Sepsis – What is it, who does it affect and what Clinical Negligence issues does it raise?

In my normal daily life, I’ve been unfortunate enough to come across sepsis in a few different situations; with a family member, a neighbour and also my own son.

As a solicitor, I’ve had a number of clients suffer, sometimes fatally, with sepsis. But what is it and why do we need to know about it?

What is sepsis?

Sepsis often comes about as a result of infection, like a respiratory infection, or a urinary infection. It occurs when the body goes into overdrive trying to fight the infection and starts damaging its own tissues and organs. If it is allowed to get too far without treatment, it can be fatal.

According to figures from the Sepsis Trust, around 11 million people a year worldwide die of sepsis. It is estimated that around 48,000 people a year die in the UK from sepsis.

Spotting the signs of sepsis

Signs of sepsis can manifest differently in babies and children, compared to adults. Children under five may vomit repeatedly, may not be passing urine and may not feed. Older children may have rapid breathing, mottled skin or seem very lethargic and difficult to rouse. Adults may also have mottled skin, may not pass urine, may be breathless and may have slurred speech.

A useful mnemonic has also been developed, SEPSIS, to help the general population become more aware of possible symptoms:

• Slurred speech and/or confusion
• Extreme shivering or muscle pain
• Passing no urine in a day
• Severe breathlessness
• ‘It feels like you’re going to die’
• Skin mottled or discoloured

There is also an increasing awareness of maternal sepsis which develops during pregnancy, childbirth or in the months following delivery. This is rare in the UK, but does have a 10% mortality rate, according to the Sepsis Trust.

Pregnant women are at increased risk of developing sepsis, because of various changes which occur within their immune system during pregnancy. Maternal sepsis is just as life threatening as sepsis in someone who is not pregnant, with the potential to not only harm the mother but also the baby.

The long-term impact of sepsis

Outcomes from sepsis can be devastating. For survivors, they often suffer significant physical, mental and cognitive disabilities in the months or years following.

Some people develop Post Sepsis Syndrome, which can include long term symptoms such as fatigue, impaired memory or concentration, weakness and mood changes.

All of these consequences can drastically impact their personal and family lives, and their ability to work.

Clinical Negligence and sepsis

Errors in dealing with sepsis can occur in all types of clinical setting including GP, out of hours services, A&E, post-surgery or care homes. Within these settings, various things can go wrong to give rise to a medical negligence claim regarding sepsis.

There can be delay or failure in diagnosis, or in referring on to hospital or a specialist. Signs of deterioration can be missed, or the significance of reattendance to GP or A&E with repeat or similar symptoms might not be recognised. A further issue that can arise is a failure to interpret abnormal blood tests, and/or a delay in prescribing antibiotics to combat the infection itself.

When looking at these types of cases, some common themes arise. Communication is key: between doctor and patient, and between doctor and doctor. Often a range of clinicians can be involved with one patient, from different departments and specialisms.

If the patient is in hospital, they might be transferred between different wards and departments. It is vital that everyone is kept up to speed with exactly what is going on, and that the patient’s concerns and reported symptoms are listened to.

This feeds into the second common theme: record keeping. Effective record keeping is vital for patient safety in these cases. As noted above, numerous medical staff might come in and out of this patient’s life over the course of this illness, so they need to be able to pick up the notes and know exactly what is going on. Conversations and symptoms need to be documented.

Terminology and the type of language used must be consistent and specific, otherwise there is no way of knowing whether the situation is improving or deteriorating.

Finally, all primary care organisations (e.g. GP practices) and hospital Trusts, should have guidance in place with regards dealing with sepsis. There is also plenty of national guidance which should be followed and is there for a reason. If there has been any deviation from this, the reasons why should be clearly documented.

Martha’s Rule

Martha’s Rule, which was piloted in 2024 and has recently been rolled out across the remaining acute trusts in England, was established as a result of issues identified in the care of Martha Mills, a 13 year old girl who died of sepsis in 2021.

The three core components of Martha’s Rule include: patients and families being asked daily how they are feeling and whether they feel there are any change; all staff being able to ask a different team for a second opinion if they feel their concerns are not being escalated; and patients and families themselves being able to escalate their concerns if they do not feel they are being listened to.

According to NHS England, Martha’s Rule does seem to be making a positive impact. Data from September 2024 to July 2025 indicates that 41% of the escalation calls related to an acute deterioration and 265 of those resulted in life saving transfers of care to either an intensive care or high dependency unit, or another enhanced level of care.

Clinical Negligence services

If you have been affected by negligent treatment surrounding sepsis and would like to know more about how we can help you – and help prevent the same mistakes happening in the future, contact us today on 03333 058375 or email ClinNeg@psg-law.co.uk for a free, no obligation discussion. We’re here to help you.