Sepsis: Is it on the increase?

Is sepsis on the increase?

According to NHS England, 15,722 people died of sepsis in the year to April 2017. This is an increase of about one third in 2 years.

Does this mean that we are getting worse at managing sepsis? Or is it just that more deaths are being recorded as due to sepsis rather than some other cause? It is not unusual for some deaths from sepsis to be recorded as due to infection (which is not the same).

It may be that both are true. However, Prof Sir Brian Jarman thinks that some of these deaths are preventable. Some may be due to staff shortages or overcrowding on wards. And there seems to be a variation in practice between different hospitals.

What is sepsis?

Sepsis is a complication of some infections. The most common types of infection which trigger sepsis are pneumomia, abdominal infections, kidney infections and infections of the blood. The Sepsis occurs when the body’s immune system release chemicals into the blood stream to fight the infection but instead they cause inflammation which can be cause serious harm.

Sepsis is a very serious condition which can have life-changing consequences. It can lead to the loss of arms, legs, or even your life. Its symptoms include fever, a fast heart rate and a fast pulse. It develops into a second stage – known as ‘severe sepsis’. Symptoms include discoloured skin, decreased urine output, a low platelet count, breathing difficulty, chills and unconsciousness. A third stage is septic shock, where organs start to fail.

How can we manage sepsis better?

Sepsis has had a higher profile in recent years and hospitals have introduced early warning systems to identify the condition earlier. These are often known as ‘MEWS’ or ‘NEWS’ (modified or national early warning score). This is a way of recording regular observations of pulse rate, blood pressure and the level of oxygen in the blood. The observations are given a score. Scores of certain levels should trigger review and investigation. When the scoring systems are used correctly they are an effective way of diagnosing sepsis early.

Some hospitals are better than others at using these scoring systems. Prof Jarman wants hospitals to learn from the best.

It is important not only to recognise sepsis early but to manage it correctly. Management involves supporting a patient’s vital functions – heart rate and breathing – but also dealing with the source of the infection.

Where do things go wrong?

Things can go wrong when staff do not carry out observations correctly, don’t do them often enough, record the information incorrectly or do not follow protocols. This can lead to delay in diagnosis. There are also treatment failures. Those failures can be in treating the underlying cause of infection or in supporting a patient’s vital functions whilst treating the underlying cause.

Sepsis: Claims for damages

Where the failure to diagnose or manage sepsis correctly has caused death or serious injury, patients or their families may be entitled to bring claims to make good their loss. Examples of successful claims include:

• A man in his 40s who was left partially paralysed and brain damaged after a long delay in diagnosing sepsis. He was admitted to hospital on a Friday evening and neglected over the weekend. By the time he was diagnosed, he had developed septic shock and then had a stroke.
• A man in his 30s who developed sepsis after developing an infection in his leg. His leg had to be amputated above the knee.
• A young woman who died 48 hours after giving birth to her first child by caesarean section.
• A woman who was admitted to hospital with infection following a miscarriage. She was correctly diagnosed and admitted to intensive care but nothing was done to manage the underlying infection until it was too late. She sadly died.

If you would like advice about a possible legal claim please telephone 0800 044 8488. Our specialist lawyers are expert in handling complex sepsis claims.