Medical errors often arise when physicians rule out a condition because a common sign or symptom is not present. For instance, physicians can be quick to dismiss infection when there is no fever or abnormal white blood count (WBC). But those signs of infection are not always present. In fact, these signs or symptoms are frequently absent in certain patient populations or due to circumstances of the case.
“Sepsis” is defined as the body’s inflammatory response to infection when two or more of the following are present: (1) abnormally high or low temperature; (2) abnormally elevated heart rate; (3) abnormally high respiration rate (aka “shortness of breath”); and/or (4) abnormal WBCs, including a so-called “bandemia” or “left shift” caused by rapid production of young whites blood cells. Notice that this definition does not require either fever or an elevated white count to be present. When increased heart and respiration rate are present in an ill patient, but temperature and white count are normal, it may be medical malpractice to ignore the possibility of infection.
The Journal of Emergency Medicine recently reminded its readers that fever and white count are not foolproof. In fact, the article pointed out that more than half of the patients studied had a normal white count despite having an infection. Seventeen percent of infected patients had both a normal white count and no fever.
There are many reasons why temperature and white count can be normal in a patient with an infection. For example, when these may not appear until later in an infection, particularly in elderly populations. Temperature can be masked in patients who are on fever-relieving medications or who receive chilled intravenous fluids that reduce the body’s temperature. White counts are likewise subject to a number of factors.
In Ohio, when physicians fail to follow accepted standards of medical practice and cause injury to a patient. they are liable for harm caused to the patient by such medical errors. When the treatment of an infection is delayed, and it progresses from an early treatable infection to an advanced septic shock or organ failure such that the patient dies or sustains other avoidable injuries, it may be worthwhile to speak to an experienced medical negligence attorney.
