The tragic case of a mother who died after sepsis was not detected when she went to Burton's Queen's Hospital has featured on national television.
Margaret Jackson's sad story was featured on top BBC investigative show Panorama last night, Monday, September 11, which looked at the number of deaths from the potentially deadly infection, which might have been prevented had the signs been spotted earlier.
Sepsis is a serious complication of an infection which, without prompt treatment, can lead to multiple organ failure and death. On the show bosses at Queen's hospital admitted that they needed to do better when dealing with such cases. It has already apologised to Mrs Jackson's family over her death.
Since the show Queen's has made vast improvements and was now screening 98 per cent of in-patients to prevent such further tragedies, said a spokesman.
Mrs Jackson was the mother of Panorama reporter Alistair Jackson and after her death he decided to look into how she died. Her family told how she deteriorated in just two days and died at the Belvedere Road hospital.
Mrs Jackson, who had been treated by her GP for a urinary tract infection in 2015, but soon afterwards she was admitted to Queen's Hospital with chest pains and a high temperature.
Her husband John recalled how quickly his wife’s health deteriorated. He said: "She woke up in the morning and said 'I've never felt as ill as this before'.
"She quite clearly said to me at one point 'oh God is this the end?' and I said 'no don't be silly, of course not' and I think those were virtually the last words she ever uttered."
Although sepsis was not recorded as having contributed to Mrs Jackson's death, Dr Ron Daniels, chief executive of the Sepsis Trust, who was contacted by Alistair, did conclude that his mum had received antibiotics "too late."
Dr Daniels said on camera: "There is no evidence from the notes that sepsis itself was considered even in the face of abnormal observations and even when she started to deteriorate very quickly."
Mrs Jackson was eventually prescribed antibiotics but there was a three-hour delay in administering them and it was too late to help her.
The doctor said: "She received them eventually but I think it's quite clear that she received them too late. There was opportunity to administer antibiotics several hours before they were ultimately administered.
"I think it's unlikely that earlier antibiotics would have done any harm and it's entirely possible that they might have improved her chances of survival."
Dr Magnus Harrison, medical director at Burton Hospitals NHS Foundation Trust which runs Queen's Hospital, said after the show that Queen's had been open with Panorama about its journey in dealing with sepsis.
He said: "Sepsis is an incredibly serious, potentially life-threatening condition, so early diagnosis and treatment is crucial. We are absolutely committed to training and awareness on sepsis and we have made significant progress in the last few years, now seeing screening rates of nearly 100 per cent for patients, resulting in timely diagnosis.
"We do recognise that this has not always been the case in the past and we needed to do better.
"We have been open with the makers of Panorama about our journey and the importance to us of getting it right for every patient, every time. We have worked closely with the UK Sepsis Trust to ensure that our plans for improvement were implemented across our hospitals according to national best practice and with the support of a dedicated specialist sepsis nurse.
"These improvements, particularly in advancing training and awareness among our clinical staff, will continue. We also want to help our local communities recognise the signs of the infection, so they feel empowered to ask, 'could it be sepsis?' if they have concerns and we welcome any opportunity to raise national awareness on this topic."
In 2015, concerned at the growing number of sepsis cases going undetected, the NHS told hospital trusts to examine how successful they were at identifying patients with the condition.
Figures from 104 trusts seen by Panorama in the 12 months leading up to March 2017 show 78 per cent of eligible patients were being screened and 63 per cent were getting antibiotics within one hour, which means one in four NHS hospital trusts was failing to give antibiotics to half their patients with sepsis within the recommended time, said the show.
Health Secretary Jeremy Hunt said on camera that NHS had "more to do to stop preventable sepsis deaths occurring.
He told Panorama: "There are preventable deaths happening but we are bringing them down and I think that the picture is much improved from two years ago, but there's a long way to go. Safety is at the top of the NHS's in-tray and sepsis is, if you like, a litmus test as to whether we are getting there. And I would say that what it shows is that we are making progress but there is a lot more work to do."
Britain's Sepsis Crisis – by BBC Panorama
There are 44,000 deaths every year in the UK
There are 14,000 preventable deaths every year in the UK
37 per cent of patients that need antibiotics for sepsis are not getting them within an hour
14 hospital trusts are only screening one in every two people with signs of sepsis
Causes of sepsis
Sepsis can be triggered by an infection in any part of the body. The most common sites of infection leading to sepsis are the lungs, urinary tract, tummy (abdomen) and pelvis.
Sepsis may develop when you're already in hospital. For example, you're more likely to develop sepsis if:
- you've recently had surgery
- you've had a urinary catheter fitted
- you have to stay in hospital for a long time
Sources of infection
Types of infection associated with sepsis include:
- lung infection (pneumonia)
- an infection of the thin layer of tissue that lines the inside of the abdomen (peritonis)
- an infection of the bladder, urethra or kidneys (urinary tract infection)
- an infection of the gallbladder (cholecystitis) or bile ducts (cholangitis)
- skin infections, such as cellulitis – this can be caused by an intravenous catheter that's been inserted through the skin to give fluids or medication
- infections after surgery
- infections of the brain and nervous system – such as meningitis or encephalitis flu
- (in some cases)
- bone infection (osteomyelitis)
- heart infection (endocarditis)
Sometimes the specific infection and source of sepsis can't be identified.
What causes the symptoms of sepsis?
Usually, your immune system keeps an infection limited to one place. This is known as a localised infection.
Your body produces white blood cells, which travel to the site of the infection to destroy the germs causing infection.
A series of biological processes occur, such as tissue swelling, which helps fight the infection and prevents it spreading. This process is known as inflammation.
If your immune system is weak or an infection is particularly severe, it can quickly spread through the blood into other parts of the body. This causes the immune system to go into overdrive, and the inflammation affects the entire body.
This can cause more problems than the initial infection, as widespread inflammation damages tissue and interferes with blood flow.
The interruption in blood flow leads to a dangerous drop in blood pressure, which stops oxygen reaching your organs and tissues.
People at risk
Everybody is potentially at risk of developing sepsis from minor infections. However, some people are more vulnerable, including people who:
- have a medical condition that weakens their immune system – such as HIV or Leukaemia
- are receiving medical treatment that weakens their immune system – such as chemotherapy or long-term steroids
- are very young or very old
- are pregnant
- have a long-term health condition – such as diabetes
- have just had surgery, or have wounds or injuries as a result of an accident
- are on mechanical ventilation – where a machine is used to help you breathe
- have drips or catheters attached to their skin
- are genetically prone to infections
Sepsis is a particular risk for people already in hospital because of another serious illness.
Bacterial infections that can be caught in hospital, such as MRSA, tend to be more serious, as these bacteria have often developed a resistance to many commonly used antibiotics.