A ‘needlestick’ injury occurs when a person’s skin is punctured by a needle or other sharp object. Healthcare professionals live in fear of them in view of the risk of potential exposure to blood-borne viruses, the most common being Hepatitis B, Hepatitis C and Human Immunodeficiency Virus (HIV).

However, it is rare that such injury is caused and so the basis for most needlestick claims is alleged psychological distress arising out of a concern surrounding possible infection.

Difficulties defending such claims

Despite the relatively low risk of serious injury, needlestick claims are notoriously difficult to defend because the circumstances in which they occur are often preventable and, as such, these claims can be the source of much frustration for claims handlers.  

Discarded sharps can be easily concealed in linen or refuse bags and cause injury to those who encounter them unexpectedly. Most incidents occur when a needle has been used in clinical treatment and has been disposed of inadequately.

Failure to dispose of a needle safely gives rise to a foreseeable risk of injury with the likely consequence that the trust (who will be held vicariously liable for the negligent act or omission of any employee) will be found to be negligent and in breach of its statutory duty under Section 2 of the Occupier’s Liability Act 1957 and Regulation 9 (iii) of the Workplace (Health, Safety and Welfare Regulations) 1992. 

Costs consequences

Such claims do not usually attract high damages awards, with physical effects usually lasting just a few days and any stress and anxiety lasting up to six months waiting for the ‘all-clear’ after testing.

However, such claims can become repetitive in certain areas of practice and, given the evidential difficulties in defending such claims, costs can soon build up.

Risk of a high value claim

It is important to be aware that some claims attract higher awards if the injured person suffers a significant psychiatric disorder. In 1998 a junior doctor at Charing Cross Hospital received damages totalling £465,000 after she became fearful of using needles, which prevented her from practising as a clinician.

The solution

In order to reduce the risks to visitors and employees and the cost of associated litigation, we would suggest:

  1. Having a formal and comprehensive internal policy in place which educates staff on the safe use of needles and what to do in the event that they are injured, including what support is available from their line managers and the Occupational Health Department.
  2. Regularly reviewing working practices, eliminating the use of needles where possible or, look to incorporate medical devices with built-in safety protection mechanisms.
  3. Providing effective personal protective equipment (PPE) in appropriate circumstances.
  4. Regularly training staff in ‘sharps’ safety.
  5. Undertaking risk assessments.
  6. Investigating any area/department where there is high incidence of sharps injuries and claims to try to eliminate the cause.
  7. Maintaining evidence of all of the above.

Adopting such measures may not provide trusts with a complete to defence to all needlestick claims, but may assist in showing that risk was reduced to the lowest possible level or in arguing contributory negligence, i.e. that the claimant has failed to follow training. Similarly, staff support and effective vaccination/treatment and advice may assist with reducing anxiety and any subsequent damages award.