"I contracted a deadly infection in the hospital": how to protect yourself and what to do if it happens

It would seem that a hospital is a place where you are safe and where you will definitely get help. But sometimes, that's exactly where things go wrong. This happened to the heroine of our article, Olena: one preventative procedure turned the life of a healthy person into a struggle with a debilitating infection, the indifference of doctors, and the helplessness of medicine against resistant bacteria.

LIGA.net I spoke with infectious disease specialist Anastasia Neklyudova and medical lawyer Olga Shevelova to find out:

• which nosocomial infections occur most often in Ukrainian medical facilities;
• the main routes of their transmission in hospitals;
• which patient groups are most vulnerable;
• modern methods of infection prevention and control;
• how a patient can independently reduce the risk of infection in a hospital;
• how to prove that the infection was acquired specifically in the hospital;
• how to obtain a copy of a hospitalized patient's medical record;
• what liability is foreseen for the hospital or medical staff in case of proven infection;
• what legal steps a patient or their relatives can take to recover damages.

Elena's Story

Until May 2025, I was a healthy person. The only issues I had were mild gastritis and gallbladder motility problems, but these didn't interfere with my life. I worked, studied, and enrolled in English courses that I planned to finish, but later had to drop them due to health issues. I have never had any serious diagnoses or chronic illnesses.

My gastroenterologist prescribed the colonoscopy. To be honest, there weren't any particular indications – it was more of a preventative measure. But now I understand that it was the wrong decision; I was just listening to the doctors.

After two or three days, I experienced abdominal discomfort, a more frequent urge to urinate, and later, burning, stinging sensations, and a rash on my body, with new symptoms appearing every day. I'd never experienced anything like this before, so I immediately became concerned.

When my temperature started rising almost daily – up to 38.5 °C, and then I developed lower back and joint pain, numbness in my head, and swollen lymph nodes, I realized that this was not a common inflammation.

I immediately consulted a urologist and a gynecologist. The diagnoses were: acute cystitis, pyelonephritis, and inflammation of the female reproductive system. Later, a rheumatologist and a neurologist were involved, as I began experiencing numbness, weakness, and joint pain. Lymphadenopathy and reactive arthritis were detected. After that, all the doctors started referring me to infectious disease specialists, as all the symptoms and diagnoses were related to infection and inflammatory processes in my body.

It was found in the intestines, urine, and a urogenital swab. E. coli and Klebsiella pneumoniae with ESBL – bacteria resistant to most antibiotics due to special enzymes that destroy them. The antibiogram showed that these bacteria were insensitive even to drugs that I had never taken before.

I underwent six courses of different antibiotics, including the strongest ones. None of them yielded results. The treatment was very difficult, especially the last course, which I was prescribed while hospitalized in the infectious disease hospital: it was a real blow to my body.

I was very frightened when the ultrasound showed enlarged lymph nodes all over my body, as well as hepatomegaly (enlarged liver, most likely from taking antibiotics). The granulomas in the spleen and macrophages in the organs appeared after May; the ultrasound before that showed nothing. This wasn't related to my lifestyle, but to the infection and medication.

Physically, my condition gradually worsened: I had a constant fever, persistent pain, and weakness. Emotionally, it led to exhaustion and a feeling of complete helplessness. My life turned into a series of endless hospital visits and tests.

I sent official requests to the clinic where all my problems began. Initially, they confirmed that the complaints were registered. However, after my public post, they claimed that "there were no complaints." This was a blatant lie. The clinic is avoiding any responsibility.

My attitude towards medicine and private clinics has changed drastically after this experience. Before, I trusted doctors and was convinced that the more expensive the services, the higher their quality. Now I understand that in private clinics, money sometimes comes before the patient.

After my public appeal, dozens of people started contacting me. Some described being injured, others received incorrect diagnoses, and still others contracted infections. The stories varied, but the conclusion was the same for everyone: the clinic is harmful and does not take responsibility. I can't verify the truth of every story, but the sheer number was striking and made me realize that my case is not unique.

During this period, my family and close friends were very supportive. They tried to be there for me, although they themselves were confused, because it's hard to calmly watch as your loved one is constantly sick.

The hardest thing for me wasn't the physical pain, but the indifference. You can endure pain, but unfair treatment and coldness from doctors destroy you morally much more strongly.

Because of the ineffectiveness of antibiotics, I started to become interested in bacteriophages. These are viruses that infect and destroy bacteria. When nothing helps, you start looking for all possible options. Many people with similar stories wrote to me asking to share the contacts of clinics that deal with this treatment. For me, it's not a guarantee, but just a chance, just a hope to hold onto.

Today, the most important thing for me is the chance to recover. At the same time, I would have expected at least a modicum of humanity from the clinic, a sense that they cared about the situations happening to their patients. I would have liked to see that they were truly interested in people's health, not just their money. Instead, it turned out that after you've been harmed, you're left alone with the problem, and your real story is dismissed as slander from competitors. This makes treatment terrifying and trust in doctors almost impossible.

Elena's story is, unfortunately, not an exception. Such cases occur more often than we would like, and they serve as a reminder that even where we expect safety and recovery, risks exist. What infections can be contracted in a hospital setting, and how to minimize these risks, is discussed specifically for... LIGA.net explained infectious disease specialist Anastasia Neklyudova.

What are the most common nosocomial infections that occur in Ukrainian medical facilities?

The most common nosocomial infections in Ukraine are catheter-associated infections, nosocomial pneumonia, and postoperative complications. Typical pathogens are... Escherichia coli, Klebsiella, Pseudomonas aeruginosa (Pseudomonas aeruginosa), Enterococcus faecalis, Candida, Bacteroides.

Each hospital-acquired infection has its own characteristic pathogens: pneumonia has one set, urinary tract infections another. And we shouldn't forget about...Clostridium difficile, which is also a causative agent of nosocomial infections.

What are the main routes of infection transmission in hospitals?

The main routes of infection transmission in hospitals are primarily related to hand hygiene of patients and medical personnel. Therefore, it is so important to adhere to the WHO's 5 moments for hand hygiene: before touching a patient, before aseptic procedures, before contact with bodily fluids, after touching a patient, and after contact with patient belongings.

An important factor is also the use of medical devices, especially invasive devices – catheters, as well as endoscopic equipment such as colonoscopes and gastroscopes. Surfaces, the hospital environment, and ventilation systems can also be sources of transmission.

However, the basis of prevention, the foundation on which the safety of patients and staff depends, remains a simple but critically important thing – hand hygiene.

Which patient groups are most vulnerable to nosocomial infections?

Patients in intensive care units are most vulnerable to nosocomial infections, as they have many invasive access points – tracheostomies, mechanical ventilation devices, and numerous catheters. Post-operative patients are also at risk, especially those receiving mandatory immunosuppressive therapy. Vulnerable groups also include people with oncohematological diseases and patients with immunosuppression due to HIV infection.

We must also remember infants, whose immune systems are not yet fully developed, and the elderly, whose immune systems are naturally aging. These groups have the highest risk of developing nosocomial infections.

What are the modern methods of prevention and control of nosocomial infections used?

Regarding the prevention of nosocomial infections, it is important to remember that in Ukraine, Order No. 1614 of the Ministry of Health is in effect, which regulates the infection control system. This also includes the implementation of infection control programs, training of medical personnel, the creation and adherence to local protocols, and the conduct of internal audits. International clinical practices are also important, including WHO guidelines on hand hygiene and the use of alcohol-based antiseptics.

Proper catheter care and minimizing indications for their placement, as well as controlling the duration of their use, play a significant role. It is necessary to determine the spectrum of circulating pathogens and their antibiotic susceptibility in hospitals. Particular attention should be paid to the hygiene of the premises: special equipment and antiseptics must be used for cleaning. For example, in facilities where... ClostridiumSpecial anti-sporicidal agents must be used.

Rational antibiotic therapy is extremely important. This means that reserve antibiotics should not be used immediately – therapy should be based on the principle of escalation. Furthermore, treatment should last exactly as many days as prescribed by the protocol: no longer "for prophylaxis" and no shorter than necessary to achieve the result. This approach not only allows for effective treatment of infections, but also avoids harm to the patient and shortens their hospital stay.

How can a patient independently reduce the risk of infection while staying in the hospital?

A patient can independently reduce the risk of infection during their stay in the hospital if they follow a few important rules.

First, hospitalization should only occur for medical reasons. All "preventative drips," traditional "drips for blood pressure," or other procedures without real necessity should not be a reason for hospitalization.

Secondly, it is necessary to take care of personal hygiene: wash your hands regularly or treat them with antiseptic, especially after touching various surfaces. It is also worth disinfecting your personal belongings that you use in the hospital, such as your phone or wallet, and not bringing unnecessary items from home to the hospital.

Thirdly, it is necessary to monitor the condition of catheters and other invasive access devices. If the patient is conscious and understands the situation, they should ask questions: when the catheter is planned to be removed, why redness has occurred, why pain has appeared. Passivity in such cases can be harmful, so an active position is important.

Finally, the control of chronic diseases is important. This is especially true for diabetes, cardiovascular diseases, and atherosclerosis – their decompensation increases the risk of infections. In the case of oncohematology, the situation is more complex, but regarding basic somatic diseases, the patient must do everything possible to stabilize them.

Therefore, the active participation of the patient in their own treatment and adherence to basic rules significantly reduce the risk of developing nosocomial infections.

But what should a patient do if infection in a medical facility could not be avoided, and what responsibility is foreseen for doctors? About this... LIGA.net said medical lawyer Olga Shevelova.

How can one prove that an infection was acquired in the hospital, and not before hospitalization?

According to paragraph 4 of Section I of the Procedure for Implementing Infection Prevention and Control in Healthcare Facilities Providing Inpatient Care, approved by Order of the Ministry of Health of Ukraine No. 1614 of August 3, 2021, healthcare-associated infections are diseases that occur in a patient during the course of receiving medical care.

Infections that were already present in the patient or were in the incubation period at the time of hospitalization are not considered nosocomial.

Nosocomial infections are those that a patient acquires in a medical facility and that manifest after treatment, if their connection to medical procedures is proven.

Important evidence in such a case is, first and foremost, the primary medical documentation:

• Medical data, including laboratory test results before hospitalization showing no signs of infection, during inpatient treatment, and after hospitalization (meta-confirmation of the absence of infectious diseases in the history, taking into account the incubation period).
• The medical record of an inpatient (Form No. 003/o), which contains all data on prescribed medications, data from instrumental studies, procedures performed, operations, etc.
• Extract from the medical record of an outpatient (inpatient) (form 027/o), extract from the Register of Medical Records
• Data on infection control in the department, results of bacteriological studies.
• Results of the clinical expert commission.
• Results of forensic medical examination.

According to the instructions approved by Order No. 110 of the Ministry of Health of Ukraine dated February 14, 2012, "On Approval of Forms of Primary Accounting Documentation and Instructions for Their Completion Used in Healthcare Facilities Regardless of Ownership and Subordination," the inpatient medical record is kept by the attending physician during the patient's stay in the hospital, and after discharge – in the archive of the healthcare facility. Form No. 003/o is stored in the healthcare facility for 25 years.

Order No. 110 provides for the issuance to the patient of a record form such as a discharge summary from the medical record of an outpatient (inpatient) patient, which is filled out by doctors of healthcare facilities upon discharge from inpatient care or in case of the patient's death. However, healthcare facilities that enter medical records into the Register of Medical Records, referrals, and prescriptions in the electronic healthcare system do not use form No. 027/o. At the patient's request, an extract from this register is provided.

Therefore, when a patient is discharged from inpatient care, they receive a discharge summary in form 027/o or an extract from the medical records register.

How to obtain a copy of a hospitalized patient's medical record?

According to Article 39 of the Law of Ukraine "Fundamentals of the Legislation of Ukraine on Health Protection", a patient who has reached the age of majority has the right to receive accurate and complete information about their health status, including the right to review relevant medical documents concerning their health.

Parents (adopters), guardians, and custodians have the right to receive information about the health status of the child or ward.

A healthcare professional is obligated to provide the patient, in an accessible form, with information about their health status, the purpose of the proposed examinations and treatments, the prognosis of the possible development of the disease, including the presence of a risk to life and health.

If information about a patient's illness may worsen their health or the health of individuals specified in Part Two of this Article, or harm the treatment process, medical professionals have the right to provide incomplete information about the patient's health status and to limit their access to certain medical documents.

In the event of a patient's death, members of their family or other authorized individuals have the right to be present during the investigation into the cause of death and to familiarize themselves with the conclusions regarding the cause of death, as well as the right to appeal these conclusions to the court.

A provision with identical content is also contained in Article 285 of the Civil Code of Ukraine. More detailed provisions regarding the right of citizens to be informed about their health status can also be found in a number of laws.

The legislation does not contain a clear obligation for healthcare facilities to provide a copy of the medical record to the patient, but current Ukrainian legislation grants the patient the right to obtain medical documentation, including a copy of the medical record concerning that patient.

According to the Law of Ukraine "On Protection of Personal Data," to obtain personal data, including copies of medical records, a patient must submit a request for access to personal data to the healthcare facility. The request must contain the surname, first name, and patronymic, place of residence, and details of the document identifying the requester, and must specify the list of personal data requested.

Taking the above into account, the patient needs to gather evidence of the absence of infection at the time of hospitalization, and record the time of symptom onset after being in the hospital, taking into account the incubation period of the pathogen.

What liability is foreseen for the hospital or medical staff in case of proven infection?

In the event that it is proven that the patient was infected specifically in the healthcare facility, the liability may be as follows:

1. Civil law (compensation for material and moral damages)

If the patient suffered harm at the hands of medical personnel while they were performing their professional duties, the employer, i.e., the healthcare facility, is liable (Part 1, Article 1172 of the Civil Code of Ukraine).

What is needed for this? The conditions for tort liability must be present.

The following circumstances must be proven:

• The offender's unlawful conduct consists of providing untimely, inadequate, and substandard medical care. According to the Law of Ukraine "Fundamentals of the Legislation of Ukraine on Public Health," the duties of the attending physician include timely and qualified examination and treatment of the patient. Medical, pharmaceutical workers, and rehabilitation specialists are obligated to contribute to the protection and strengthening of people's health, the prevention and treatment of diseases, and to provide timely and qualified medical, pharmaceutical, and rehabilitation assistance.
• The presence of damage.
• The existence of a causal link between the unlawful conduct and the harm. The correctness of the medical worker's actions is established in accordance with the requirements of standards and other regulatory legal acts in the field of healthcare. This is established by forensic experts. To prove this aspect, a forensic medical examination must be appointed and the elements of a criminal or civil offense established. This is established only by the court.
• Guilt is presumed. The defendant must prove the absence of guilt in his actions; that is, he bears the burden of proof. The absence of guilt of the person who caused the damage must be proven independently by him; he bears the burden of proof. If the person who caused the damage has not proven his innocence, he is considered guilty of causing the damage. Doubts in establishing the innocence of the person who caused the damage must be interpreted in favor of the person who suffered damage as a result of unlawful actions.

This is a legal element that must be proven in court to recover money from a healthcare facility for harm to a patient.

2. Disciplinary liability of the physician: reprimand or dismissal in accordance with the Labor Code of Ukraine.

3. Administrative liability for violations of sanitary legislation in the form of fines.

4. Complete or partial suspension of operations of the department/hospital based on a decision of the administrative court.

5. Criminal liability may arise for a doctor if the infection caused serious health consequences or death.

What legal steps should a patient or their relatives take to recover damages (moral and material)?

In a pre-trial procedure, first of all, a written request for compensation for damages should be submitted to the hospital management, along with copies of documents confirming the facts cited by the patient, the patient's legal representatives, or other authorized persons. At this stage, it is best to seek professional legal assistance.

In court. Filing a lawsuit.

To ensure the patient clearly understands the scope of potential claims, it is worth noting that material damages, which are subject to compensation in case of injury or other damage to health, include:

• Earnings (income) lost as a result of loss or reduction of professional or general working capacity;
• Expenses incurred due to the need for enhanced nutrition, sanatorium-resort treatment, purchase of medicines, prosthetics, external care, etc.;
• Treatment costs.

Regarding moral damages arising from the non-provision or improper provision of medical care, these include:

• Physical pain and suffering incurred by an individual in connection with a disability or other health impairment;
• Mental suffering experienced by an individual in connection with unlawful conduct directed at them, their family members, or close relatives;
• Violation of the honor and dignity of a natural person.