Litigating Cases on Behalf of Children Suffering Infection and Sepsis
Sepsis in adults can be catastrophic and life-threatening. In children, it is particularly devastating and potentially lethal. Actions on behalf of children usually stem from misdiagnosis of a developing infection. These cases must be vigorously litigated to ensure care for the child now and into the future.
Sepsis is defined by the CDC as “the body’s extreme response to an infection. It is a life-threatening medical emergency. Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Most cases of sepsis start before a patient goes to the hospital. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.”
Misdiagnosis is so common, and treatment protocols varied, that a program named “Surviving Sepsis Campaign” was developed by the Society of Critical Care Medicine. A specific protocol was developed for children. Two observations must be made: first, sepsis must be screened for and recognized so that it can be treated before organ damage occurs, and second, it ought to be avoided in the first place through early diagnosis and treatment of developing infection.
Children who suffer from infections can quickly decline and get into trouble. They may appear unwell, pale, listless, cranky or sleepy. Urine output declines, as can appetite, and fevers may occur—along with rapid breathing, work of breathing, high heart rate and even seizures. Blood pressure is often maintained and then precipitously drops. Age groups with differing vulnerabilities are 0-3 months, 3-6 months and children older than 6 months. Different types of infections, bacterial, viral, fungal and those targeting specific organs (pneumonia, UTI, osteomyelitis, heart, lung, brain, CNS, etc.) require some similar but often significantly different approaches.
Not all children can be competently cared for at home or in community hospitals. Referral to a tertiary-level facility may be required for pharmacological, respiratory, one-to-one or other support.
In order to properly litigate these cases, the first step must be to obtain a comprehensive medical record, interview of relevant witnesses and creation of a chronology, which includes an analysis of the relevant guidelines. The parent or guardian of the child must be closely interviewed about the development of symptoms, triage, assessments by nursing and physicians, and comments they may recall being made. Not everything is written down, and what is written down may be a better picture than what occurred.
The experts needed to assess the case before it begins include all relevant treatment providers. These may include ambulance, family doctors, triage, ED nursing, ED physicians, pediatricians, ID, neuroradiology, radiology, pharmacology, pediatric nursing and tertiary-level specialists. Without their advice and input, you will not know who dropped the ball, nor when, how and why.
At that point, if a case demonstrates negligence and causation, ensure the case has sufficient damages to warrant proceeding. Ensure the parents/guardians appreciate the risks in the case. Be blunt. Ensure they understand the time commitment they will have and the potential for their child’s involvement. Obtain written instructions and a Joint Retainer agreement that permits you to proceed on behalf of the child should there be a falling out in the family. Explain the settlement process and CFAs, as well as their approval. There is much more to know about damages, which is beyond the scope of this article. But with your ducks in a row, you are ready to plead the case with confidence and clarity.
In my experience, these are multimillion-dollar cases that require experience, medical knowledge, and access to reliable experts. They will be well-defended. Your pockets must be deep enough to prepare the case credibly. Be honest, and if that is a barrier for you, seek out a co-counsel or refer the case outright before you plead, if possible, and certainly before examinations for discovery.
If that is you, please call us for an open, no-judgement conversation about the case. Together, we can settle this.
