Sepsis misdiagnosis can and does occur in the emergency department and in similar situations like urgent care clinics (UCC). How, though, how does sepsis misdiagnosis in the ER or even UCC happen?
Often, people don’t “look” sick. A patient may come in with signs and symptoms that may be attributable to the flu or another, more benign condition, when in fact he or she has sepsis. It can truly be an insidious disease – otherwise healthy people need not have mottled skin (blotchy, red-purplish marbling) or be disoriented. Rather, a patient can have diagnosable, treatable sepsis and not look like they have a deadly disease.
Electronic Health Record (EHR) systems are getting more sophisticated, and when routine vitals suggest possible sepsis are input into the system, alerts often activate for providers to consider sepsis as a possible diagnosis. Even order sets (for laboratory tests and imaging) are automatically generated for the providers to consider.
If a patient presents to an ER or a UCC and her vital signs and symptoms suggest sepsis, but no EHR algorithm has been instituted to assist clinicians in diagnosing it, that may give rise to hospital liability, especially if there is no good reason for such an algorithm to be used.
Alternatively, valuable data in the form of concerning lab values may not be acted on in a timely manner for various reasons. This can include physicians who are overworked, or care transitioning from one doctor who is leaving his or her shift and another who is coming on. Because it is so important to treat sepsis quickly, even an hour or two of delay can mean the difference between life and death.
Tragically, sometimes providers, even with these alerts and suggested course of action, ignore the possibility the patient has sepsis and fail to fully consider it. Although clearly physicians should exercise their judgment in diagnosing conditions, that judgment must be evidence-based. When a physician substitutes his or her “gestalt” for science, and a patient suffers a devastating outcome as a result, that may also give rise to liability.
Sepsis misdiagnosis in the ER and UCCs can and does occur in Washington State. When catastrophic harm occurs as a result, it may give rise to a viable claim for medical malpractice.
