VICKIE: This is Connie Chappelle, Certified Legal Nurse Consultant. Connie, I’ve asked you to visit with me today on sepsis-related legal nurse consultant jobs. I know that this can be a huge issue in litigation and I know that you’ve been involved both from a plaintiff and defense perspective. Is that right?
CONNIE: That is correct.
VICKIE: First, how do these cases even come to fruition? What’s the problem; why do sepsis cases end up getting mismanaged?
CONNIE: Because I’ve reviewed so many sepsis records, I can tell you facilities are not getting this right 100% of the time.
VICKIE: But why? Why are they not getting it right?
CONNIE: They could miss an element. They could miss finding out that the patient has severe sepsis or septic shock. If the patient has severe sepsis or septic shock they failed to order the appropriate antibiotics. They failed to order 30 cc’s per kilogram of crystalloid fluid administration. Those kind of things.
VICKIE: I’m hearing two themes. One is misdiagnosis. Another theme is mismanagement. In other words, they’re not treating it properly.
CONNIE: That is correct.
VICKIE: Sepsis is challenging to treat, even if you know what you’re doing.
CONNIE: Absolutely. Sepsis can progress rapidly from sepsis to severe sepsis to septic shock and then to organ failure.
VICKIE: Again, these are serious cases for that very reason as you are suggesting.
CONNIE: Absolutely. Once they get to organ failure, it’s hard to pull them back.
VICKIE: From a defense perspective, are there ways that you can help the defense on sepsis-related legal nurse consultant jobs? What are you looking for to help them defend the case?
CONNIE: It depends on what the plaintiff has claimed. In one case that I looked at, the plaintiff claimed that nursing should have gotten the wound culture on the second emergency department visit, even though the provider didn’t order it. So the defense attorney was consulting with me to find an expert witness to say, “You’re not going to get a specimen when the provider doesn’t order it. You’re wasting your time there.” That’s from a defense perspective, how we defend this.
VICKIE: Also, these patients that become septic, my memory of them when I worked in the hospital is that they’re often very complicated patients to begin with. Can the defense use that to complicate the case and muddy up the waters and try to show that this was an inevitable process that was going to happen?
CONNIE: They can. However, one of the things I look at for defense cases is, “Did they do what they were supposed to do when the patient arrived at the hospital?” And so basically, if they didn’t do that, then they really can’t use that claim of, “The patient was just so sick when they got here.” Great, but you needed to do what you were supposed to do.
VICKIE: They’ll definitely try to use that.
CONNIE: They will try.
VICKIE: Any other tips that you want to share with your CLNC® colleagues about sepsis-related legal nurse consultant jobs?
CONNIE: Don’t be afraid when the attorney contacts you, either plaintiff or defense, and says, “Hey, I’ve got a sepsis case for you” because these cases are no different from what you do in your other cases. You’re going to review the records and identify the standards of care. Were they met or not met? Did the patient get what they were supposed to get in the time they were supposed to get it? Remember, with your sepsis cases it’s all about time, time, time.
VICKIE: Timing! You got it. Thank you so much Connie.
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