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Sepsis: A Common, but Unnecessary Cause of Malpractice in the U.S.

Written by Berkowitz

sepsis

Sepsis is a condition where the body reacts severely to an infection. When sepsis occurs, the body sends a flow of chemicals into the bloodstream – attempting to correct the threat. The chemicals lead to severe inflammation, which can slow the blood flow to vital organs and eventually lead to permanent damage.

While sepsis is severe, it does not have to occur. In fact, most cases of sepsis are easily avoided just through proper care and monitoring of the patient. Furthermore, if sepsis does occur, catching and treating it quickly can eradicate the condition before it ever becomes life-threatening.

Quick Facts to Know About Sepsis

Sepsis is a medical emergency. It is not a condition that is diagnosed and watched to see how it progresses. Instead, a physician must respond quickly and aggressively to avoid permanent organ damage.

While there are common symptoms, patients do not always exhibit the same symptoms. This makes it commonly misdiagnosed, or missed entirely.

What is Sepsis Exactly?

Sepsis is a condition known as septicemia. Septicemia leads to sepsis when the bacteria released in the bloodstream starts to secrete poisons. The immune system’s inflammatory response strikes against the poisons, which then results in sepsis.

Sadly, sepsis is still not widely understood even with medical research. It is, however, a life-threatening organ dysfunction that is caused by a dysregulated response to an infection.

Septic Shock – The Fatal Infection

When sepsis is not diagnosed and treated promptly, the patient will eventually develop septic shock. Septic shock is a widespread infection that affects the body’s organs and tissues. It eventually leads to catastrophic organ failure and a dramatic drop in blood pressure. Septic shock is quite rare, and in some cases, a patient can still survive the shock phase if they receive treatment.

However, more than 50 percent of cases of septic shock do result in death. Therefore, it is imperative that a patient receive treatment long before this phase occurs.

The Risk Factors for Developing Sepsis

Sepsis can happen even in a completely healthy person. Age and general health do not always matter. However, certain risk factors increase the likelihood that a patient will develop sepsis. With these known, it is the duty of the treating physician to monitor the patient’s progress and ensure that sepsis does not develop.

Risk factors include:

  • Weakened immunity, such as from an illness or recent operation
  • Chronic illnesses, including AIDS, cancer, diabetes, or liver disease
  • Severe wounds, like burns and penetrating wounds

Symptoms of Sepsis: It is Easy to Diagnose?

Sepsis does have a few symptoms, but it shares those symptoms with multiple other conditions. This is why it is commonly misdiagnosed.

However, patients or those caring for loved ones should be aware of these common symptoms and report them to the treating physician immediately. Furthermore, healthcare professionals must know the symptoms of sepsis and look out for them, especially when caring for patients with weakened immune systems, the elderly, or patients recovering from surgical procedures.

Common symptoms of sepsis include:

  • Sweating
  • Rapid heart rate
  • Rapid breathing
  • High fever
  • Chills and shivering
  • Feeling faint or dizzy
  • Confusion
  • Slurred speech
  • Nausea, vomiting, and gastrointestinal upset
  • Low urine or severe dehydration
  • Discolored and clammy skin
  • Loss of consciousness

The skin does not have to feel hot to the touch for it to be sepsis. In fact, the skin can be cool to the touch in a sepsis patient.

The Escalation into Sepsis

Sepsis does not just happen. Instead, a patient typically suffers from an infection which goes undiagnosed. This untreated infection begins the development of sepsis.

Sepsis symptoms are like any other hospital acquired the infection, but there is a bodily response that makes it stand out from an ordinary infection. When the infection goes untreated and escalates into sepsis, injuries and the risk of a fatality increase dramatically.

In fact, mortality rates for sepsis average 20 to 40 percent, and it is a major cause of death after emergency room and intensive care treatments.

Proper Tests and Diagnosis is Key

When a doctor suspects an infection, they should confirm that infection with testing. After diagnosing an infection, doctors can treat the patient with antibiotics or another course of treatment to stop the infection from creating sepsis.

If a physician observes the signs and symptoms of sepsis, they must consider the patient’s medical history and the possibility that sepsis has occurred.  A physical examination alone may confirm their suspicions.  However, blood tests can also confirm sepsis, as can the use of imaging scans.  These scans can further help a doctor to evaluate the severity of the case when sepsis is diagnosed.

How is Sepsis Treated?

Sepsis is treated like other infections by using antibiotics. Doctors may have to guess the type of infection that caused the sepsis, however, and then treat the patient based on their educated guess. Once sepsis takes hold, antibiotics are rarely enough. Instead, the physician may need to treat the symptoms of sepsis along with the underlying infection.

These treatments can include:

  • Intravenous fluids to avoid severe dehydration
  • Vasopressors
  • The use of central lines
  • Organ support
  • Breathing support

Common Causes of Sepsis from Negligence

Not all cases of sepsis are the result of negligence. However, certain conditions, when ignored or treated improperly, can increase the likelihood a patient will develop sepsis. These conditions include, but are not limited to the following.

Bed Sores

Bed sores occur in nursing homes and hospitals where a patient must remain lying down or seated in the same position for an extended period. When the resident is not properly cared for or repositioned properly throughout the day, the bed sores can turn into severe ulcers. These open wounds are highly susceptible to infection, and often if the nursing home is already neglecting the patient, they are less likely to treat the bed sores too. Therefore, these sores become infected and eventually lead to sepsis.

Intravenous Lines

Patients with an IV are at high-risk for developing an infection. Intravenous lines are in direct contact with the patient’s blood; therefore, if the patient develops an infection and that infection is not properly cared for, he or she could develop sepsis.

Intravenous contaminations typically occur when the insertion site is not properly sanitized, or the IV line itself is not properly cleaned in between use. Physicians and nursing staff can see the signs of an infection, typically because the area surrounding the IV is red and painful.

Surgical Site Infections and Wounds

Anyone that has received surgery, minor or major, needs medications to prevent an infection. Physicians may not always prescribe an antibiotic after a minor surgery, but they will instruct the patient what to look for in case an infection develops. Also, physicians must follow up with their patient to ensure the surgical site is healing.

When the body does not heal properly, or the site takes longer to heal than it should, the patient is at higher risk for developing an infection. Sadly, this could also result in sepsis if the physician does not treat the infection promptly.

Undiagnosed Infections

An undiagnosed infection is very common in the emergency room. A patient may appear in the emergency room with symptoms of an infection, but the hospital may ignore those symptoms or improperly treat the patient.

Also, the patient may not exhibit the same symptoms expected once sepsis develops, or the hospital could ignore the qSOFA criteria.

What is the qSOFA?

Today, medical professionals are required to use the qSOFA or Quick SOFA to diagnose patients at risk for sepsis. It also helps determine the in-hospital probability of a mortality with a suspected infection.

qSOFA includes assessing the patient’s altered mental status, respiratory rate, and systolic BP.

The score helps physicians decide the risk, but is not a 100 percent guarantee on diagnosis. A single point may put the patient in the non-high-risk category, which means the physician must still monitor the patient and do a serial qSOFA assessment.

Once the score reaches two or more, the patient is considered at high-risk. Therefore, the physician must do an organ dysfunction test, and blood test with serum lactate to determine the full SOFA score.

The Long-Term Effects of a Sepsis Result

While a person could survive sepsis, the long-term effects of this condition are often much worse than patients and their loved ones realize. Some of these effects are short-term, while others could impact the quality of life a patient has – or significantly shorten their expected lifespan.

Cognitive Problems

Following a severe case of sepsis, a patient could suffer from impairment, memory loss, and brain damage. When the blood pressure drops significantly low for too long, the question of brain damage arises. This is because low blood pressure decreases blood flow to the brain, which results in limited oxygen for the brain.

Gangrene

If sepsis is undiagnosed by medical professionals, the infection could erode the tissues of the body, especially on the hands, fingers, toes, and feet. As the tissues die, they become gangrenous and will require surgery to correct.

Amputation

Sadly, once sepsis is diagnosed, patients are often given excessive amounts of vasopressors. Vasopressors are what keep the patient’s blood pressure at normal levels. While this prevents the patient from premature death, the vasopressors will lead to gangrene of the appendages, which may require amputation.

And obviously, if a patient requires an amputation, their quality of life will be diminished. They may be unable to work in their chosen occupation ever again, and basic enjoyment of life can suffer in a number of ways.

Post Sepsis Syndrome (PSS)

Patients that survive sepsis may suffer from Post-Sepsis Syndrome (PSS). In fact, the Sepsis Alliance estimates that 50 percent of survivors will suffer from PSS, which includes physical and emotional long-term effects. The effects of PSS include:

  • Extreme exhaustion and fatigue
  • Vivid hallucinations, panic attacks, and night terrors
  • Insomnia
  • Poor concentration
  • Self-esteem issues
  • Cognitive impairments
  • Joint and muscle pains

What Causes PSS?

In most cases, PSS comes from patients that were hospitalized for extended periods in the Intensive Care Unit (ICU). Many of these patients had to endure amputations, as well as other complications from their illness.

Post-Traumatic Stress Disorder

Even those who do not have PSS could still suffer Post-Traumatic Stress Disorder (PTSD). An ICU visit could trigger PTSD, and may last for several years. Often, PTSD can affect a person to the point where they cannot  return to work or even leave their home. In fact, a 2013 study by Johns Hopkins found that people with a history of depression were two times more likely to develop PTSD after being admitted into the ICU.

Chronic Pain

Those that survive sepsis may also suffer from chronic pain. Sadly, the cause of this is unknown but worsened physical function may be to blame for the increased pain.

Lung Damage

When sepsis is so severe that it impairs a patient’s ability to breathe, they could suffer from long-term lung complications even after making a full recovery. These complications could include increased breathlessness, pains in the chest, and a higher risk of developing lung infections.

Heart Complications

Even a year after recovery, some patients report chest pain, pulse issues, and inability to work out because they cannot regulate their heart rate. Some of these symptoms are improved with medication and eventually correct themselves on their own. Other patients have permanent heart complications.

Kidney Damage

When sepsis is severe enough to damage the tissues of the body’s organs, some may require dialysis or support by a machine for the rest of their lives. Some may have to wait until they make a full recovery to receive a kidney transplant – depending on the severity of the sepsis.

Holding Healthcare Professionals Responsible for Sepsis

Sepsis is a highly unnecessary condition. If you or a loved one developed sepsis because of inadequate medical care or negligence, you may be entitled to compensation.

Contact Berkowitz and Hanna, LLC today to schedule your no-obligation consultation. Call 866-479-7909 or contact us online to get started.

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