Sepsis & infection negligence news

 

MBRRACE - Sepsis and maternal deaths

The recent report, Saving Lives, Improving Mothers’ Care, from UK maternity services watchdog MBRRACE, found that in 2013-2015, 41% of the women who died during pregnancy, childbirth or postnatally, might have had better outcomes with improved care.

Whilst the number of deaths from indirect causes of maternal sepsis had decreased overall – an improvement they attribute in part to raised awareness of the condition resulting from the campaigning work of organisations such as the UK Sepsis Trust - 24 of the reviewed maternal deaths between 2013 and 2015 had sepsis as their primary infective cause. Nearly half of these were directly caused by sepsis and four arose from urinary tract sepsis or wound infection after caesarean section.

The report referred to the World Health Organisation’s (WHO) new international definition of maternal sepsis for 2017, which describes maternal sepsis as "a life threatening condition defined as organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion or post-partum period."

Multiple opportunities are being missed at all stages

It went on to make specific recommendations for prevention and treatment of sepsis in maternity services, many of which reflected the panel’s identification of a recurrent, dominant theme that multiple opportunities are being missed at all stages of pre-pregnancy, pregnancy, birth and postpartum to anticipate and take steps to reduce the patient’s risk.

With this in mind, recommendations were made for high level action to ensure that it is seen as the responsibility of all health professionals to facilitate opportunistic counselling and advice. Preventative measures should include increasing uptake of the flu jab, as influenza is a known cause of maternal sepsis-related death. In the recognition that women might be put off by having to attend yet another appointment, the report recommended that as pregnant women attend maternity services during pregnancy, funding should be made available for the delivery of influenza immunisation in maternity services as part of their antenatal care, rather than as a separate appointment in primary care.

Recommendations for the recognition and prevention of postpartum sepsis included the somewhat obvious instruction to community midwives to have a thermometer with them when they carry out home visits so that they can check the temperature of postpartum women who are unwell. The panel regarded having the ability to check the postpartum mother’s temperature as a minimum requirement, along with checking blood pressure, pulse and respiratory rate. They recommended that the new NICE Guidelines (not due for publication until 2020) should make this guidance clear.

In addition, health professionals were reminded to check the unwell woman’s overall clinical condition rather than relying solely on her MEOWS score which tracks changes over time in observations such as temperature, blood pressure, heart rate and respiratory rate. This is another recurrent theme, echoing the findings of the RCOG’s Each Baby Counts report which reminded maternity healthcare providers that accidents (and claims) could be avoided if they would assess the patient taking into account the full clinical picture rather than just looking at the CTG.

Following a reminder that the key actions for diagnosis and sepsis are:

  • Timely recognition
  • Fast administration of intravenous antibiotics
  • Quick involvement of experts with senior review noted as essential

…other recommendations included "declaring sepsis" – by invoking a protocol to ensure that all relevant members of the multidisciplinary team are informed, aware and act upon a potential diagnosis of sepsis, again drawing on the importance of escalation and communication between the various disciplines of health professionals who together are responsible for the woman’s care.

Multiple presentations by the woman, even in different settings (eg at the GPs surgery, then at A&E) should be seen as a "red flag" warning, requiring careful review and escalation to senior clinicians.

The panel emphasised that chronic illness and immunosuppression are in themselves risk factors for sepsis. Women with chronic illness, such as diabetes or sickle cell trait which put them at increased risk of infection should, therefore, have a lower threshold for admission to hospital, antibiotic administration and input from senior clinicians.

"Critical care is a management modality not a place."

In the event of a shortage of ITU or HDU beds, the report reminds healthcare providers that "critical care is a management modality not a place" If a woman is ill enough to need intensive care, she also needs close observation and support whilst awaiting transfer to ITU. The requisite level of care should be provided wherever the woman is located and not delayed whilst waiting for a critical care unit bed.

Whilst the significant reduction in maternal deaths from sepsis between 2010-2012 and 2013-2015 is a welcome demonstration of the value of the awareness raising work of the UK Sepsis Trust, there is much work still to do if the government is to meet its target of halving the number of maternal deaths overall by 2030.

Anticipating and reducing risk, adopting responsibility, communication and timely escalation emerge as the essential learning points for health practitioners, especially in times of high activity in maternity and A&E units.

If a family member or friend has died due to medical negligence and has left behind dependant children we may be able to help. Contact us on 0800 884 0718 or email mednegclaims@boyesturner.com for a free initial discussion.

World Sepsis Day

World Sepsis Day is held annually on 13 September in order to increase awareness of this condition which accounts for at least 8 million deaths worldwide per year.  Despite the widespread media coverage, statistics show that as few as 7% of people are aware of sepsis in some countries. With early recognition and treatment, mortality can be reduced by 50%, so raising awareness of sepsis could prevent many needless deaths worldwide.

What is sepsis?

Sepsis is the body’s response to overwhelming and life-threatening infection and can lead to tissue damage, organ failure, and death. In other words, it’s the body’s over-active and toxic response to an infection. The immune system usually works to fight any germs (bacteria, viruses, fungi, or parasites) to prevent infection. However, for reasons medics don’t quite understand, sometimes the immune system stops fighting the “invaders,” and begins to turn on itself. This is the start of sepsis.

People who are at high risk of contracting an infection (such as the very young, the very old, those with chronic illnesses and those with an impaired immune system) are at higher risk of developing sepsis. For more sepsis definitions click here.

What are the symptoms of sepsis?

  • patches of discoloured skin
  • decreased urination
  • changes in mental ability
  • low platelet (blood clotting cells) count
  • problems breathing
  • abnormal heart functions
  • chills due to fall in body temperature
  • unconsciousness

Sepsis can be diagnosed at an early stage with basic tests such as temperature, breathing rate and heart rate. The longer sepsis is allowed to attack the body, the higher the chance of a serious injury or fatal consequences.

The UK Sepsis Trust work continually to raise awareness of sepsis and to improve guidance so that the number of avoidable deaths and other life changing effects, such as limb amputation, can be reduced. As part of our commitment to reduce and alleviate the impact of sepsis, Boyes Turner are supporting the UK Sepsis Trust in raising awareness of the signs and symptoms of the disease and the importance of urgent medical treatment. Our hope is that together we can help bring an end to the suffering caused by this devastating disease.

Boyes Turner’s specialist medical negligence team have dealt with numerous cases where delayed treatment or misdiagnosis of sepsis has led to life changing consequences. Click here to read how we have helped families investigate their concerns about injuries caused by negligent medical treatment of sepsis.

Starfish: an "ordinary" life turned upside down

Starfish is a heart-breaking story of a man who had to undergo life-saving, but hugely invasive surgeries after contacting sepsis.

The film is based on the true story of Tom Ray, a man from Rutland in the East Midlands who had to have all four of his limbs amputated and part of his face removed after contracting sepsis shortly before the birth of his second child. Tom survives the ordeal but the film shows the difficulties he and his wife Nicola live through following the amputation.

Tom believed his severe stomach pains were due to out of date sausages. But when Tom’s condition worsened, he was taken to hospital. When Tom reached hospital, doctors did not diagnose the life-threatening condition, sepsis in a timely manner. Drastic surgery was advised in the hope of saving Tom’s life, and a distraught Nicola had to consent to the surgery to amputate all four of Tom’s limbs and most of his lower face.

Starfish realistically portrays the impact of Tom’s amputations, with the real Tom Ray providing a body double for the film. The film highlights the physical struggles Tom experiences, but also the psychological consequences, care needs and financial difficulties of not being able to work. Tom did not receive any kind of insurance payment for his injuries. The family had to turn charitable fundraising to pay for prosthetic limbs.

Boyes Turner’s medical negligence solicitor, Sita Soni says about the film, “Starfish depicts the emotional journey of Tom and Nicole’s personal struggles after Tom’s battle with sepsis. It does not shy away from the life changing impact of amputations and the support that is needed for the amputee and the family as a whole. From my experience with sepsis and amputation medical negligence cases, the impact of this silent killer is devastating especially when injuries could have been avoided with an early diagnosis and treatment, as Starfish shows. Having the right support and rehabilitation in place is crucial.”

Starfish - Sepsis film, Boyes Turner Sepsis Claims Lawyers

Why is this film important?

Approximately 44,000 people die of sepsis every year in the UK, that is a higher mortality rate than from heart attacks and some common cancers. Early diagnosis and treatment of sepsis is vital to saving lives and avoiding life changing injuries such as amputation. Recent studies indicate that as many as 14,000 lives could be saved by better medical care.

Simple steps, such as giving intravenous antibiotics and fluids in the first hour of attending hospital can reduce the risk of death by sepsis by over one-third.

This release of Starfish has coincided with the UK Sepsis Trust’s (UKST) fight against sepsis and awareness campaigns to help prevent future tragedies.  Boyes Turner have joined UKST, along with Tom Ray and his wife Nicole to campaign for better sepsis care, raise sepsis awareness and support the families affected by sepsis.

One of the aims of the UKST is to empower individuals feeling unwell to question, “could this be sepsis?” and seek early medical advice. For more information of the signs and symptoms of sepsis, click here.

Starfish can save lives. We urge you to see Starfish and help raise sepsis awareness. For more information about the film, click here.

Our specialist solicitors have many years of experience of representing clients in sepsis and amputation claims.

We understand the impact sepsis can have on individuals and their families. Compensation can help with rehabilitation for sepsis survivors and financial worries for those that are bereaved as a result of sepsis.

Starfish, an inspiring story brought to film - released on 28 Oct 2016

Starfish, an inspirational story of love, strength and determination following Tom Ray’s battle with sepsis, is due to be released in cinemas this week.  The film, starring Joanne Froggatt and Tom Riley, will be released in cinemas across the country including Reading’s Showcase cinema.

Starfish - Sepsis film, Boyes Turner Sepsis Claims Lawyers

Starfish, the film

“The true and incredibly moving story of Tom and Nicola Ray (Tom Riley, Joanne Froggatt), whose love is tested to the limit when their perfect life falls apart.

When Tom puts his small daughter to bed one chilly December evening, he has everything he could ever want – the house of his dreams, the life of a writer, a beautiful wife and a second baby on the way, By the next morning, all of this is in jeopardy as Tom succumbs to the devastating illness that is sepsis.

As Tom and Nic battle to hold their family and their marriage together, the strength of their relationship is the only thing that can save them.”

Tom Ray

Tom’s devastating battle with sepsis required amputation of all four limbs and a partial face amputation to save his life. Starfish openly reveals Tom’s struggle with his new disabilities and the strain on his marriage and ability to care for his children.

Tom Ray and his wife Nicole are campaigning with the UK Sepsis Trust (UKST) for greater awareness of the risks of sepsis with the aim that the number of fatalities and life changing injuries will be reduced with early diagnosis and treatment. One of the aims of the UKST is to empower individuals feeling unwell to question, “could this be sepsis?” and seek early medical advice. For more information of the signs and symptoms of sepsis, click here.

This film can save lives. We urge you to see Starfish and help raise sepsis awareness. For more information about the film, click here.

Boyes Turner partners with UK Sepsis Trust

Last week, Boyes Turner screened exclusive clips of Starfish with UKST. The screening, which took place at Boyes Turner’s office, was an inspirational evening with presentations from the UKST, Pippa Cross (producer of Starfish), and Terence Canning who tragically lost his brother to sepsis four years ago.

The screening was attended by Boyes Turner clients, barristers, rehabilitation organisations and charities.

The strength and determination from the UKST and those that have a devastating connection to sepsis to raise awareness and talk about their experiences was powerful and very moving. Ruth Meyer, a partner at law firm Boyes Turner said about the event, “the speakers were inspirational and together with the film made me realise how much just one moment in time can have such a devastating impact.”

Support for the film and UKST

Dr Ron Daniels BEM, Chief Executive of the UK Sepsis Trust and global sepsis expert, said It’s exciting to bring together UKST supporters and the Starfish team to celebrate the progress we can make by bringing this extraordinary film to as many audiences as possible. Together we can save thousands of lives every year if we ‘Just ASK: could it be sepsis?'”

Julie Marsh, solicitor at Boyes Turner said “Despite seeing the clip for the second time, none of the raw emotional power was lost.  Now I just can’t wait to see the whole film next week.  An honour to meet Terence Canning and talk about how sepsis touched him and his family so tragically, and his campaign to raise awareness of sepsis all over the country.”

Vitek Frenkel of Frenkels said “it was a very moving and informative evening. The clips brought home how quickly sepsis can strike and how devastating it can be. I commend the UKST for all their efforts to bring about awareness of sepsis and how simple questions at the right time could save many lives.”

Sita Soni, solicitor at Boyes Turner, said “Starfish shows just how suddenly sepsis can develop with life changing consequences when it isn’t treated quickly.  It was a honour to host this screening and we are proud to be involved with the UKST helping them in the fight against sepsis.”

The UK Sepsis Trust feature film starfish

Starfish - Surviving Sepsis

Tonight Julie Marsh, Sita Soni, Laxmi Patel and Ruth Meyer from Boyes Turner Solicitors will be attending a UK Sepsis Trust screening of the trailer of the new feature film “Starfish” which tells the incredible story of Tom Ray’s battle with sepsis.

The film tells the story of Tom and Nicola Ray, whose life changed beyond all recognition in 1999, when 38 year old Tom contracted septicaemia.

As a result of the infection, Tom had to have both legs and arms amputated and part of his face removed.

At the time of Tom’s illness, he had a two year old daughter, Grace, and his wife was nine months pregnant.  As a result of Tom’s illness, his wife had to give birth to their son while Tom was in a coma on the other side of the hospital, fighting for his life.

Tom’s symptoms started when he has violent stomach pains which he puts down to a couple of out of date sausages he had eaten.  Even when he reached hospital, doctors were slow to diagnose the life threatening blood disease.

Tom’s wife Nicola was faced with the decision to permit surgeons to amputate all four of Tom’s limbs, and most of his lower face, in an effort to save him.

Starfish is based on interviews with Tom and Nicola, and diaries that Tom kept at the time.

The couple have both been involved in the production of the film, Tom actually trained as an actor and very much wanted to be part of the acting world.

The team are very much looking forward to seeing the trailer of the film, and meeting with people from The UK Sepsis Trust.

World Sepsis Day 2016 - 13 September

The purpose of World Sepsis Day 2016 is to increase awareness of this life changing condition.

Sepsis, also known as septicaemia, blood poisoning or septic shock, causes the body’s immune system to go into overdrive as it tries to fight an infection and can result in the immune system damaging tissues and organs. In serious cases, sepsis can cause a drop in blood pressure, multiple organ failure, kill the body’s tissues and in extreme cases, septic shock can be fatal.

Sepsis claims more lives than any cancer

In fact, every three to four seconds someone dies of sepsis – we must keep this deadly condition in the spotlight. 

Sepsis is a treatable condition with a timely diagnosis and urgent medical treatment.

So why do we only too often hear about its devastating impact? Worryingly, the UK Sepsis Trust reports 44,000 deaths a year from sepsis.

Sepsis is often diagnosed at an early stage based on simple measurements such as temperature, heart rate and breathing rate. However, sometimes these signs are missed or misdiagnosed. Occasionally there signs are more indicative of sepsis such as dizziness, confusion, diarrhoea, vomiting, reduced urine output which are still missed or not treated urgently.

The longer sepsis has to attack the body, the higher the chance of serious injury or fatal consequences.

We have dealt with numerous cases where misdiagnosis or delayed treatment of sepsis had devastating consequences. Click here to read how we have helped families investigate their concerns about sepsis medical negligence.

World Sepsis Day 2016

The UK Sepsis Trust have worked tirelessly to campaign for better awareness of sepsis and sepsis guidance to reduce the number of avoidable deaths and other life changing effects such as amputation. The publication of sepsis guidelines on 13 July 2016 highlighted the importance of early diagnosis and treatment of sepsis. The moving video posted from Melissa Mead, William Mead’s mother, on social media has also powerfully highlighted why the fight against sepsis is vital. William sadly died from sepsis a few days after his first birthday.

Medical staff must now routinely consider – “is this sepsis?”  This requires training and better awareness of the urgency of sepsis treatment.  Likewise patients are urgent to think and ask their doctors – “could it be sepsis?”

Sepsis negligence claims solicitor, Sita Soni said:

“Days such as World Sepsis day and other national campaigns are vital to raise awareness of sepsis, keeping it in the spotlight in the public eye and for medical professionals.  We’re helping charities such as the UK Sepsis Trust raise awareness and support families who have been tragically affected by sepsis.  Sadly William Mead’s story isn’t a one-off, but we hope that awareness campaigns and new guidelines prevent future tragedies.”

Sepsis and amputation

Sepsis accounts for 44,000 death annually in the UK. Caught early, the outlook is good for the vast majority of patients, which is why it is crucial not to incur any delay in seeking medical attention.Sepsis negligence claims - Boyes Turner medical negligence claim lawyers

Infection can give rise to sepsis, especially when there is an infection in a wound site.  Sepsis can lead to shock, which then leads to multiple organ failure and can lead to death especially if it is not recognised early and treated promptly.

During the summer of 2015, Ruben Harvey-Smith suffered a burn to his chest, when an iron was knocked over. Ruben’s mum rushed him to Accident and Emergency at Ipswich Hospital, where he was given pain killers and the burn was dressed.

Ruben’s mum Louise was told there was a possibility that a third degree burn could affect the deeper tissue, and normally Ruben would have been referred to Chelmsford Specialist Burns Unit.  Unfortunately it was closed because of outbreak of an infection.

Louise was therefore advised to take Ruben to the Chelsea & Westminster Hospital, 80 miles away, the following morning. She did so, Ruben’s burn was redressed and he was advised to go back to Chelmsford four days later.

Louise was given a list of symptoms to look out for that could indicate that Ruben might have sepsis, or blood poisoning.

The following morning, Louise was worried as Ruben was cold and shivering and appeared quite unwell. He developed a rash, and Louise was concerned that he was drowsy.  She immediately phoned the Chelsea & Westminster Hospital, and doctors were concerned that an infection had set in.  She was advised to take him immediately to Ipswich A&E.

On the way to the Hospital, Ruben was sick.

Once Louise arrived at the Hospital the doctors monitored Ruben’s temperature, and gave him Calpol.  They diagnosed tonsillitis. Ruben’s heart rate even rose at one point to 190 beats per minutes, but the doctors still failed to recognise the onset of sepsis.

Ruben was then discharged home.

Louise was still worried when she arrived home with Ruben, and so contacted the Chelsea & Westminster Hospital again.  The doctors were concerned that Ruben was showing signs of toxic shock syndrome, and she was advised to immediately take him back to Ipswich Hospital.  On arrival, Ruben was taken into the resuscitation unit.

Ruben was transferred by ambulance to St. Mary’s Hospital in Paddington, and Ruben was given IV antibiotics.  Although he began to respond to the treatment, his limbs were swollen and discoloured, and the sepsis that was set in after the burn, had caused the blood supply to his legs to reduce.

Doctors told Louise that they would need to amputate both of Ruben’s legs, and some of his fingers, in order to save his life.

A year later, Ruben has learned to walk on prosthetic legs, and has found a way to manage every day tasks such as dressing himself, although these are difficult.

Louise has pursued a claim on Ruben’s behalf and the Ipswich Hospital Trust has admitted full liability for the shortcomings in the care that Ruben received.

Now Ruben and his family need to focus on helping Ruben adapt, and achieve all the care, prosthesis and equipment that he will need for the remainder of his life.

Julie Marsh, an expert amputation negligence claims lawyer, commented on the case:

“It is sad to read about this case involving Ruben, and there are clear examples here that Ruben was suffering with symptoms clearly indicative of sepsis which should have been recognised by his treating doctors. There has been a lot in the press recently regarding sepsis, and the UK Sepsis Trust are working with other charities to raise awareness of the signs and symptoms of sepsis.  You can read more about this here and how to recognise the symptoms of sepsis”.

Sepsis awareness campaign - Stand by your word

Sepsis remains a hot topic in the media. It has recently been announced that William Mead’s mother is in discussions with Health Secretary, Jeremy Hunt about supporting a sepsis awareness campaign. She has asked him to stand by his word in terms of raising public awareness of sepsis, both in children and adults. 

Do we need a sepsis awareness campaign?

12 month old, William Mead died in December 2014 after medical staff failed to Sepsis Awareness Campaign - Boyes Turner Medical Negligence Claimsspot that he had signs of sepsis. A damning NHS report identified 16 mistakes which had contributed to his death.

Sepsis is often named ‘the silent killer’ because it can be difficult to identify but is surprisingly common, read our previous article here. A sepsis awareness campaign is designed to help members of the public and health professionals spot the early signs of sepsis and the symptoms to look out for.

Delay in diagnosis of sepsis

Having acted for clients who have experienced long term health complications following a delay in diagnosis of sepsis, we have first-hand knowledge on the importance of supporting and promoting sepsis awareness. A sepsis awareness campaign could help avoid needless deaths in the future.

Our specialist solicitors have many years of experience of representing clients in sepsis claims so do contact us and we will advise you whether we feel that you have a negligence case.

58 year old mother's death from sepsis - inquest finds "missed opportunities"

An inquest at West London Coroner’s Court found that there were “missed opportunities” which may have prevented Mrs Kamalalginidevi Pararajasingam’s death from sepsis.

Mrs Pararajasingam, who ran a convenience store in Surbiton, died from sepsis at Kingston Hospital on 18 November 2015. She went to the hospital early on 18 November with a fever, pain on passing urine and general confusion. Medical staff recognised that Mrs Pararajasingam was suffering with an infection and required intravenous antibiotics. These were not received before she died as medical staff were unable to insert the cannula to administer the medication.

Coroner, Chinyere Inyama heard that doctors and nurses failed on 18 attempts in four hours to provide treatment at Kingston Hospital.  Eventually a registrar was asked to place a central line but before this was done, Mrs Pararajasingam went into cardiac arrest and died. The post mortem found that the main cause of death was septic shock.

Mr Inyama said that as a result of Mrs Pararajasingam’s condition, she should have been monitored every hour, but this was not done. He also said that there were “missed opportunities” to “provide treatment that might have altered the outcome.”

Dr Emily Ormerod, a consultant who carried out the internal investigation at the hospital following Mrs Pararajasingam’s death, told her family – “We completely and wholly accept we did not give your mother the best chance of survival.”

The West London Coroner’s Court was told that the hospital’s protocol in dealing with patients with sepsis has been amended but it has not yet been implemented.

Mrs Pararajasingam’s daughter said – “It is clear that staff had tunnel-vision in their attempts to insert a cannula and failed to see that our mother was deteriorating. We are truly saddened that despite sepsis awareness campaigns and the hospital’s own guidelines, our mother did not receive the treatment she needed.

We are truly devastated by the loss of a kind hearted, honest and loving mother. Mum was truly unique, she always saw the good in people and could never turn a blind eye to someone who needed her help. She had a profound effect on many people especially to those visited her shop. We’d like to thank our friends and the community for their kind words and support through this difficult time.

We hope that Kingston Hospital and many other emergency departments across the country take lessons from our mother’s death and implement change, so that this doesn’t happen to other patients.“

The family is now considering legal action against the Trust. Law firm Boyes Turner LLP is representing the family. Sita Soni, a solicitor in Boyes Turner’s Medical Negligence team said 

“It is utterly tragic that a 58 year old woman experienced a string of failures to provide her with basic care and medication. Mrs Pararajasingam’s family have been left devastated by her death, and whilst the inquest has provided some answers, there are still concerns about the care Mrs Pararajasingam received before she died. We hope that the investigation conducted by the hospital and the overhaul in the hospital’s sepsis protocol will lead to significant changes in the way patients with sepsis symptoms are treated to prevent similar tragic incidents in the future.”

Coroner concludes that neglect directly contributed to death of 62 year old man from septicaemia

The failure of staff at the Royal Derby Hospital to administer the correct antibiotics before and after an operation resulted in the death of man from septicaemia, an inquest has concluded.

Paul McCandless, Assistant Coroner for Derbyshire, concluded that neglect ‘directly contributed’ to the death of 62 year old Simon Tulitt, who died three days after an initial operation for colon cancer.

The Coroner also ordered Derby Teaching Hospitals NHS Foundation Trust to report regularly for the next 10 months on progress into ensuring that a system was in place to prevent repetition.

Trust managers have apologised to the family of Mr Tulitt and insisted that lessons have been learnt.

Our specialist solicitors have many years of experience of representing clients in sepsis claims so do contact us and we will advise you whether we feel that you have a negligence case.

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