‘Gross failings’ by medical staff lead to another child fatality from sepsis – is enough being done to stop this happening again?

12 April 2017

Last week it was ruled by a coroner that failures by an NHS hospital caused the death of a 5-year old boy from sepsis, raising fresh concerns that despite a nationwide awareness campaign, the condition is still not being spotted or treated early enough by doctors.

The young boy known as AJ was taken to his GP with a temperature, cough and rash and after his condition worsened, he attended A&E where he was treated for croup. Although he continued to deteriorate, he had been in A&E for 12 hours before an assessment for sepsis was carried out. He tragically died of a heart attack a few hours later.

Sepsis is the second biggest killer in the UK after heart disease and in a report from NHS England it is estimated to claim the lives of 37,000 people each year. The term sepsis describes the condition where the immune system goes into overdrive and can cause inflammation, swelling and blood clots. This can cause a drop in blood pressure, which cuts blood supply to vital organs. While it is one of the world’s most deadly diseases it remains one of the least recognised and there is evidence to show that prompt, appropriate treatment could save around 12,000 sepsis deaths a year.

It is also not just about fatalities, it is a life changing illness that can leave survivors with physical and physiological problems such as chronic pain, post-traumatic stress, seizures, kidney problems or limb amputations.

A campaign, delivered by Public Health England and the UK Sepsis Trust, was launched last year which aimed to promote awareness of the condition and overhaul how the NHS tackles the disease. Following the inquest into the death of 1 year old William Mead in 2014, the damning NHS report into his care highlighted a series of significant failings and missed opportunities to diagnose the condition. Since then Jeremy Hunt insisted there has been a sustained effort safety standards in hospital, including identifying sepsis.

While it is crucial that medical staff are trained to recognise the early stages of sepsis, the campaign also seeks to make the wider public, in particular parents, aware of the signs of the disease. Every hour counts and in some cases there can be very few obvious symptoms at all. The UK Sepsis Trust compiled a list of the 6 most common signs and symptoms:

  • Slurred speech or confusion
  • Extreme shivering or muscle pain
  • Passing no urine (in a day)
  • Severe breathlessness
  • Patient saying "I feel like I might die"
  • Skin mottled or discoloured

It is also important to recognise abnormalities in blood pressure, heart rate and temperature. A patient's blood pressure may plummet which may be a sign that the body's organs, such as the lungs, brain and kidneys are not getting enough blood and are beginning to fail. A NCEPOD enquiry found that poor recording of vital signs by GP’s can lead to red flags being overlooked so it is important that doctors listen to patients and use their judgment effectively.

The deaths of AJ and William are a stark reminder of how devastating the consequences of a doctor missing sepsis can be. We hope that lessons are learned from the tragic events; the government campaign must lead to tangible change and ensure that all medical staff, from ambulance paramedics to nurses and doctors, are alert to the possibility of sepsis from day one. This is the only way we can hope to avoid another preventable child fatality making the headlines. 

If you have any comments about this blog, or would like to speak to a member of the Clinical Negligence and Personal Injury team, call 020 7814 1200 or email us at claims@kingsleynapley.co.uk

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