Healthcare-associated infections and medical malpractice claims in the Veneto Region (2010–2024): a retrospective analysis of regional claims data

BACKGROUND: Healthcare-associated infections (HAIs) are a major clinical and medico-legal concern, as they are associated with increased morbidity, mortality, and healthcare costs. Severe HAIs may lead to malpractice claims related to failures in prevention or management. Although compensation claims capture only a fraction of HAI episodes, they mainly reflect the most serious cases and provide relevant clinical and medico-legal information. This study analyses trends in malpractice compensation claims related to HAIs in the Veneto Region (Italy). METHODS: A retrospective analysis of medical malpractice claims was conducted using data from the Healthcare Error Monitoring Information System (HEMIS) in the Veneto Region (Italy) from 2010 to 2024. Claims related to healthcare-associated infections were classified by patient outcome, site of infection, and healthcare setting. Trend analyses were performed using three-year aggregated periods, and descriptive statistics were applied. RESULTS: Among 19,380 medical malpractice claims filed over 15 years in the Veneto Region, 1,106 (5.7%) concerned HAIs. While overall claims declined over time, HAI-related claims increased both in absolute terms and proportionally. Non-fatal injuries accounted for 73.9% of HAI-related claims, whereas death-related claims rose from < 10% to > 40% over the study period. Surgical site infections were the most frequent, while bloodstream and respiratory tract infections predominated among death-related claims, the latter largely driven by SARS-CoV-2. Of 561 closed claims, 57.0% resulted in compensation, and total HAI-related compensation amounted to EUR 36.7 million, evenly distributed between death and non-fatal injury cases. CONCLUSIONS: HAI-related medical malpractice claims showed a distinct increasing trend over time, contrasting with the decline observed for overall claims, and accounted for a growing proportion of death-related cases. These findings highlight the medico-legal relevance of healthcare-associated infections and support the need for strengthened infection prevention strategies and risk management policies within healthcare systems.