OBJECTIVE To analyze the characteristics of liability disputes involving medical damages related to hospital-associated infections, and to elucidate the corresponding legal risks for healthcare institutions in infection prevention and control.

METHODS By searching the "China Judgment Online" for civil judgments regarding medical damages related to hospital-associated infections from Jan. 1, 2018, to Jan. 1, 2025, 90 cases were enrolled. Descriptive statistics were adopted to analyze the distribution of cases, faulty behaviors, focus of disputes and characteristics of liability determination. The Kruskal-Wallis H test and Fisher′s exact test were employed to examine the correlation between corresponding variables and compensation amounts.

RESULTS The hospitals involved were predominantly tertiary institutions (71.11%), with the highest compensation amount reaching RMB 2.4036 million. Orthopedics (16.67%) was identified as the department with the highest incidence of disputes, where surgical site infections accounted for the largest proportion of cases (39.02%). The primary faulty behaviors were inadequate infection prevention and control (36.27%) and non-compliance with diagnostic and treatment standards (30.39%), while the determination of causality (51.37%) emerged as the core point of dispute. In 47.78% of the cases, the hospital was held responsible for ≥50% of the liability. Furthermore, surgery and intensive care unit (ICU) admission were identified as significant risk factors associated with these disputes (P < 0.05).

CONCLUSIONS This study identifies tertiary hospitals, orthopedic surgeries, surgical site infections and ICU admission as high-risk factors for disputes related to hospital-associated infections. Inadequate infection prevention and control and non-standardized diagnosis and treatment are the main faults, while the determination of causality highly relies on the integrity of the evidence chain. This research provides important reference for medical institutions to strengthen infection prevention and control, standardize diagnostic and treatment practices and reduce the risk of medical damages.