According to the CDC 99,000 people die annually from hospital-acquired infections. As Betsy McCaughey Ross, the former Lieutenant Governor of New York put it, “You don’t often come across such a big problem that you can prevent.” McCaughey started the committee to reduce infection deaths in New York.
In Pennsylvania we suffer similar problems from hospital-acquired infections. The problem is two fold. First the communication of infection from patient to patient through contacts with health care providers and visitors results in a large proportion of people needlessly being infected.
More importantly, however, needless infections rarely have permanent or devastating results if the presence of infection is promptly recognized and properly treated. It is in general wrong to await the treatment of an infection until you have identified the specific organism involved. Once it is recognized that there is a potential infection in a part of the body, whether in the soft tissue, lung, urinary tract or elsewhere, waiting for results of cultures that identify the specific organism involved is entirely unnecessary. Instead, immediately after a specimen of potentially infected material has been obtained for culture analysis an appropriate antibiotic should be selected based on those organisms most often afflicting the organ or tissue involved. In addition, antibiotic should be selected with a broad enough coverage spectrum that a wide spectrum of different organisms that might be causing infection will be effectively controlled. The antibiotic initially chosen can be changed if clinical improvement does not occur or if culture results (sometimes not available for days) suggest a different drug is indicated.
In the case of surgical wounds, redness, warmth, swelling and pain are all signs of a potentially infected wound. In addition fever, chills and night sweats are further often late signs of infection. Antibiotics may be inadequate to address a particular infection even if they are appropriate to the bacteria involved. This is because sometimes the infection becomes associated with a collection of bacteria and pus, an abscess, which requires surgical drainage in order for antibiotics to be effective. Moreover, abscesses once formed in the abdomen, soft tissue or elsewhere can seed bacteria into the blood causing bacteremia leading to septic shock and death. Since many infectious deaths are preventable, it is tragic that so little effort is employed in hospital systems to identify those suffering permanent injury or dying from preventable or earlier treatable infections.
In this firm we have examined countless cases of patients having suffered adverse consequences from infections. It is often the case that the patient’s infection in the first instance was not preventable. It is very difficult to show that a particular infection was acquired because of breaks in sterile technique by hospital personnel. Patients in hospitals are susceptible to infection because they are often ill. Anytime surgery has been performed the surrounding tissue has an impaired ability to resist the consequences of infection.
It is for this reason that it is so important that signs of infection are rapidly recognized and reacted to.
Persons whose lives have been lost or have suffered debilitating catastrophic injury as a consequence of delay in the diagnosis and proper treatment of an infection have been assisted by our office on many occasions. Serious injury and death following infection therefore always justifies an inquiry as to whether there was a timely and proper response to the signs of infection that may have been present.
Quite often it is the case for various reasons that an infection grows to have grave consequences in spite of the fact that it is recognized and properly treated. Even in these circumstances it is typical that doctors and nurses involved in the care of the patient inadequately explain to the survivors and family the course which led to the unfortunate result. We have served hundreds of families in relieving doubts concerning whether a very bad result was preventable or not. Though these end up being families we don’t represent, we nevertheless serve them and are grateful to have the opportunity to bring them to an understanding of what otherwise might have been a life-long matter of concern.
