Sepsis is a medical emergency that requires urgent recognition and treatment. When it is missed or not acted upon promptly, the consequences can be devastating. Despite clear national guidance and increasing awareness, failures to identify sepsis remain a common feature in clinical negligence claims.

At Harding Lister Law, Scott Harding-Lister and his team of experienced clinical negligence solicitors regularly act in cases where patients have deteriorated in hospital settings and early warning signs have not been recognised or escalated appropriately. These cases often involve failures at ward level, where observations are recorded but not acted upon, or where nursing staff do not escalate concerns to senior clinicians.

This article explains how sepsis develops, what signs should be identified in both adults and children, the treatment that should be provided, and how failures in care can give rise to a medical negligence claim.

What Is Sepsis

Sepsis is the body’s overwhelming response to infection, which can lead to tissue damage, organ failure and death. It can arise from infections such as pneumonia, urinary tract infections, abdominal infections or infected wounds.

The progression from infection to sepsis can be rapid. A patient may appear relatively stable and then deteriorate significantly within hours. This is why early recognition and prompt treatment are critical.

Healthcare professionals are trained to identify deterioration using structured monitoring systems, including the National Early Warning Score. Where these systems are not followed, or where warning signs are ignored, clinical negligence can arise.

Recognising a Deteriorating Patient

A key aspect of patient safety in hospitals is the identification of deterioration. Nursing staff are usually responsible for monitoring vital signs and recognising when a patient’s condition is worsening.

Observations should include:

• Heart rate
• Blood pressure
• Respiratory rate
• Oxygen saturation
• Temperature
• Level of consciousness

These observations are used to calculate an early warning score. If the score reaches a certain level, escalation to a doctor or senior clinician is required.

Clinical negligence often occurs when:

• Observations are not recorded properly
• Abnormal results are not acted upon
• Early warning scores are calculated incorrectly
• Concerns are not escalated to senior staff

In sepsis cases, these failures can lead to significant delays in treatment.

Signs of Sepsis in Adults

The UK Sepsis Trust provides clear guidance on the signs that should raise concern. In adults, early signs of sepsis include:

• High or very low temperature
• Shivering or feeling unusually cold
• Rapid heart rate
• Fast breathing or breathlessness
• Confusion or disorientation
• Extreme pain or discomfort
• Pale, mottled or discoloured skin
• Reduced urine output

These symptoms should prompt urgent assessment. Where these signs are present and not acted upon, this may amount to a failure to diagnose sepsis.

More severe signs, often referred to as red flag sepsis, include:

• Difficulty staying awake
• Severe breathlessness
• Very low blood pressure
• Little or no urine output
• Blue or mottled skin

These are medical emergencies requiring immediate intervention.

Signs of Sepsis in Children

Recognising sepsis in children can be more challenging, but it is equally critical. The UK Sepsis Trust highlights several warning signs that should not be ignored.

In children, signs of sepsis may include:

• Rapid breathing or grunting
• Fast heart rate
• Fever or very low temperature
• Reduced urine output or dry nappies
• Lethargy or difficulty waking
• Irritability or inconsolable crying
• A rash that does not fade when pressed
• Pale, mottled or bluish skin
• Cold hands and feet
• Vomiting or poor feeding

In babies and young children, parents and carers are often the first to notice that something is not right. In a hospital setting, staff must respond promptly to these concerns.

Failure to recognise these signs or to escalate concerns appropriately can lead to delayed treatment and serious harm.

What Treatment Should Be Provided

Once sepsis is suspected, treatment must be immediate. National guidance, supported by the UK Sepsis Trust, recommends the rapid implementation of the “Sepsis Six” within one hour:

• Administer oxygen
• Take blood cultures
• Give intravenous antibiotics
• Start intravenous fluids
• Measure lactate levels
• Monitor urine output

Delays in any of these steps can significantly worsen outcomes. In many sepsis negligence claims, the central issue is whether treatment was initiated promptly once warning signs were present.

How Clinical Negligence Occurs in Sepsis Cases

Sepsis negligence claims often involve failures at multiple stages of care. A common pattern is that a patient begins to deteriorate, but this is not recognised or acted upon in time.

Examples of failures include:

• Not identifying abnormal vital signs
• Failing to carry out sepsis screening
• Not escalating concerns to a doctor or senior nurse
• Delays in prescribing or administering antibiotics
• Poor communication between healthcare professionals

These failures can occur over several hours, during which the patient’s condition deteriorates significantly.

Examples from Cases We Have Handled

Scott Harding-Lister and his team have extensive experience acting in sepsis claims arising from failures in hospital care. The following examples reflect common scenarios encountered in practice.

Failure to Escalate Deterioration

In one case, a patient recovering from surgery developed a raised temperature, increased heart rate and rapid breathing. These were recorded in the nursing notes, but no escalation took place.

The early warning score indicated that a medical review was required, yet no doctor was contacted. By the time the patient was reviewed, they had progressed to septic shock and required intensive care treatment.

Earlier escalation would likely have led to earlier antibiotics and a significantly better outcome.

Misinterpretation of Symptoms

In another case, a patient became confused and lethargic over the course of a day on a medical ward. These symptoms were attributed to the patient’s underlying condition rather than recognised as signs of sepsis.

No sepsis screening was undertaken, and no senior review was requested. The patient deteriorated overnight and developed multi-organ failure.

Expert evidence confirmed that the signs of sepsis were present and should have been recognised earlier.

Failure to Act on Observations

We have also acted in cases where abnormal observations were recorded but not acted upon. In one matter, repeated high early warning scores were documented, but no escalation occurred.

This resulted in a delay in diagnosis and treatment. By the time antibiotics were administered, the patient’s condition had significantly worsened.

Such cases often involve a breakdown in systems designed to protect patients.

Why These Failures Occur

Sepsis negligence cases often involve systemic issues rather than isolated mistakes. Contributing factors may include:

• Staffing shortages
• Inadequate training
• Poor communication
• Failure to follow established protocols
• Overreliance on junior staff without appropriate supervision

From a legal perspective, the question is whether the care provided fell below the standard expected of a reasonably competent healthcare professional.

The Consequences of Delayed Treatment

The consequences of failing to identify and treat sepsis promptly can be severe. Patients may suffer:

• Organ failure
• Limb loss due to poor circulation
• Brain injury
• Long-term disability
• Death

Even where a patient survives, the long-term impact can be significant, requiring ongoing medical care and support.

Investigating a Sepsis Negligence Claim

At Harding Lister Law, we take a thorough approach to investigating sepsis claims. This involves:

• Obtaining full medical records
• Reviewing nursing notes and observation charts
• Analysing early warning scores
• Instructing independent medical experts
• Assessing whether earlier treatment would have made a difference

This detailed process allows us to determine whether there has been a failure to diagnose sepsis or a delay in treatment.

Time Limits and Funding

Clinical negligence claims are subject to strict time limits. In most cases, proceedings must be issued within three years of the date of negligence or the date of knowledge.

We understand that bringing a claim can feel daunting. Many of our cases can be run under a conditional fee agreement, meaning that funding arrangements can be structured so that legal costs are dependent on the success of the claim. We provide clear and transparent advice on all funding options at the outset.

Why Choose Scott Harding-Lister and His Team

Scott Harding-Lister and his team specialise in clinical negligence and medical negligence claims. They have extensive experience in handling complex sepsis cases involving failures in hospital care.

The firm offers a personal and dedicated service, ensuring that each client receives careful attention. With a strong understanding of both legal and medical issues, the team is well placed to investigate and pursue claims effectively.

Conclusion

Sepsis is a medical emergency that requires urgent recognition and treatment. The warning signs are well established, and healthcare professionals are trained to respond to them.

When a deteriorating patient is not identified, or when concerns are not escalated appropriately, the consequences can be life-changing. These are the circumstances in which clinical negligence claims arise.

If you or a loved one has suffered because of a failure to diagnose sepsis or a delay in treatment, it is important to seek specialist legal advice.

Scott Harding-Lister and his team are here to help. They can investigate what happened, advise you on your options, and pursue a claim where appropriate.