.

Scientific and educational review material. Substantial reproduction requires acknowledgement of the source; conclusions must be interpreted in the full context of the paper and its references.