Sepsis And Septicemia

The body’s natural immune response helps to detect and respond to bacteria, viruses, and other foreign and harmful substances. When the immune system recognizes harmful antigens, the body responds in a number of ways. However, the body’s inflammatory immune system response can also cause injury to tissues and organs. 

Sepsis is an inflammatory immune response to infection. Sepsis that goes on untreated can lead to septicemia, organ damage, and death. Doctors and healthcare professionals are supposed to be aware of the signs and symptoms of sepsis and provide proper treatment. Unfortunately, when doctors fail to diagnose or fail to properly treat sepsis, it can lead to injury or death. Injury victims and family members who lose a loved one to sepsis may have a claim for medical malpractice. 

Immune Response and Sepsis

When the body detects bacteria, viruses, or other foreign substances, the immune response attempts to defend the body against the harmful substances. This includes the inflammatory system responding to injury by bacteria, toxins, trauma, or other causes of damage. The most common causes of sepsis include bacterial infections (gram-negative and gram-positive), fungal infections, or viral infections. 

One of the purposes or the body’s inflammatory response is to isolate the foreign substance from spreading throughout the rest of the body. The way inflammation helps slow the spread of infection is through increased blood flow, phagocytic cells release, and tissue damage. The signs of initial inflammation include: 

• Redness, 
• Heat, 
• Swelling, and
• Pain.

The capillaries in the area of the infection constrict to carry blood away from the damaged area. This causes redness and an increase in tissue temperature. Capillary permeability also allows cells and fluid to leave through entering surrounding tissue, leading to swelling. Dilation of the peripheral vasculature can result in pooling of the blood, low blood pressure, and hypoperfusion of the organs. 

Signs and Symptoms of Septicemia

The signs and symptoms of sepsis can vary by patient. Very old and very young patients with a weakened immune system may have very different symptoms than those with a strong immune system. Some common signs and symptoms of sepsis include: 

• Fever
• Chills
• Low body temperature
• Increased heart rate
• Increased breathing rate
• Confusion 
• Swelling or edema
• Decreased urination
• High blood sugar
• Metabolic acidosis
• Respiratory alkalosis
• Low blood pressure
• Fatigue 
• Anxiety
• Malaise

Highest Risk of Sepsis

Individuals with an impaired immune system may be at the highest risk of developing sepsis. Others with an increased risk of sepsis or septicemia include individuals with: 

• Leukemia
• Cirrhosis
• Diabetes
• Neutropenia
• Solid tumors
• Acquired immune deficiency syndrome (AIDS)
• Individuals on immunosuppressive drugs
• Burn injuries
• Trauma injuries
• Catheters
• Prosthetic devices
• Urinary tract infections

Identifying and Treating Sepsis

Early identification and treatment of serious infections and sepsis can give patients a better chance of recovery and reduce complications. A diagnosis of sepsis can involve reviewing the patient’s medical history, physical examination, blood test and lab results, and monitoring the patient’s hemodynamic status. 

The patient’s history can help identify the possible source of the infection, whether it was community acquired, and if the patient is immunocompromised. Information may include exposure to animals, travel, occupational hazards, medications, underlying diseases, alcohol use, or tick bites.  

Physical examination of the patient may indicate the area of infection, including patients with suspected pelvic infections. 

Lab tests may provide the best information to help identify possible sepsis. Culture samples of suspected infection sites can identify the source of the infection for antimicrobial therapy. Blood test results can also indicate possible infection.  

The Sequential Organ Failure Assessment (SOFA) score can be used to predict outcome and mortality rate. The lower the SOFA score, the lower the risk of mortality. The SOFA score uses the following criteria: 

• Arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO2/FiO2)
• Respiratory support
• Platelet count
• Bilirubin
• Mean arterial pressure
• Dopamine dose
• Epinephrine dose
• Norepinephrine
• Dobutamine
• Glasgow coma score
• Creatinine level
• Total urine output

Treating a Septic Patient 

In treating a patient with sepsis, the initial treatment may focus on stabilizing the patient, clearing bacteria or microorganisms from the blood, and treating the original source of infection. 

Stabilizing the patient generally requires regular monitoring of vital signs, including blood pressure, heart rate, breathing rate, and temperature. Responding to the infection may involve treatment with antimicrobials, depending on the source of infection. Treating the original focus of the infection may involve removing foreign bodies, draining purulent fluid, and removing infected tissues. 

Sepsis and Medical Malpractice

Sepsis and septicemia can be caused by medical malpractice. Improper healthcare treatment that can lead to sepsis or increase the damage caused by septicemia may include: 

• Hospital acquired infection, 
• Infection during surgery,
• Failure to diagnose sepsis,
• Failure to properly treat sepsis, 
• Failure to monitor patients during surgery,
• Failure to monitor pregnant patients,
• Failure to document observations and treatment, or
• Failure to inform patients about the risks of surgery, including infection. 

Doctors and healthcare professionals owe their patients a duty of care. If the doctor fails to meet that standard of care, which causes injury or harm, the doctor may be liable for damages. Damages in a medical malpractice claim may include: 

• Medical bills
• Loss of income
• Pain and suffering

Death Caused by Sepsis 

Many families find out that their loved one is hospitalized with an infection, only to learn that the family member later dies from the infection. The hospital may not give the family a clear answer to what happened or what caused the infection. The family may have to file a wrongful death lawsuit to get answers. 

A wrongful death claim allows family members to get compensation for the loss of a loved one. It is also a way for family members to make sure the hospitals and healthcare system is held accountable for mistakes and negligence. Damages in a wrongful death lawsuit can include expenses related to the care and treatment of the deceased prior to their death and damages suffered by the family members after losing a loved one.

Sepsis and Medical Malpractice Attorneys

If you lost a loved one to sepsis while under a doctor’s care, you should talk to an experienced medical malpractice attorney about holding the doctor and hospital accountable for their negligence. Do not hesitate to contact Gilman & Bedigian today for a free consultation.