The story of 11-year-old Rory Staunton of Queens, New York, who suffered a routine cut on his arm during basketball practice and died four days later of septic shock --after being sent home from the emergency room at NYU Langone Medical Center--is a cautionary tale for parents from Parenting magazine and Yahoo Shine:
In a statement just released to Yahoo! Shine, Rory's parents, Cieran and Orlaith Staunton write, "Our beloved son Rory was the light of our lives. He should never have died. It is clear to us he did not receive the basic standard of care which would have saved him and which he, as an innocent child, above all, had a right to expect. Our beloved boy is gone but we want to ensure that no other family experiences the utter heartbreak and grief we have because of such substandard care." The Stauntons have announced their intention to pursue Rory's Law, which would require hospitals to discuss the results of a child's blood work before discharge, among other measures.
A chilling chronicle of Rory's last days and his death on April 1 was reported yesterday by The New York Times.
On Wednesday, March 28th, the 11-year-old cut his arm during basketball practice in school. It was a small cut mentioned casually in passing to his mother that night. Rory had a stomach-ache by the time he went to bed.
That night, just after midnight, (March 29th), Rory woke up vomiting and complaining of pain in his leg. By morning he had a fever of 104.
On Thursday, March 29th, he went to the office of his pediatrician, Dr. Susan Levitzky, already feeling so sick that he had to lean on his mom to walk in. He threw up twice in the office. The pediatrician said the cut on the arm wasn't the issue and recommended that Rory go to the emergency room. Dr. Levitzky noted Rory's parents' concern that his skin was blotchy when they pressed on it--a symptom that could indicate sepsis, Dr. Michael B. Edmond, the chairman of the division of infectious diseases at Virginia Commonwealth University told the Times--but didn't follow it up. Rory's leg pain was also a sign that could mean an invasive infection, according to Dr. Edmond.
Thursday March 29th, 7:14pm, Rory went to the emergency room and was discharged two hours later, after being diagnosed with "acute febrile gastritis" (the flu), and told to take Tylenol.
Friday at 10a.m. Rory's parents started calling the pediatrician again. His skin had turned blue around his nose and even a slight touch made him cry out in pain. The pediatrician recommended fluid and crackers again, but then said to return to the emergency room, as reported by the Times.
On April 1, Rory Staunton died in intensive care, of severe septic shock brought on by the infection.
The Staunton family's statement continues, "NYU hospital and its Emergency Room were in turn extremely negligent in their treatment of Rory. Signs of serious illness were ignored and Rory was allowed leave the hospital desperately ill. Rory's pediatrician continued the following day, despite our appeals, to dismiss our concerns. We believe NYU hospital and Rory's pediatrician should acknowledge their negligent treatment of him to the Staunton family, treatment that we believe resulted in his death. They owe it to Rory and the children who will come after him, to ensure that this never happens again."
NYU Langone Medical Center and Dr. Susan Levitzsky did not immediately return calls for comment.
What to Know about Sepsis (From WebMD.com)
Sepsis is a serious medical condition caused by an overwhelming immune response to infection. Chemicals released into the blood to fight infection trigger widespread inflammation.
Inflammation may result in organ damage. Blood clotting during sepsis reduces blood flow to limbs and internal organs, depriving them of nutrients and oxygen. In severe cases, one or more organs fail. In the worst cases, infection leads to a life-threatening drop in blood pressure, called septic shock. This can quickly lead to the failure of several organs -- lungs, kidneys, and liver -- causing death.
Sepsis occurs in 1% to 2% of all hospitalizations in the U.S. It affects at least 750,000 people each year.
The term sepsis is often used interchangeably with septicemia, a serious, life-threatening infection that gets worse very quickly and is often fatal.
Sepsis Causes and Risk Factors
Bacterial infections are the most common cause of sepsis. However, sepsis can also be caused by other infections. The infection can begin anywhere bacteria or other infectious agents can enter the body. It can result from something as seemingly harmless as a scraped knee or nicked cuticle or from a more serious medical problem such as appendicitis, pneumonia, meningitis, or a urinary tract infection.
Sepsis may accompany infection of the bone, called osteomyelitis. In hospitalized patients, common sites of initial infection include IV lines, surgical incisions, urinary catheters, and bed sores.
Although anyone can get sepsis, certain groups of people are at greater risk. They include:
• People whose immune systems are not functioning well due to illnesses such as HIV/AIDS or cancer or use of drugs that suppress the immune system, such as those to prevent rejection of transplanted organs.
• Very young babies.
• The elderly, particularly if they have other health problems.
• People who have recently been hospitalized and/or had invasive medical procedures.
• People with diabetes.
Because sepsis can begin in different parts of the body, it can have many different symptoms. Rapid breathing and a change in mental status, such as reduced alertness or confusion, may be the first signs that sepsis is starting. Other common symptoms include:
• fever and shaking chills or, alternatively, a very low body temperature
• decreased urination
• rapid pulse
• rapid breathing
• nausea and vomiting
The first step to successful treatment for sepsis is quick diagnosis. If sepsis is suspected, the doctor will perform an exam and run tests to look for:
• Bacteria in the blood or other body fluids
• Source of the infection, using radiologic imaging such as X-ray, CT scan, or ultrasound
• A high or low white blood cell count
• A low platelet count
• Low blood pressure
• Too much acid in the blood (acidosis)
• Altered kidney or liver function
Other tests of bodily fluids and radiologic tests, such as X-ray or CT scan, can help in diagnosing the cause of the infection. People diagnosed with severe sepsis are usually placed in the intensive care unit (ICU), where doctors try to stop the infection, keep vital organs functioning, and regulate blood pressure.
Sepsis treatment usually begins with:
• Broad-spectrum antibiotics, which kill many types of bacteria
• IV fluids to maintain blood pressure
• Oxygen to maintain normal blood oxygen
Once the infectious agent is identified, the doctor can switch to a drug that targets that particular agent. Depending on the severity and effects of sepsis, other types of treatment, such as a breathing machine or kidney dialysis, may be needed. Sometimes surgery is necessary to drain or clean an infection.
Often doctors prescribe other treatments, including vasopressors (drugs that cause the blood vessels to narrow) to improve blood pressure.
Permanent organ damage can occur in people who survive sepsis. Death rates are 20% for sepsis and over 60% for septic shock.