Hospital-Acquired Sepsis in Oregon: Suing the Hospital

Hospitals are where people go to get well, but they are also where some serious infections happen. The Centers for Disease Control and Prevention reports that on any given day, about 1 in 38 hospital patients has at least one healthcare-associated infection.¹ Some of those infections turn into sepsis, and without fast treatment, sepsis can quickly lead to organ failure and death.²

When a patient enters an Oregon hospital with an unrelated condition and leaves with sepsis caused by a hospital-acquired infection — or never leaves at all — the family often wants to know what the law says about hospital accountability. This post explains how Oregon medical-malpractice law treats institutional liability for hospital-acquired sepsis, the special rules that apply to public hospitals under the Oregon Tort Claims Act, and the deadlines that govern those claims.

How hospitals cause sepsis

Healthcare-associated infections (HAIs) are infections that patients get while or soon after receiving health care, from a bloodstream infection introduced by a central line to a surgical-site infection caused by contamination during a procedure. CDC notes that HAIs can be caused by many different germs, and its examples of HAIs include central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), surgical-site infection (SSI), and ventilator-associated pneumonia (VAP).¹ The same CDC page lists methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile (C. diff) among its related topics.¹

An HAI can lead to sepsis, which CDC describes as "the body's extreme response to an infection." In CDC's words, "Sepsis happens when an infection you already have triggers a chain reaction throughout your body."² CDC lists low blood pressure, fever, increased heart rate, and trouble breathing among the physical findings providers use to diagnose sepsis, and it stresses that without fast treatment, sepsis can quickly lead to tissue damage, organ failure, and death.²

What makes hospital-acquired sepsis distinct is not the biology — sepsis is sepsis — but the setting. Patients who develop HAI-related sepsis may already be vulnerable: post-surgical, immunocompromised, on a ventilator or central line, or recovering from critical illness. They are also already inside the institution that is supposed to be monitoring them.

What the hospital owes its patients

In a hospital-acquired-sepsis case, questions about the hospital's care can have both a clinical component (what individual nurses, physicians, and respiratory therapists do at the bedside) and an institutional component (what the hospital does as a system to prevent and detect infections). CDC frames the institutional baseline this way: healthcare providers should always follow core infection-control practices to reduce the risk of spreading germs to patients.¹

Common institutional duties that come up in hospital-acquired-sepsis claims include:

• Hand-hygiene programs. Documented hand-hygiene policies, monitoring, and corrective action when compliance falls.
• Central-line and Foley-catheter bundles. Insertion checklists, daily review of necessity, and removal as soon as the line or catheter is no longer needed.
• Surgical-site infection prevention. Pre-operative skin preparation, perioperative antibiotic timing, sterile technique, and post-operative wound monitoring.
• Antibiotic stewardship. Programs that limit unnecessary antibiotic use. CDC notes that "HAIs are associated with medical devices, complications following surgery, transmission between patients and healthcare workers, antibiotic overuse, and more."¹
• MRSA and C. diff prevention protocols. Screening, isolation, and environmental cleaning practices specific to high-risk organisms.
• Sepsis screening and rapid response. Standing protocols for nurses to flag changes in vital signs, lactate, white-blood-cell counts, or mental status, and to activate a rapid-response team or sepsis bundle.

These institutional measures are usually documented in hospital policies and quality-improvement records. In a hospital-acquired-sepsis claim, those policies — and the records showing whether they were followed in the patient's case — often become central evidence.

When the standard of care is breached

Not every hospital-acquired infection is malpractice. Even a hospital that follows every published infection-prevention measure can still see HAIs in vulnerable patients. The legal question is generally whether the hospital — through its staff, systems, or policies — fell below the standard of care.

Common patterns that can support a claim include:

• Documented protocol breaches. A central-line infection occurs in a patient where the insertion checklist was skipped, sterile technique was not maintained, or the line was left in after it was no longer needed.
• Late sepsis recognition. Vital-sign changes consistent with early sepsis are recorded but not flagged or escalated; the patient deteriorates over hours before a rapid-response team is called.
• Antibiotic delay. Sepsis is suspected, but the time-stamped record shows the first dose of empiric antibiotics was hours later than the hospital's own protocol calls for.
• Outbreak with inadequate response. Multiple patients on the same unit develop the same organism within a short window, and the hospital's response — environmental cleaning, screening, isolation — was incomplete or delayed.
• Inadequate staffing. A patient who needed close monitoring did not get reassessed for hours because of nursing ratios or coverage gaps that fell below the institution's own published norms.

Whether any pattern falls below the standard of care depends on the specific facts and on testimony from qualified experts in infection control, hospital medicine, and nursing.

Public hospitals and the Oregon Tort Claims Act

Some Oregon hospitals are owned or operated by public bodies — county hospitals, university medical centers, or state-affiliated institutions. Claims against those facilities are governed by the Oregon Tort Claims Act, which sets its own notice requirements and its own filing deadline.

Under ORS 30.275(1), no action arising from an act or omission of a public body, or of its officers, employees, or agents, within the scope of the Act can be maintained unless notice of claim is given as the statute requires. Under ORS 30.275(2), notice must be given within one year after the alleged loss or injury for wrongful death, and within 180 days after the alleged loss or injury for all other claims, not counting a period of up to 90 days during which the injured person is unable to give notice because of the injury or because of minority, incompetency, or other incapacity.³ Notice can be satisfied in several ways the statute spells out — formal written notice, actual notice to the appropriate officials, filing a lawsuit within the applicable period, or payment by the public body — but the burden falls on the claimant to prove timely notice was given.³

Missing the OTCA notice deadline can bar a claim against a public hospital even when the two-year OTCA filing deadline under ORS 30.275(9) would still be open.³ That is why the public-vs-private status of the hospital is one of the first things a lawyer evaluating a hospital-acquired-sepsis case wants to confirm.

How long you have to file

For private-hospital claims, the medical-malpractice deadlines under ORS 12.110(4) apply. The action must be commenced within two years from the date when the injury is first discovered or in the exercise of reasonable care should have been discovered.⁴ In Gaston v. Parsons, 318 Or 247 (1994), the Oregon Supreme Court held that "injury," as used in ORS 12.110(4), "consists of three elements: (1) harm; (2) causation; and (3) tortious conduct." The court held that the period "begins to run when the plaintiff knows or in the exercise of reasonable care should have known facts which would make a reasonable person aware of a substantial possibility that each of the three elements (harm, causation, and tortious conduct) exists."⁵ In any event, the action must be commenced within five years from the date of the treatment, omission, or operation the action is based on, with a limited extension where fraud, deceit, or misleading representation kept an action from being filed within those five years.⁴

Public-hospital claims run on the OTCA's own two deadlines instead. Notice of claim must be given within the ORS 30.275(2) period: 180 days after the alleged loss or injury, or one year for wrongful death. And under ORS 30.275(9), except for a few statutes it lists, "notwithstanding any other provision of ORS chapter 12 or other statute providing a limitation on the commencement of an action," the action "shall be commenced within two years after the alleged loss or injury."³ That two-year OTCA period takes the place of the ORS 12.110(4) deadlines, and of the three-year wrongful-death period in ORS 30.020, for a claim within the scope of the Act.

What an attorney evaluates

When an Oregon attorney reviews a possible hospital-acquired-sepsis claim, the questions are usually:

• Was the infection genuinely hospital-acquired, or was it incubating at admission? (Microbiology timing matters.)
• What did the hospital's own infection-prevention policies require, and what does the record show was actually done?
• When did vital signs first suggest sepsis, and how quickly did staff escalate care, draw labs, and start antibiotics?
• Is the hospital public or private? If public, has the OTCA notice deadline already run, or is it still open?
• For a private hospital, are the deadlines under ORS 12.110(4) — and ORS 30.020 if the patient died — still open? For a public hospital, is the two-year period under ORS 30.275(9) still open?

These questions are evidence-driven. A hospital-acquired-sepsis case is sometimes the predictable result of a vulnerable patient and an unforgiving organism, and sometimes the result of system failures that experts can document. The honest way to answer is to pull the hospital's records, infection-control documentation, and staffing data and review them with experienced infection-control and hospital-medicine experts.

This article is educational

This article describes Oregon law in general terms. It is not legal advice and does not create an attorney-client relationship.

Time limits matter. Most Oregon personal-injury and auto-accident claims must be filed within two years of the injury or accident. Medical malpractice claims must be filed within two years of when you knew or reasonably should have known of the negligence, with an outer limit of five years from the act itself (with a fraud exception). Wrongful death claims must be filed within three years of the date of death. Claims against public bodies (cities, counties, state agencies, public hospitals) require a notice of claim within 180 days. Missing these deadlines typically ends a case.

If you think you may have a claim, call Huegli Law at 971-317-6436 for a free case review. Todd Huegli is licensed in Oregon and consults on cases in Oregon only.

Footnotes

1. U.S. Centers for Disease Control and Prevention, About Healthcare-Associated Infections. https://www.cdc.gov/healthcare-associated-infections/about/index.html ↩ ↩² ↩³ ↩⁴ ↩⁵

2. U.S. Centers for Disease Control and Prevention, About Sepsis. https://www.cdc.gov/sepsis/about/index.html ↩ ↩² ↩³

3. ORS 30.275 — Notice of claim; time of notice; time of action. https://oregon.public.law/statutes/ors_30.275 ↩ ↩² ↩³ ↩⁴

4. ORS 12.110 — Actions for certain injuries to person not arising on contract. https://oregon.public.law/statutes/ors_12.110 ↩ ↩²

5. Gaston v. Parsons, 318 Or 247, 864 P2d 1319 (1994). https://static.case.law/or/318/cases/0247-01.json ↩