How an MRSA Nursing Negligence Expert Witness Reviewed Delayed Infection Control and Cannula Monitoring
- Apex Experts
- Sep 30
- 2 min read
When a missed infection control handover leads to MRSA bloodstream infection
A vulnerable patient with a complex medical history and known MRSA-positive status was admitted to hospital while unwell. Although infection control procedures were in place, and decolonisation treatment was prescribed, the expert found it was not commenced until days later despite clear nursing documentation of pain and exudate at the cannula site.
An Apex MRSA nursing negligence expert witness reviewed the care records and concluded that the delay in identifying and managing the patient’s MRSA status contributed to a preventable bloodstream infection. Poor cannula monitoring, missed handovers during ward transfers, and a failure to escalate the deterioration were central themes.
What the MRSA nursing negligence expert witness found below standard
The patient had been MRSA-positive for over a year prior to admission. Despite this, nursing and clinical staff failed to flag this status on entry or to act on it swiftly once identified. Key failings included:
A PCR swab result indicating MRSA was reported after the patient was transferred but not handed over to the receiving ward
Decolonisation therapy was prescribed but not started until two days later
Pain and discharge at the cannula site were reported by the patient and ignored until removal
VIP scores for the cannula were recorded in a non-specific manner, with no documentation per device
The patient developed a bloodstream infection requiring IV antibiotics and vascular assessment
“There were multiple missed opportunities to start decolonisation and escalate cannula site concerns. The nursing response did not meet a reasonable standard of care.”— Apex MRSA Nursing Negligence Expert Witness
What an MRSA nursing negligence expert witness expects in high-risk admissions
In any patient with a known or suspected infection risk, especially MRSA, a qualified expert would expect:
Infection control flags visible on arrival and handover
Decolonisation therapy started on the same day it is prescribed
Accurate and device-specific VIP scoring documented regularly
Timely escalation for pain, discharge, or cannula site changes
Full continuity of care maintained during any ward transfers
In this case, the delay in commencing decolonisation, combined with the missed MRSA handover and unsupervised cannula monitoring, contributed to the development of MRSA bacteraemia and potentially prolonged hospitalisation.
Continuity of nursing care breaks down when communication fails
The expert also highlighted a breakdown in communication between departments. Despite infection control advising prompt decolonisation, no handover occurred during the patient’s ward transfer. No clinical reasoning was recorded for the delay in treatment, and no mitigating factors (such as staffing levels) were documented.
The expert concluded the standard of nursing care could not be defended on liability grounds.