Sepsis is an illness caused by infection in the bloodstream by bacteria that frequently enter the body through open wounds or pressure sores.  Occasionally referred to as: severe sepsis, sepsis infection, septic shock, severe sepsis or septicemia– sepsis is a medical complication that commands the full attention of all caregivers.

In order to provide sepsis patients the best chances of recovery and resumption of daily activities, the condition must be identified and treated as early on as possible.  In cases where treatment is delayed, sepsis can aggressively take hold of organs eventually resulting in their inability to function.

Most medical experts agree that at least two of the following must be present in a patient in order to make a diagnosis of sepsis:

• Hyperventilation (more than 20 breaths per minute)
• Heart rate above 90 beats per minute
• White blood cell count below 4000 cells/mm

After a diagnosis of sepsis has been confirmed it is incumbent that treatment be initiated as quickly as feasible.  Most treatment incorporates the use of intravenous antibiotics given in an inpatient setting.  Even after the treatment has been concluded, doctors will usually monitor sepsis patients for years following their original illness to ensure that they remain healthy.

Related:

• Elder Abuse Lawsuit Seeks Damages From Facility That Failed To Monitor & Treat Wounds
• Sepsis Lawsuit Alleges Caregivers Neglect To Blame For Patient’s Death
• Lawsuit Allegations: One Week In The Nursing Home Results In Significant Deterioration Of Pressure Sores & Sepsis

“To know that more could and should have been done to prevent his suffering is simply unbearable,” said 32-year-old Louise Norton, in an interview with the Reading Post. “If by speaking out we can somehow force change, I will feel in some small way justice has been done.”

According to the Post, 64-year-old Mervyn Elkington was admitted to Royal Berkshire Hospital (RBS) in March 2009, with a diagnosis of renal failure. Over the next several months, Elkington’s health deteriorated rapidly. On June 19, 2009, Elkington died as a result of sepsis - an illness caused by infected bed sores.  A coroner’s report issued May 19 highlighted several missed opportunities to treat Elkington’s bed sores. The report emphasized that delays in MRI scans, as well as carrying out appropriate surgeries, strongly contributed to Elkington’s death.

“Though [Mr. Elkington] was a very ill man, the post-mortem carried out after his death suggests that he suffered from infected pressure sores,” said Norton’s lawyer, medical law expert Peter Cutler. “It is the cause of these pressure sores that the family is keen to establish.”

Louise Norton maintains that her father consistently received inadequate care while at RBS, saying specifically that nurses didn’t have knowledge of how to properly operate beds designed to help prevent bed sores.

Joe Wise, a spokesman for RBH, countered Norton’s claims.

“We are confident that we did all we could for Mr. Elkington,” he reportedly said. “He was extremely ill, with many serious health problems.”

Related:

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The Vanderbilt/Brown study found that 750,000 patients develop sepsis in the U.S. each year alone, and that more than 60 % of those patients are over the age of 65. Risk factors for sepsis, according to the study, include: weakened immune system, frequent hospitalizations, malnutrition, and incidences of pneumonia. Another strong risk factor is exposure to medical tubes and catheters; both of which often serve as portals for infection.

Patients with sepsis frequently display what the study calls “confusion or altered mental states,” or delirium. Other signs of sepsis include: weakness, loss of interest in food, urinary incontinence, and falls.

The study recommends that hospitals implement strong infection-control programs. It also recommends that hospitals devote more resources to observing elderly patients – yet also acknowledges the challenges in doing so.

“It may be difficult to obtain samples of blood, body fluids or tissue from patients who are cognitively impaired, debilitated, dehydrated or frail,” the study notes. “Positioning patients for high-quality chest radiography is [also] difficult.”

According to the study, sepsis accounts for close to $17 billion in U.S. hospital costs each year.

Related:

Early Detection Is The Key Element To Successful Sepsis Treatment

Lawsuit Alleges: One Week In The Nursing Home Results In Significant Deterioration Of Pressure Sores & Sepsis

Survival rates for sepsis patients is dependent on how quickly the medical facility identifies the problem and implements treatment

According to court documents, Murphy was a patient at the Hearthstone at the Mainlandnursing home from May- September 2010. Hearthstone at the Mainland is one of fifteen Texas facilities run by Houston-based Hearthstone Management, Inc. The documents say that Murphy, who was 69, suffered a fall about three weeks into his residency.

At the time, the court documents say, doctors told the Murphy family “that he did not have injuries related to the fall.” However, the suit alleges that doctors diagnosed Murphy with “infected wounds to the buttocks, feet and legs,” and “acute renal (kidney) failure.”

According to Murphy’s autopsy, the cause of death was determined to be sepsis (sometimes also referred to: severe sepsis, sepsis infection, septic shock, severe sepsis, septicemia) a severe infection caused by an advanced stage bed sore on Murphy’s sacral area. The autopsy also determined that Murphy had a urinary tract infection (UTI), as well as a colon infection. The plaintiffs in the case, Peter Murphy and James Joseph Murphy III, are suing Hearthstone Management for survival damages, and are seeking a juried trial. The court documents do not state the plaintiffs’ relationship to Christopher Murphy.

Related:

Early Detection Is The Key Element To Successful Sepsis Treatment

Sepsis

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Is sepsis related to bed sores?

Pressure Ulcers- Prevention and Management (PDF)

Doreen Betts, who died in May, 2009, contracted sepsis after developing severe pressure sores on her feet. Sepsis is a serious blood infection that has a mortality rate of more than 50 percent. Betts was a patient at the Kersal Mount Nursing Home in Sheffield, recently renamed the Laurels and The Limes Care Home.

“Mrs. Betts was clearly a victim of neglect,” said Sarah Rowland, a medical law specialist at British law firm Irwin Mitchell. “Any level of neglect is unacceptable, but what Mrs. Betts went through was particularly horrific. Had the nursing home acted with the proper level of care and attention, Mrs. Betts would not have died in such a painful manner.”

Three months before her death, Betts’ GP (general practitioner) had recommended that Kersal Mount refer her to a bed sores specialist. The request was ignored, according to the BBC. At Betts’ inquest, consulting pathologist Nicholas Tiffin found that Betts would not have died, had she not developed the infected pressure sores.

“We were distraught to find that the home had ignored the recommendation to refer her to see a settlement,” said Betts’ son, Stephen. “Nothing can bring her back, nor can it alleviate any of the horrendous pain and discomfort she went through in those final weeks.”

The Betts family, represented by Irwin Mitchell, has settled with Kersal Mount for an undisclosed sum.

Sepsis (sometimes also referred to as: severe sepsis, sepsis infection, septic shock, severe sepsis, septicemia) is a deadly, yet surprisingly common medical condition.  According to a recent sampling of hospital patients:

• Sepsis is the 10th leading cause of death in the U.S.
• 33% of people who contract sepsis will die from the disease
• Medical expenses to treat sepsis cost approximately $17 billion per year

The Banner Desert Medical Center in California recognized the substantial problems associated with sepsis and has begun to implement a prevention and treatment program.  Believed to be the first of its kind, the California hospital uses a scientific formula to detect warning signs that indicate a patient is at risk for contracting sepsis.  The diagnostic program evaluates:

• changes in body temperature
• increases in heart rate
• changes in respiratory rate
• decreases in white blood cell count

After the early symptoms of sepsis are identified, the hospital is able to rapidly administer medical treatment and greatly improve the patients survival rate.  In the first two months of its use at Banner Medical Center, the hospital credits the new program with the early detection of sepsis in 60 patients  and likely a substantial number of lives as well.  Read more about this important development in sepsis prevention here.

Hopefully this sepsis detection tool can be applied to patients in a nursing home setting as well.  Too often the implementation of medical treatment for nursing home patients is delayed due to inadequate training of staff and insufficient medical equipment.

Related Bed Sore FAQ’s:

Is sepsis related to bed sores?

Are bed sore patients at risk for amyloidosis?

Why is a colostomy needed for patients with severe bed sores?

Why are physically disabled patients at risk for developing bed sores?

Nursing Homes Abuse Blog: Sepsis

Nursing Home Injury Laws: California

In particular, the Illinois nursing home lawsuit claims that Caseyville Nursing and Rehabilitation was negligent in the following manners:

• Failing to conduct a skin assessment when the woman entered the facility
• Inadequately staffed their facility
• Failed to develop a comprehensive ‘care plan’ for the patient
• Failed to notify a physician regarding the deterioration in the woman’s medical condition

Short-term or ‘respite care’ admissions to nursing homes are a common service that many facilities provide.  When patients are admitted to nursing homes for a period of days or weeks, the facility still has the same responsibilities to care for them as they do for their longer-term patients.  Even for short-term admissions, nursing homes should conduct an assessment of the patients needs and create a care plan with the assistance of the patients family and physician to assure all of the patients needs are met.

Read more about this nursing home lawsuit involving a septic patient here.

Related Bed Sore FAQ’s

Why do bed sores commonly develop on the buttocks?

What are the stages of bed sores?

Is sepsis related to bed sores?

Nursing Home Injury Laws: Illinois

What is an autopsy?

An autopsy is a detailed medical examination of the person’s body and organs following death to establish the specific cause. Autopsies are performed by a physician, a pathologist, who is trained to evaluate results from physical examinations and laboratory results from tissue and blood samples to determine the cause of death.

Once the examination and laboratory results have been evaluated, an autopsy report is rendered. The report notes the physical findings and states a cause(s) of death.  Because the report is rendered from an impartial author, it can be particularly useful in a litigation setting.  Similarly, just a the report may be useful in case against a nursing home or hospital, results may also absolve the facility of responsibility if the results do not substantiate poor care.

In order to secure the most accurate results, most pathologists suggest performing an autopsy 24 to 48-hours after the death of a person.  Depending on where the death occurred  and the circumstances surrounding it, the autopsy may be performed by the state medical examiner or by a physician at a private hospital.

Is an autopsy called for in cases where a bed sore may have contributed or caused a death?

In my opinion, particularly in cases involving severe bed sores (also called pressure sores, pressure ulcers or decubitus ulcers), autopsies can be extremely helpful in rebutting arguments made by facilities who may argue that a death was the result of ‘old age’ or due to a ‘variety complicated medical factors’.

Autopsies can be particularly helpful in prosecuting wrongful death matters related to bed sores due to the fact that a physician can make a medical determination as to the cause of death.  Specific medical complications such as infection and sepsis may be confirmed by an autopsy as opposed to speculation.

If you wish to have an autopsy performed on a loved one, you should contact your coroner or local hospital to get information about facilities that can perform one at your request.

Related Nursing Homes Abuse Blog Entries

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A colostomy is a major surgical procedure that involves cutting the colon into a shorter piece and bringing it through the wall of the abdomen.  A colostomy bag is attached to the end of the colon exiting the abdomen where fecal material is collected.  The end of the colon that leads to the rectum is closed off and becomes dormant.  Many colostomy procedures can be reversed, if and when they are no longer needed.

While the thought of a colostomy may be disheartening, for many people suffering from severe bed sores it is likely an essential part of the overall healing process.  Without a colostomy, many bed sore patients suffer from a systemic infection know as septicemia or sepsis.

Sepsis (also referred to as: severe sepsis, sepsis infection, septic shock, severe sepsis, septicemia) must be identified and treated as early on as possible in order to provide the best chances of survival.  If left undiagnosed and untreated, sepsis can be fatal. In order to make a diagnosis of sepsis, at least two of the following must occur: a heart rate above 90 beats per minute, hyperventilation (more than 20 breaths per minute) and white blood cell count below below 4000 cells/mm.

Symptoms of sepsis include:

• Fever
• Low body temperature (hypothermia)
• Loss of ability to appreciate surroundings
• Cool hands and feet
• Anxiety
• Shaking
• Organ dysfunction

Frequently, people use the term sepsis to describe ‘severe sepsis’ and ‘septic shock.’  Severe sepsis is used to describe people who have organ dysfunction following a diagnosis of sepsis.  People diagnosed with septic shock have sepsis with hypo-tension (abnormally low blood pressure).

Sepsis is a common medical condition; it accounts for:

• 1-2% of all hospitalizations
• 25% of all intensive care visits
• 100,000 deaths per year
• The most common cause of death in intensive care units

In order for treatment to be most effective, it must be implemented as soon as the diagnosis is made.  Generally, treatment consists of antibiotics and surgical drainage.  Nutritional supplements are also suggested as treatment for sepsis.

Related:

Lawsuit Alleges: One Week In The Nursing Home Results In Significant Deterioration Of Pressure Sores & Sepsis

Did Assisted Living Facilities Neglect Result In Patient’s Impacted Bowel & Death?

Tennessee Court Helps Establish Standard Of Care In Nursing Home Negligence Cases