%0 Journal Article
%T Questions on causality and responsibility arising from an outbreak of Pseudomonas aeruginosa infections in Norway
%A Bj£¿rn G Iversen
%A Bj£¿rn Hofmann
%A Preben Aavitsland
%J Emerging Themes in Epidemiology
%D 2008
%I BioMed Central
%R 10.1186/1742-7622-5-22
%X We conclude that many factors contributed to causing the outbreak, but that contamination of a medical device in the production facility was the major necessary condition. The reuse of the medical device in hospitals contributed primarily to the size of the outbreak. The unintended error by its producer ¨C and to a minor extent by the hospital practice ¨C was mainly due to non-application of relevant knowledge and skills, and appears to constitute professional negligence. Due to criminal procedure laws and other factors outside the discourse of causality, no one was criminally charged for the outbreak which caused much suffering and shortening the life of at least 34 people.In 2002, we traced the source of a large outbreak of Pseudomonas aeruginosa infections to contaminated mouth swabs extensively used in Norwegian health care [1]. The investigation revealed many weaknesses and errors in the chain from production to use [2].During and after the outbreak investigation, questions of causality, responsibility and liability were raised: Who and what caused the outbreak, who were responsible for the extent of the outbreak, could the damages have been mitigated by acting sooner or differently, should anyone be punished? Questions of causality, responsibility and blame have always been a part of the history of infections. Two examples are the debate on where the Spanish flu came from and who was responsible for starting the Aids epidemic.The concept of causality is intuitively simple and yet so intricately complex. In epidemiology causality has been hotly debated [3-11]. In philosophy of science there is a long tradition of discussing both the content of the term and how to achieve knowledge about the association of events [12]. In law, decisions on responsibility and liability rests on whether a specific action has caused specific harm or loss to another, and jurisprudence frequently defers to science in order to settle issues of causality [13-16]. However, not only is the
%U http://www.ete-online.com/content/5/1/22