Infection After a Surgical Procedure (Part II)

Medical Malpractice Attorney

In part I, I discussed how medical negligence claims may be based on postoperative infections. Except in rare situations, it is impossible to prove that an infection was preventable. When a lawyer cannot prove that there was a negligent violation of infection control measures or sterile techniques that caused an infection, the inquiry shifts to whether the infection was timely diagnosed and or treated. Delayed diagnosis or delayed treatment of a postoperative infection can support a claim for medical malpractice.

Let’s start with an example. There are a variety of abdominal procedures and surgeries that result in postoperative infection, such as colonoscopy, appendectomy and gallbladder surgery. When the abdomen becomes infected, usually, the patient mounts a typical response to this infection, called peritonitis. Peritonitis is usually marked by extreme abdominal pain. This is a medical emergency. In order to save the patient’s life, antibiotics must be started immediately. But, just as importantly, the responsible surgeon has to obtain “source control,” meaning that the source of the infection must be eradicated. This may include fixing a perforated bowel or removing bowel contents or bile that has spilled into the abdominal cavity.

Continuing with the example of abdominal sepsis, a delay in diagnosis or a delay in treatment can lead to progression of the early infection, called sepsis, to a more advanced condition called severe sepsis. Severe sepsis, likewise, can progress to shock, wherein the patient’s blood pressure falls so low that blood and oxygen is not able to get to vital organs. Those organs began to fail. Early organ failure might appear as the kidney shutting down, resulting in the patient failing to make urine, or a change in mental status resulting from inadequate blood supply to the brain. When organ dysfunction and underperfusion is prolonged, the organs begin to shut down entirely, resulting in multi-organ failure. Without reversal, the patient will die. When caught early, however, sepsis can be treated and reversed through the use of antibiotics, source control and supportive treatments.

To prove a delay in diagnosis of infection, a medical malpractice lawyer will look to see if there are signs of the infection in the medical record, including changes in vital signs, like an increase pulse, temperature or respiration rate (shortness of breath), or changes in the patient’s white blood count. Pain or swelling can be early indicia of an infection as well. Later manifestations include signs of organ shutdown, as discussed.

Delays in diagnosis may occur for a number of reasons. For example, nursing staff or untrained residents may fail to recognize the severity of a situation, and then fail to notify the attending surgeon about a developing sepsis. On the other hand, the nurses and residents caring for the patient at bedside may communicate concerns about a change in the patient’s condition to the attending physician, but the attending physician fails to return to assess the patient and undertake emergent treatment.

When there is a negligent delay in diagnosing and/or treating an infection and it leads to serious injury, including brain damage from anoxic brain injury, or death, you should contact a medical malpractice attorney, in Cleveland, OH, like the office of Mishkind Kulwicki Law Co., L.P.A. to determine your rights.