Delayed diagnosis of hospital infections can lead to a progression of disease and an adverse outcome. Left untreated, infections can progress from a local problem to sepsis, a systemic response to the infection. With further progression, sepsis can turn to shock, organ failure and, ultimately, death. Likewise, a delay in treatment can make it necessary to employ life-saving medicines, called pressors, that carry their own risks. Further, once a patient suffers an arrest, resuscitation has been shown to cause cognitive damage from so-called reperfusion injuries.
One of the challenges that a medical malpractice lawyer faces in proving a claim for a delay in diagnosis and treatment of hospital infections has to do with proving that the delay resulted in a worsening of the patient’s condition. Unfortunately, when there is poor medical care, important details are often lacking from the medical record. We frequently look to vital signs as a way to distinguish between a patient who is merely septic (blood pressure is normal) and one who has gone into septic shock (hypotension is evident).
Lab values also offer important clues to the patient’s status. Recent studies show that lactate levels correlate with progression of hospital infections. Lactate, or lactic acid, is a byproduct of the anaerobic metabolism that sets in when the body’s cells are getting insufficient oxygen and the usual aerobic metabolism shuts down. The seminal study on early goal-directed therapy for infections recommends that lactate levels be drawn during treatment for sepsis since they are a fair measure of prognosis. Subsequent studies confirm that lactate levels can show whether an infection has progressed to a dangerous stage that puts the patient at risk of an adverse outcome. For instance, see: http://emergency-medicine.jwatch.org/cgi/content/full/2012/914/1?q=pfw-featured&eaf.