Sepsis and Nursing Home Lawsuits

Many nursing home patients die of sepsis.  Often, this does not result in a nursing home lawsuit because the infection occurred in the absence of negligence from a nursing home.  But, too often, sepsis is the result of a bedsore or other preventable condition because of nursing home negligence or neglect.  With nursing home sepsis, there are often signs that show an infection if the nursing home staff is paying attention.

Our lawyers handle nursing home sepsis lawsuits where a death occurs because the patient was not properly diagnosed and treated. This page talks about sepsis and the settlement value of sepsis wrongful death nursing home lawsuits.

What Is Sepsis?

Sepsis is an extremely dangerous and often fatal medical condition in which an infection becomes so advanced that it invades the bloodstream and the body’s immune system begins to damage its own organs. Sepsis is essentially the result of a person’s immune defense system being overrun. Well over a million cases of sepsis are reported in the U.S. each year and 250,000 people die from it on annual basis.

Sepsis Nursing Home Statistics

Nursing home sepsis statistics are very daunting for a topic few people focus on until they have a parent or spouse dealing with sepsis:

• Nursing home residents are seven times at great risk for severe sepsis diagnosis than non-nursing home residents (14% vs. 1.9%)
• A half a million patients go to the ER with severe sepsis every year in the U.S.
• There are one million sepsis cases a year
• 40% of patients that have sepsis that go into septic shock die

What Are the Stages of Sepsis?

Sepsis develops in 3 distinct phases: (1) sepsis, (2) severe sepsis, and (3) septic shock. Sepsis is something that often occurs in serious cases of medical malpractice or nursing home neglect. In this post, we will explain and describe the 3 phases of sepsis infections.

STAGE I: Sepsis

The first stage of sepsis appears when patients with an infection develop a specific set of signs and symptoms that indicate that the infection has progressed into sepsis. The preliminary symptoms for any sepsis diagnosis include:

• Fever: a very high body temperature (above 100 degrees) is always a sign of a significant infection because the body’s internal temperature rises when it tries to fight off bacteria.
• Infection: while fever is a sign of systemic infection, other infections (e.g., an infected cut, or urinary tract infection) have more localized symptoms such as redness and swelling or pain and discomfort.
• Mental Decline: an acute downward change in mental capacity such as being confused or “dazed” and not able to process information or move normally.
• Extreme Illness: severe body pain and discomfort along with shortness of breath and other very severe types of illness symptoms.

If two or more of these initial signs and symptoms are present, a diagnosis of stage one sepsis can be made if any combination of the following additional diagnostic criteria is present:

• Inflammatory Symptoms: symptoms of inflammatory response consistent with sepsis include: very high white blood cell count, abnormal levels of “immature” white blood cells, and elevated levels of procalcitonin (PCT) and plasma C-reactive protein.
• Hemodynamic Symptoms: hypotension (low blood pressure), low mixed venous or central venous oxygen saturation levels, high cardiac index.
• Organ Malfunction Symptoms: low urine output, high creatinine in the blood, abnormal blood clotting, high bilirubin levels, and low platelets.

STAGE II: Severe Sepsis

The second stage of sepsis is known as severe sepsis. Severe sepsis occurs when there are clear signs of organ dysfunction and tissue hypoperfusion. The following diagnostic indicators are used to identify when sepsis has progressed into severe sepsis (stage 2):

• Hypotension: hypotension (low blood pressure) would be systolic pressure below 90 mm Hg and arterial pressure under 70 mm Hg, or an overall decrease in systolic pressure of 40 mm Hg or more.
• Lactate Elevated: abnormally high levels of lactate in the blood is a sign that an infection is interfering with normal organ function, causing excess lactate to accumulate.
• No Urine Output: if the patient is consuming fluids but not urinating it can be another sign that their organs are not fully functioning.
• ARDS: Acute Respiratory Distress Syndrome (“ARDS”) is a condition in which respiratory failure and malfunction are caused by acute inflammation in the lungs.
• Platelet Count: a very low blood platelet count is a sign of severe sepsis suggesting poor organ functioning.
• Changes in Skin Color

This combination of symptoms will only be used to reach a diagnosis of severe sepsis when they are clearly the result of stage I sepsis (not related to a pre-existing condition). The symptoms should also be seen to continue even after fluid replacement.

STAGE III: Septic Shock

The third and final stage of sepsis is called septic shock. Septic shock occurs when multiple vital organs in the body begin shutting down entirely. The diagnostic symptoms of septic shock are the same as those listed above for severe sepsis, except that septic shock is usually characterized by a very sudden and dramatic drop in blood pressure and a spike in lactic acid levels in the blood. Septic shock symptoms:

• Acute Hypotension: systolic blood pressure drops below 65 mm Hg and cannot be maintained above that level without medication.
• Lactic Acid Spike: extremely high levels of lactic acid in the blood will indicate that oxygen is not being distributed to organs by the blood cells.

Sepsis in Elderly Patients

Elderly people are particularly vulnerable to sepsis because the human immune defense system weakens as we get older. Older people are also much more likely to have chronic medical issues like diabetes, cancer, kidney disease, and other issues that can further weaken and undermine the immune system.

Sepsis in elderly patients most commonly originates from either a respiratory infection such as pneumonia or a urinary tract infection, both of which are very common in older people. Bedsores (also known as pressure sores) are also a common source of infections that can lead to sepsis in elderly patients. Nursing home neglect is a common cause of bedsores and when not properly treated they can lead to infections and sepsis.

Can Bedsores Lead to a Sepsis Infection?

A properly treated bedsore should not cause a sepsis infection.  The problem is that nursing homes often do not identify and do the little things necessary to treat a bedsore.  This turns a small problem into one that can be fatal.

Can Sepsis Be Effectively Treated by a Nursing Home?

As long as sepsis is diagnosed early only in its progression, it can be effectively treated with antibiotics and fluid replacement. If the condition is not promptly diagnosed, however, it can become too advanced for treatment to work.

How Long Does It Take to Die from Sepsis?

Severe sepsis can potentially cause organ failure and death within just a few days without any treatment. Even if sepsis does not cause death within the first few weeks, it can have lingering effects and indirectly contribute to death months and even years after the initial infection.  Approximately 40% of patients who survive the first month of sepsis will die within the next 2 years.

Can Nursing Home Neglect Cause Sepsis?

Yes. When immobile residents at nursing homes are not regularly moved and repositioned by staff, they can develop bedsores. If left untreated (through negligent care), bedsores can progress into an infection and quickly lead to sepsis.