Check this out – failure to diagnose tick bite sepsis (especially in KIDS!!!) = lawsuit:
Keep with you always, a hard copy of this (because this is the exact description of sepsis by Allen Steere):
The article says…
“Emergency medicine was never just a clock-in, clock-out field, and we must always be aware of the risk that extends beyond the ED visit. Whether it is failing to follow up on that urine culture, treat a low serum potassium, or identify abnormal discharge vitals, failure to treat can become the basis of litigation as soon as you discharge a patient.
“These and other examples of failure to diagnose or treat could be averted through improved systems that help EPs promptly recognize disease. I predict that some high-risk presentations will cause increasing litigation in emergency medicine. Sepsis has evolved from a diagnostic challenge to a regulatory nightmare with SEP-1. All clinicians agree that the lack of SIRS can’t rule out sepsis (low sensitivity) and that the presence of SIRS doesn’t confirm sepsis (low specificity), yet CMS launched the SEP-1 core measure in 2015, requiring CMS-participating hospitals to utilize the SIRS criteria and lactate measurements to screen for sepsis.
“What has emerged are complex hospital-wide sepsis alert responses designed to capture any potential septic patient rapidly. The unintended consequence of casting a wide net for sepsis is the increased utilization of tests to work up patients presenting to the ED with a low-grade fever and flu-like symptoms. Now the determination of negligence in treating sepsis will shift from failure to diagnose sepsis to failure to identify organ impairment resulting from sepsis.
“This is a subtle but important change that places EPs at increased legal risk. The plaintiff attorney will have an easier time convincing a jury that the EP should have ordered sepsis labs or identified severe sepsis in a patient who demonstrated SIRS at triage than convincing a jury that the EP should have diagnosed sepsis in a patient whose symptoms were exactly the same as those of a viral syndrome.
“A case in point: A 30-year-old postpartum patient returned to the hospital ED two days after discharge complaining of fever and vaginal pain. Despite an elevated white count with bandemia and left shift as well as low platelets, she was discharged with a diagnosis of urinary tract infection. She was brought back to the ED within 12 hours and admitted for severe sepsis. She died from septic shock and disseminated intravascular coagulation within three days of admission. The advanced practice provider allegedly failed to recognize lab values indicative of sepsis. The jury awarded the patient’s husband more than $20 million, the second highest medical malpractice verdict in Minnesota’s history. (www.Law360.com; Aug. 29, 2017; http://bit.ly/2yZFsOM.)”