Sepsis – what is it, who does it affect and what clinical negligence issues does it raise?

In my normal daily life, I’ve been unfortunate enough to come across sepsis in a few different situations; with a family member, a neighbour and also my own son. As a solicitor, I’ve had a number of clients suffer, sometimes fatally, with sepsis. But what is it and why do we need to know about it?

What is sepsis?

Sepsis often comes about as a result of infection, like a respiratory infection, or a urinary infection. It occurs when the body goes into overdrive trying to fight the infection and starts damaging its own tissues and organs. If it is allowed to get too far without treatment, it can be fatal.

According to figures from the Sepsis Trust, around 11 million people a year worldwide die of sepsis. To put that into recent context, 6.8 million people worldwide are thought to have died from Covid19 so far. It is estimated that around 48,000 people a year die in the UK from sepsis.

Who does sepsis effect?

Many people assume that sepsis only really occurs in new-borns, or the elderly. Studies in America have shown that it’s actually around 50/50 in terms of the illness affecting those of working age versus the elderly or very young.

So this is an illness that can come about throughout the general population, and that can have drastic consequences. If the development of the sepsis, or its outcome, could have been prevented, then it is vital this is investigated – not only for that patient but also to try and prevent it happening again.

Clinical negligence and sepsis

Errors in dealing with sepsis can occur in all types of clinical setting including GP, out of hours services, A&E, post-surgery or care homes. Within these settings, various things can go wrong to give rise to a medical negligence claim regarding sepsis. There can be delay or failure in diagnosis, or in referring on to hospital or a specialist. Signs of deterioration can be missed, or the significance of re-attendance to GP or A&E with repeat or similar symptoms might not be recognised. A further issue that can arise is a failure to interpret abnormal blood tests, and/or a delay in prescribing antibiotics to combat the infection itself.

When looking at these types of cases, some common themes arise. Communication is key: between doctor and patient, and between doctor and doctor. Often a range of clinicians can be involved with one patient, from different departments and specialisms. If the patient is in hospital, they might be transferred between different wards and departments. It is vital that everyone is kept up to speed with exactly what is going on, and that the patient’s concerns and reported symptoms are listened to.

This feeds into the second common theme: record keeping. Effective record keeping is vital for patient safety in these cases. As noted above, numerous medical staff might come in and out of this patient’s life over the course of this illness, so they need to be able to pick up the notes and know exactly what is going on. Conversations and symptoms need to be documented. Terminology and the type of language used must be consistent and specific, otherwise there is no way of knowing whether the situation is improving or deteriorating.

Finally, all primary care organisations (e.g. GP practices) and hospital Trusts, should have guidance in place with regards dealing with sepsis. There is also plenty of national guidance which should be followed and is there for a reason. If there has been any deviation from this, the reasons why should be clearly documented.