Antisepsis and genital hygiene in scrotal surgery: liability claims in the event of treatment errors

Systematic observance of infection control principles in surgery, whether conducted on an inpatient or outpatient basis, is an indispensable precondition for quality management. In Germany, the introduction of the Protection against Infection Act (IfSG) on 1 January 2001 represented a milestone for regulation of the framework conditions in outpatient surgery. Once again, infection control issues were the main focus of attention. Section 36(1) IfSG stipulates that infection control policies specify in-house procedures for infection prophylaxis in agreement with quality assurance measures. On 1 January 2004 this was further reinforced, inter alia, by means of a new tripartite contract based on Section 115b of Book 5 of the German Code of Social Law (SGB V). Since experience shows that incidents are more likely to result in liability claims the smaller the operation and the more unexpected the complications from a lay person's perspective, surgery carried out on patients who spend the night before and after the operation outside the hospital or clinic is becoming a particularly liability-prone area. In the event of a postoperative infection, often involving a protracted hospital stay and in some cases considerable permanent damage, the patient often cites an infection control error. This paper highlights by way of example some liability aspects whose observance as a matter of principle can reduce the liability risk for the physician.