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Failure to Diagnose Infection Leads to Verdict

Article posted on: 07/09/2008

Recently, the family of a 39 year old Michigan construction worker who worked as a ditch digger and pipe layer received a 9 million dollar jury award in a medical malpractice/negligence lawsuit following the man's death from a fungal infection. The man, who took medicine for rheumatoid arthritis (which resulted in a compromised immune system) began suffering from a fever of unknown origin. After 10 days, he was admitted to a hospital under the care of two internal medicine doctors and an infectious disease specialist. For nine days, he underwent tests, including a general fungal test. He subsequently became critically ill and died. The cause of death was ultimately determined to be disseminated histoplasmosis, a fungal infection contracted from the soil. Because of the man's daily contact with the soil, the family argued that the defendant doctors should have performed a biopsy or urine test to timely rule out histoplasmosis while he was hospitalized. At the conclusion of the trial, the jury found the health care providers negligent awarded the family $9 million dollars.

While histoplasmosis is relatively rare when it comes to infections, our lawyers often become involved in cases in which a person has contracted an infection, and ultimately develops sepsis as a result of the infection going undiagnosed for a long period of time. Sepsis - the body's ultimate response to a bacterial infection -- is characterized by severe reaction of the body's organs to the foreign bacteria and/or death. Sepsis is also referred to as systemic inflammatory response syndrome (SIRS). Although sepsis often results from the widespread invasion of bacteria into a patient's bloodstream, this invasion is not essential for the development of severe sepsis since local infection/inflammation can also cause distant organ dysfunction and blood pressure irregularities. Some of the common places in the body where an infection might start include the skin (celluitis), the lungs (bacterial pneumonia), liver, gall bladder, lining of the brain (meningitis), the bloodstream, the bones, the bowel, or the kidneys. For hospitalized patients, common sources of infections include bedsores (decubitus ulcers), surgical drains, intravenous lines, or surgical wounds. Unfortunately, bacteria live and breed in hospitalized settings, and thus, many healthy people who have suffered an injury requiring a drain, or IV lines or open ports into their blood stream often contract an infection that turns into sepsis.

Epidemiologists blame this large increase on the explosive rise in antibiotic-resistant bacteria caused by overuse of antibiotics as well as on the increasing numbers of people living with immune systems weakened by HIV, using immune-suppressive therapy for organ and bone marrow transplants, and receiving high-dose chemotherapy for cancer. Young children and elderly people are also at a higher risk for the condition because of their weaker immune systems. Researchers have recently discovered that blocking the activity of a single enzyme known as aldose reductase can short-circuit sepsis, protecting heart function and greatly reducing sepsis deaths.

These scientists have accomplished this feat using a chemical compound very similar to a diabetes drug already in stage three clinical trials in the United States, the final level of human experimentation before a drug is considered for federal licensing approval. If those diabetes trials prove successful and the drug is approved for use in diabetics, it's possible that such an "aldose reductase inhibitor" could be used by physicians relatively quickly for "off-label" emergency use against sepsis in humans, the scientists said. When a drug is approved for one human use, individual doctors may try it out against other conditions where it appears warranted.

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