Sepsis medical negligence claims

Sepsis is usually caused by bacterial infection, although it can sometimes develop from viral or fungal infections. Sepsis most commonly arises from infection in the lungs, urinary tract, abdomen or pelvis, but it can develop from infection in any area of the body.

Septicaemia (blood poisoning which often accompanies meningitis) describes when large numbers of bacteria enter the bloodstream. Sepsis can affect multiple organs or the whole body, with or without  septicaemia.

Sepsis often develops during or after a stay in hospital. It may develop:

• after surgery
• after a urinary catheter has been fitted
• after a long stay in hospital

Sepsis can be caused by infection in any part of the body. The original infection which caused the sepsis cannot always be found. Sepsis commonly arises from:

• lung infection (pneumonia)
• appendicitis;
• peritonitis – (infection of the lining of the abdominal cavity);
• urinary tract infection (UTI) of the bladder, urethra or kidneys;
• infection of the gallbladder (cholecystitis) or bile ducts (cholangitis);
• skin infections, e.g. cellulitis;
• post-operative infection;
• infections of the brain and nervous system, e.g. meningitis or encephalitis;
• influenza;
• bone infection (osteomyelitis);
• infection of the lining inside the heart (endocarditis).

The body’s immune system usually manages to keep any infection within one area of the body. Tissue swelling (inflammation) helps prevent the infection from spreading whilst the white blood cells attack and destroy the germs which are causing the infection. Where the immune system is weak or the infection is very severe, the infection spreads to other areas of the body. The immune system reacts, causing inflammation throughout the body. The side effect of the inflammation is that it interferes with the blood supply, leading to a dangerous drop in blood pressure and lack of oxygen supply to the organs and tissues.

The NHS advises that you should call 999 or take your child to A&E immediately if they have any of the following symptoms:

• looking mottled, bluish or pale;
• very lethargic or difficult to wake;
• feeling abnormally cold to touch;
• breathing very fast;
• a rash that does not fade when you press it;
• fits or convulsions.

You should also seek urgent medical advice if your child has:

• a temperature:
  • over 38°C in babies under 3 months
  • over 39°C in babies aged 3 to 6 months
  • any high temperature in a child who can’t be encouraged to show interest in anything
  • a low temperature below 36°C

• abnormal breathing:
  • working harder than normal to breathe
  • making grunting noises with every breath
  • can’t say more than a few words at once (for older children who normally can talk)
  • pauses in breathing
• toilet/nappies - not urinated or had a wet nappy for 12 hours
• eating and drinking:
  • newborn baby under 1 month old has no interest in feeding
  • not drinking for more than 8 hours (when awake)
  • green, bloody or black vomit

• bulging soft spot (fontanelle) on a baby's head
• sunken eyes
• child cannot be encouraged to show interest in anything
• floppy baby
• weak, "whining" or continuous crying in a younger child
• confusion in older child
• unresponsive
• irritable
• stiff neck, especially when trying to look up and down

Early sepsis symptoms in older children and adults may include:

• a high or low body temperature
• chills and shivering
• rapid heartbeat
• difficulty or changes in breathing
• not feeling/acting your usual self

Many of the symptoms of sepsis are similar to meningitis, in which the first symptoms are often fever (high temperature), vomiting, headache and feeling unwell. Meningitis is another life-threatening complication of infection which must be treated as an emergency to avoid long-term, serious injury. If you think you or a family member could be suffering from meningitis or sepsis, do not delay; seek medical help urgently or call 999.

Signs and symptoms of more advanced sepsis or septic shock (in which blood pressure drops to a dangerously low level) can include:

• feeling dizzy or faint
• mental confusion or disorientation
• diarrhoea
• nausea and vomiting
• slurred speech
• severe muscle pain
• severe breathlessness
• urinating less often than usual
• cold, clammy, pale or mottled skin
• loss of consciousness

Severe sepsis and septic shock are medical emergencies. Delays in treatment can result in death or permanent, severe disability. Call 999 or go to A&E immediately.

Treatment for sepsis depends on where and how the infection began (if known) and the nature and extent of the damage that has already been done. Treatment usually involves hospital referral and/or admission, IV (intravenous – into a vein) antibiotics at first, with oral antibiotics continuing after initial treatment.

Sepsis hospital treatment is sometimes known as the "sepsis 6" because three tests and three treatments should all be initiated by the medical team within an hour of diagnosis. These are:

• antibiotics
• IV (intravenous) fluids
• giving oxygen (if needed)
• taking blood cultures (to identify which bacteria is causing the sepsis)
• taking a blood sample (to assess the severity of the sepsis)
• monitoring urine (to assess severity and kidney function)

Other tests (to identify the type of infection) will include:

• urine or stool samples
• wound culture from the affected area
• saliva, phlegm or mucus samples
• blood pressure tests
• X-rays, ultrasound scans or CT scans

Emergency hospital treatment may involve admission to an intensive care unit (ICU) if the sepsis is severe or there is septic shock.

Medical negligence is when a medical professional, such as a doctor, midwife, or nurse, or other healthcare practitioner is negligent if they act in a way that falls below any acceptable standard of care.

If someone is injured as a result of medical negligence, they are entitled to compensation for any injury that was caused and for the financial consequences of that injury.

Medical negligence claims that involve severe injury and disability should always be handled by specialist medical negligence solicitors. It takes experience and skill to successfully prove that medical negligence has caused a patient’s injuries, and to secure the highest levels of compensation.

Anyone who has suffered serious injury or disability as a result of negligent NHS or private medical care can make a medical negligence claim for compensation. Special rules apply to children, adults with mental incapacity, and claims arising from a fatal injury/someone’s death.

Children and teenagers under the age of 18, or anyone with mental incapacity, must make their claim via a ‘litigation friend’. This is usually a parent or guardian in the case of a child, or a partner or other adult family member in the case of an adult with mental incapacity.  The solicitor handling the claim takes instructions and works closely with the litigation friend whilst ensuring that decisions are made in the best interests of the child or mentally incapable adult who is making the claim.  You can find out more about making a claim for a child.

Some important decisions, such as agreements to settle a child or mentally incapable adult’s claim, must be approved by the court.  Arrangements must also be made to safeguard the child or mentally incapable adult’s compensation, whether from an interim payment, lump sum settlement or agreed future payments. Depending on the claimant’s circumstances, this may be done by paying the money into a Court Funds Office account until the child is 18,  by appointing a Court of Protection deputy or setting up a personal injury trust.  You can find out more about Court of Protection deputyship and personal injury trusts.

If the claim is for bereaved family members and dependants after medical negligence caused someone’s death, the claim must be made by the deceased’s personal representative (executor or administrator of their estate) on behalf of all who are entitled to compensation as a result of the death. You can find out more about making a fatal injury medical negligence claim here.

The NHS has a responsibility to provide its patients with a safe and acceptable level of care. If a patient is seriously injured or their condition is made significantly worse as a result of negligent NHS care, the patient may be entitled to claim compensation.

Compensation can help meet the costs of care, therapies, equipment and home adaptations that are needed when an NHS mistake causes injury or disability that permanently affects the patient’s life.

We are experts at helping clients receive the compensation they deserve from the NHS. We understand the concerns that patients and their families sometimes have about claiming against the NHS. You can read our answers to many of the most common questions on our NHS claims page or speak to one of our solicitors about your own claim by contacting us.

Whilst we cannot guarantee that any particular claim will settle out of court, we take great care in investigating and preparing each claim that we take on. Our clients’ claims usually settle successfully without the need for a contested trial.

Occasionally, cases can only be concluded by a formal court hearing, such as where:

• NHS Resolution, the NHS’s defence organisation, decides to test the courts’ approach to a particular type of claim by taking a case all the way to court;
• there is a point of law in a claim which needs clarification to avoid confusion is future cases;
• where there is strong disagreement between the medical experts for each side about whether treatment amounted to negligence or caused the injury, needing the court to decide;
• where there is a factual dispute about what happened between the parties which must be decided upon by the court before liability can be determined.

Where our client’s claim is complicated by any of the above, we may advise our client that for the case to proceed, it must go to a court hearing. Our caring and highly experienced medical negligence solicitors and barristers ensure that our clients are always kept informed and supported.

Even in non-contested cases, there will be occasions when the case is brought for shorter hearings before the court, such as after a settlement for a child or brain injured adult without mental capacity takes place. In these cases, the lawyers for both sides present the agreed settlement to the court for the judge’s approval.

Each claimant’s compensation is calculated in accordance with mandatory rules based on their individual circumstances.

Compensation for medical negligence should put the injured person back in the position that they would have been in if the negligence hadn’t happened, in so far as money can.

In a medical negligence claim, the amount of compensation depends on:

• the injury or disability that was caused by negligent care, and its severity;
• the cost of meeting the individual’s needs arising from that disability in the past, present and future, e.g. for care, home adaptations, therapies and equipment;
• the financial losses that were caused by the injury, such as loss of earnings;
• how long it is expected that the person will have the need or suffer the loss.

Compensation for medical negligence usually includes a sum for the injury, and sums to compensate for financial losses and the cost of meeting the needs that arise from the disability.

Our medical negligence solicitors ensure clients receive their compensation in the way that is best suited to meet their needs.

Depending on our clients’ injuries, individual circumstances and needs, we can recover compensation to pay for:

• pain, suffering and disability;
• care (professional or provided by the family) and assistance;
• case management;
• therapies, such as:
  • physiotherapy;
  • occupational therapy (OT) ;
  • speech and language therapy (SALT);
  • psychological counselling;
  • pain management;
• assistive technology (IT);
• rehabilitation;
• home adaptations or additional costs of suitable accommodation;
• specialist equipment and aids;
• adapted vehicles, wheelchairs and additional transport costs;
• special educational needs;
• loss of earnings/pension;
• medical treatment and surgery;
• prosthetics (after amputation);
• Court of Protection costs;
• other losses and expenses arising from the injury.

Where medical negligence caused someone’s death, compensation may be claimed by the deceased’s dependants and on behalf of the deceased’s estate. Compensation in a fatal injury medical negligence claim can be paid for:

• the deceased’s pain and suffering and disability prior to their death;
• the deceased’s financial losses and expenses arising from their injury prior to their death;
• funeral costs;
• a statutory, fixed sum bereavement payment;
• a dependant’s loss of dependency on the deceased’s income;
• a dependant’s loss of dependency on other services provided by the deceased, such as child-care, driving, shopping and housework, DIY etc.

There are three ways to fund a medical negligence claim, legal aid, no win no fee, and legal expense insurance.

A medical examination is usually needed to assess our client’s injury. Where our client has suffered multiple injuries or both physical and psychological injuries, they may need to be examined by specialists in each area. This is important to make sure that our client’s injuries are fully assessed and understood, so that they can be properly compensated.

If a medical examination is needed, we instruct the specialist and make the arrangements. We ensure that they have access to our client’s medical records and are aware of the background to the claim. The hospital or doctor against whom the claim is being made may also ask for our client to be examined by their medical expert.