Compensation for sepsis claims is paid where there has been delay in diagnosing sepsis, inappropriate advice given concerning sepsis care options, where there have been excessive delays in providing actual treatment, or where there has been any substandard care that amounts to actual Medical Negligence.
Do contact our friendly team of specialist lawyers at Medical Solicitors. We conduct most of our Clinical and Medical Negligence claims under ‘No Win, No Fee’ agreements, also known as Conditional Fee Agreements. So, your clients do not have to worry about how they can possibly afford to pay for the legal costs of sepsis negligence claims for compensation. You have nothing to lose in speaking to us
How common is Sepsis?
Sepsis itself is not rare and can be triggered by an injury or common infection. Sepsis often develops because a patient has not sought medical attention and has left their infection, whatever that may be, until a very late stage.
Sadly, in other cases, there is medical neglect, leading to death from septic shock, such as in Carol Baker’s case mentioned below.
Obviously, it is crucial that the symptoms of sepsis be recognised so that a patient can be treated and make a good recovery. Otherwise, the body’s internal organs start to fail (‘multi-organ failure’) and death can result. Worldwide, one-third of people who develop sepsis die.
For those who do survive sepsis, many are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction and/or amputations. Sepsis kills and disables millions, more than breast cancer, lung cancer, and stroke combined.
Shockingly, the latest National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report into sepsis, estimates that there could be as many as 200,000 cases of sepsis, and up to 60,000 deaths a year. The NCEPOD Report set out key findings of fact as to why there are failures to diagnose and offer timely treatment for sepsis, by GPs and in hospitals and set out some recommendations for future improvements in care. Another shocking figure puts it as follows:
In the UK, more than 100,000 people per year are admitted to hospital because of sepsis. Of these 100,000 cases, sepsis claim approximately 37,000 lives.
The outcome of failure to treat sepsis can be severe financial hardship if someone can no longer work, or if a family have lost a breadwinner, quite apart from the awful emotional fall-out.
Medical Solicitors has dealt successfully with many sepsis negligence claims. Notably, we assisted Tony Baker, who lost his beloved wife, Carol, aged 56, to septic shock after a catalogue of failures by various doctors. Her appendicitis went undiagnosed until it was far too late, leading to sepsis and septic shock. Sadly she did not survive late surgery. Carol’s full story can be read by clicking here.
£1.75 Million for a 53-year-old lady who attended an emergency department after being bitten by a dog. She was misdiagnosed with gastroenteritis, sent home without oral antibiotics, and went on to suffer septic shock. She was later admitted to hospital, needing intensive care and long rehabilitation and ending up with right leg amputation and the loss of toes on her left foot and damage to her spleen that led to further hospitalisation 4 years later.
How does Sepsis develop?
Anyone can develop sepsis after an injury or minor infection, although some people are more vulnerable. People most at risk of sepsis include those:
- with a medical condition or receiving medical treatment that weakens their immune system
- who are already in hospital with a serious illness
- who are very young or very old
- who have just had surgery or who have wounds or injuries as a result of an accident.
Sepsis commonly starts with an infection in one part of the body, for example, something as common as a urinary tract infection. However, other triggers can be such things as severe bed sores, slow healing of surgical wounds and failure to care for intravenous lines.
You may recall various people who have died from sepsis:
- Jim Henson, who created the Muppets, died in 1990 from sepsis that started out as pneumonia. He was only 53.
- Christopher Reeve (former actor, well known for Superman) died after a sudden heart attack, aged 52. The heart attack was caused by sepsis from an infected pressure ulcer.
- Alexander of Greece died aged only 27. He survived a few Wars, but became septic and died after returning home and being bitten by a pet monkey!
The body produces chemicals in reaction to bacteria or other germs in the bloodstream. Sepsis develops if the body goes into overdrive responding to these chemicals. This process can start in bodily organs, including the skin, as well as in the bloodstream. If the body is allowed to go into overdrive in this way, inflammation, swelling or blood clots can develop, as well as septic shock.
What are the symptoms of Sepsis?
- Loss of appetite
- Fever and chills
- Signs of worsening organ function such as difficult or rapid breathing, rapid heart rate, low blood pressure or low urine output
How is Sepsis Diagnosed?
The sepsis definition for diagnosis was revised, as announced at the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), February 2016, and an afternoon session of the Society for Critical Care Medicine (SCCM) 45th Critical Care Congress, and as published in the Journal of the American Medical Association.
From 2001, the standard was that Sepsis should be suspected if there is documented, or suspected infection and two or more of the following are present:
- Temperature over 38C or under 36C
- Heart rate over 90
- Respiratory rate more than 20 or respiratory alkalosis
- WBC of more than 12,000, or less than 4,000, or a normal count, but the presence of 10% immature ‘bands’
A doctor will take into account a patient’s presentation (their symptoms as above), but a diagnosis of sepsis is usually confirmed through a blood test. However, the new definition tries to try help doctors in a new way to distinguish between patients who have a bad infection and those who have a really bad infection on top of which they are developing problems in their organs that can lead to death. The new definitions do away with the current use of two or more of the above systemic inflammatory response syndrome (SIRS) criteria for sepsis diagnosis.
The revision has involved an international taskforce of doctors from around the world, including UK clinician, Mervyn Singer, MD, Professor of Intensive Care at University College London. The task force unanimously considered the requirement for two or more SIRS criteria to be unhelpful in the diagnosis of sepsis.
Recent studies have shown that SIRS symptoms occur in a large majority of hospitalized patients and are often associated with benign conditions. “The SIRS criteria do not necessarily indicate a dysregulated, life-threatening response,” the task force wrote. “SIRS criteria are present in many hospitalized patients, including those who never develop infection and never incur adverse outcomes.”
The new definition for sepsis includes evidence for infection, plus life-threatening organ dysfunction, which is clinically characterized by an acute change of two points or greater on the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score. The SOFA score is a calculator that combines various patient observations such as rate of urinary output, heart rate, blood pressure etc.
The SOFA score looks for a change in 2 or more from the baseline. It is a quick bedside score measuring respiratory rate of 22 or above, systolic BP of 100 or below, and an alteration of consciousness (confusion, agitation, coma etc). If you have infection, but none of these criteria then your chance of dying is very low. If you have all 3 criteria your chance of dying is much higher and these are the patients that need to be aggressively managed. The SOFA score predicts whether an exhaustive screening process should be undertaken.
The baseline is not standard, it may depend on whether the patient already had a pre-existing injury such as a head injury or disease process, such as kidney damage. However, a change of 2 from the individual patient’s baseline is what is looked for.
The new criteria is known as Sepsis-3.
How does Sepsis progress to Septic Shock?
Septic shock results when blood pressure falls and a patient’s blood pressure is less than 90/65 (this is called being ‘hypotensive’). Septic shock tends to develop during the first 24 hours of sepsis. As a result of problems with vital organs, people with severe sepsis are likely to be very ill and up to four in every 10 people with the condition will die. Septic shock is even more serious, with an estimated six in every 10 cases proving fatal.
Septic shock is now defined to include sepsis with fluid-unresponsive hypotension, serum lactate level greater than 2 mmol/L, and the need for vasopressors to maintain mean arterial pressure of 65 mm Hg or greater.
How is Sepsis Treated?
Anyone can measure the SOFA score, a paramedic, a GP, a nurse, so the at-risk patient can be assessed outside of a hospital setting.Patients can recover at home, with antibiotics, if sepsis is caught in the early stages.
Antibiotics, however, aren’t always enough to combat the strong infections that sepsis brings with it. Fluids are greatly needed to battle sepsis, and a saline-type fluid which contains minerals and sodium is typically provided to the patient in hospital.
Fluids are usually given to the patient intravenously in the intensive care unit. It is important that the doctors know how much urine your kidneys are making when you have sepsis, so they can spot signs of kidney failure. Therefore, if you are admitted with severe sepsis or septic shock, usually you will have a catheter inserted into your bladder to monitor your urine output.
Dialysis is given if the kidneys have failed. The patient is put on a breathing machine if necessary.
Sepsis can lead to organ failure and can be life-threatening, especially among the elderly or patients who have an illness or a weakened immune system.
It is important that the doctors know how much urine your kidneys are making when you have sepsis, so they can spot signs of kidney failure. Therefore, if you are admitted with severe sepsis or septic shock, usually you will have a catheter inserted into your bladder to monitor your urine output.
If a source of the infection can be identified, such as an abscess (collection of pus) or infected wound, this will also need to be treated.
For example, any pus may need to be drained away, or in more serious cases, surgery may be needed to remove the infected tissue and repair any damage.
Medications dobutamine and noradrenaline (called ‘vasopressors’) are used if you have low blood pressure caused by sepsis. These medications can help to increase blood pressure by stimulating the muscles involved in pumping blood around the body and constricting (narrowing) the blood vessels.
What is the Sepsis Six?
Management of sepsis after admission to hospital is popularly known as the ‘sepsis six’. This involves six elements, three treatments and three tests, which should be initiated by the medical team within an hour of diagnosis.
- giving antibiotics
- giving fluids intravenously
- giving oxygen if levels are low
- taking blood cultures to identify the type of bacteria causing sepsis
- taking a blood sample to assess the severity of sepsis
- monitoring your urine output to assess severity and kidney function
- Since the 2016 revision the SOFA score will also be used (designed to focus on what is happening in the organs in terms of a disease process, with less of an emphasis on prediction of actual death).
The future for Sepsis Care
The International Task Force has high hopes in terms of the new diagnostic definitions, stating:
“These updated definitions and clinical criteria should clarify long-used descriptors and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing it,” according to the task force’s publication.
Support after Sepsis
You may need practical advice or emotional support. Sepsis problems may have led to financial problems and consequent issues with housing. For help with all of this, please access our separate webpage (link below) with lots of links to organisations, waiting to help you.
How is a Payout calculated for Sepsis?
‘General Damages’ i.e. What is the value of a back injury?
In other countries, ‘punitive damages’ are awarded and this is why we see such high awards of compensation ($Millions and even $billions) in the United States. However, in the U.K., punitive damages are not awarded. The U.K. Judicial College sets out brackets for the value of particular types of injuries. There are a wide range of figures, examples below are taken from the 14th edition of the Guidelines.
Sepsis can lead to a very wide range of life-altering injuries, so not all are covered here, but below we summarise the brackets for brain injuries.
£247,280 – £354,260. Very Severe Brain Damage. This is serious brain injury which limits the victim’s ability to acknowledge their surrounding environment. Very little or no language function, and the need for full-time care.
£192,090 – £247,280. Moderately Severe Brain Damage. Injuries which leave the victim severely disabled and substantially dependent on others. There will be a need for constant care and other medical requirements. Disabilities may be physical or cognitive.
£131,620 – £192,090. Moderate Brain Damage (I). This bracket applies if the injured party’s dependence on others is reduced compared to the brackets above. Includes cases in which there is moderate to severe damage to intellect, changes in personality, problems with sight, speech and other senses, and serious risk of epilepsy.
£79,530 – £131,620. Moderate Brain Damage (II). This bracket includes cases in which there is moderate damage to intellect, and the possibility of returning to employment is either low or non-existent. Possible risk of suffering from epilepsy.
£37,760 – £79,530. Moderate Brain Damage (III). This includes cases in which concentration and memory are badly affected, and there is a reduced risk of epilepsy. Employment opportunities may be lower than before the injury, but there is little dependence on other people for help with day-to-day tasks.
£13,430 – £37,760. Less Severe Brain Damage. Cases where a good recovery is made and the injured party can return to social and work environments. There may be some on-going issues, such as mood swings or concentration and memory problems. At the upper end of the bracket there will be a small risk of epilepsy.
£1,940 – £11,200. Minor Brain or Head Injury. This bracket covers minor injuries in which permanent brain damage is minimal, or non-existent. The final compensation payout will depend on time of recovery, severity of initial injury, on-going symptoms and the presence of headaches.
‘There can be other consequential injuries that fall under the category of “general damages” above but are not included in the brackets mentioned above.and are separate heads of claim. For example:
- compensation for breakdown of a relationship.
- compensation for loss of enjoyment of a holiday.
‘Special Losses’ i.e. What can I claim for past, current and future financial losses?
In addition to the value of your actual injury, you are entitled to claim any financial loss, past, current and future that is not merely speculative and can be shown to have arisen as a direct result of substandard care and consequential injuries. For example, such losses can include the following: –
- Loss of income if you have been unable to work for a period of time or have had to give up work altogether. Alternatively, a partner may have had to give up work to care for you.
- Care provided gratuitously by your family or friends. This may be an ongoing requirement and a nursing expert can be instructed if so, to look at the ongoing cost of that and also to cost out future provision for such care to be provided on a private basis by professional carers, to allow a loved one or friend to get back to their normal day-to-day life.
- If a claimant finds themselves isolated as a result of their injury and would find it difficult to manage the provision of future carers, then a Nursing Case Manager can be appointed to plan for a claimant’s needs, interview, train and to employ and oversee carers required. A companion, known as a “buddy” can be employed to ease social isolation. The Buddy can regularly visit and support the claimant in the future, help them plan activities they will enjoy and take them out on those activities.
- Travel expenses to and from medical appointments.
- Accommodation costs, if you had to adapt your home in any way or even if you had to move to single-storey accommodation or have a requirement to move to single-storey accommodation. In such cases, an architect might be instructed to advise on costs. Also, if a claimant needs help to find an appropriate property, there are also experts we can instruct who specialise in finding suitable property to suit those with disabilities.
- Aids and equipment around the home such as ramps, grip rails, toilet rail, wheelchairs, scooters et cetera
- Orthotics- if mobility has been adversely affected and special footwear or spinal corsets can be shown to be of benefit. The purchase of such items and the future replacement costs can be significant.
- Any other reasonable financial losses. Such losses may at first seem somewhat speculative, but if a court is satisfied there is a reasonable need, then compensation can be given for such things as surrogacy costs (if the medical negligence has left a claimant with infertility issues).