Death due to infection - Immune Disorders Message Board

deedee1313 · 10-23-2006, 10:45 AM

I don't know if I am on the right board but here goes.My husband had a very low immune system due to renal failure and diabetes.He has been in out of the hospital over the last year many times.In August he spent two weeks in for E Coli which came from the urinary tract(due to the renal failure he had to straight cath every time he needed to urinate).On Oct. 10th he recieved vanco and gent.at dialysis for a suspected infection in the blood.They took blood and said they would know in 24 to 48 hours what the infection was.On Thur the 12th at dialysis he was about an hour into his treatment when he started to feel bad and asked to be taken to the hospital.By the time I got to the hospital he was on oxygen and he was so sick.They told me was going upstairs to the ICU because he had Sepsis.When he got upstairs they started hooking up the dialysis machine.I asked them when he was going to start antibiotics and they said that they would when dialysis was done.Early Friday morning at about 3:00 he went into cardiac arrest.He had a heart attack.They brought him back and he ended up on a ventilator but he never came out of the coma.On Sat. we made the decision to stop and he died.Since then I have been doing a lot of reading and I keep getting the same thing,that antibiotics should have been started as soon as Sepsis was suspected.Instead they waited nearly 3 and a half hours before they started his.I read that the survival rate goes down 6 to 10% with each hour delayed.Has anyone else been through this that could help me get this all sorted out.I keep thinking that I am just trying to find someone to blame so I don't want to read more into this than there is.On the other hand if I should be blaming someone than I want to hold them accountable.

pambyboo · 10-23-2006, 12:10 PM

I am so sorry to hear about the death of your husband. There are a lot of factors to consider when a patient has renal failure and is on dialysis, one of which is fluid volume. Certainly being fluid overloaded can cause it's own problems. It sounds like they had him on the strongest antibiotics that we have these days, and without knowing what the scheduled times were it's hard to know if this is negligence or not. Usually vancomycin is every twelve hours, but it also depends on what the blood levels of the medicine are. The lab will draw what they call peak and trough levels before and after administering the drug to see how the body is clearing the medicine. They want the blood levels to stay within a certain range. It is my feeling reading from what you wrote, that they had already put him on the strongest antibiotics. It also sounds as if he was very sick. In order to sue and win, you would have to prove that delaying his antibiotic treatment definitely was a factor in his death. Was he taking the antibiotics every day, or was he done with them? Was this a new infection or related to his last one? Then you need to know what organism killed him. Was it one that is resistant to the drugs he was given? (ie: VRE, MRSA). Was that already known by the doctors if it was? Dialysis patients have so many medical problems, it is a fine line keeping them alive, and certainly having sepsis is a serious one. Many elderly patients die from sepsis, especially if it isn't caught early enough. My recommendation to you is to consult with a malpractice attorney who can review the case and tell you what your options are. Keep in mind though that nothing will bring back your husband unfortunately.
Being in the medical field, I have a feeling that everything was done for your husband that could have been, and what happened is that a bacteria overwhelmed his body before any antibiotics could cure it. I seriously doubt starting the antibiotics before the dialysis would have saved him. I am so sorry for your loss. Please take care of you during this difficult time.
Pambyboo

deedee1313 · 10-23-2006, 01:33 PM

He just had one injection of vanc and gent on Tues.He went septic on Thur.He wasn't overloaded on fluids because we were very careful about that.The bacteria was E Coli.Thankyou for replying.I really just want to get all the info on this that I can.

pambyboo · 10-24-2006, 04:32 PM

Hmmm. I think it's totally strange that they only gave him one dose of each without continuing the treatment to the end. Did they start him on the vanc and gent for an e coli infection? Or was it just because they knew he had something but weren't sure what yet? I think now that yes, you may have an issue with negligence at least. One thing that would make a difference is if it was a resistant strain to vanc and gent. In that case, it would have taken a day or two to find out what strain it was, and what antibiotics were going to work on it. Hope that helps at least a little. Pambyboo

dbaum · 11-03-2006, 11:46 AM

I had a friend that was hospitalized for severe cellulitis. She has a compromised immune system and the infection quickly became systemic. The minute she hit the ER, and they suspected a widespread infection they did a cut down to insert a pic line and hung antibiotics. At the time they did not know what kind of infection it was but they ran antibiotics immediately. She was admitted to the hospital and the infection continued to get worse. By this time a culture had been taken.

They got an infectious disease Doc involved and she started combining antibiotics while they waited for the culture. Things began to work and she continued to fine tune the combination depending on the culture. She almost lost her leg and it was very touch and go but I believe the prompt and aggressive use of antibiotics saved her leg and life.

This is just one person's experience. Each case is very, very different.