For solicitors reviewing potential negligence claims, the key questions often centre on whether deterioration was recognised, whether the patient was reassessed and whether treatment or escalation happened at the right time.

About the Speaker

Dr Elora Mukherjee is a Consultant in General and Acute Medicine and an experienced medico-legal expert witness.

She has worked as an expert witness since 2009 and as a consultant in acute medicine since 2011. Her medico-legal work includes clinical negligence and personal injury matters, with experience across screening, breach of duty, causation, and condition and prognosis reporting.

Her clinical interests include acute medicine, infection, critical care and the management of patients during the crucial first stages of hospital admission.

What Does the Webinar Cover?

In this webinar, Dr Mukherjee explores how sepsis may develop during the first 24-72 hours of acute hospital care and why recognising deterioration can be challenging.

She considers the clinical signs, investigations and treatment decisions that may become particularly important when a potential clinical negligence claim is reviewed.

Key themes include:

• Recognising subtle or non-specific signs of sepsis and deterioration.
• The importance of repeated observations, NEWS trends and reassessment.
• The role of the Sepsis Six, lactate monitoring, blood cultures, fluids and antimicrobial treatment.
• Identifying when a patient should be escalated to HDU or intensive care.
• Reviewing whether the original diagnosis remains appropriate when a patient fails to improve.
• Looking beyond common sources of infection and considering alternative diagnoses.
• Separating a potential breach of duty from the question of whether that breach actually caused additional harm.

One of the recurring themes throughout the webinar is that a delay or error does not automatically establish causation. The clinical course still needs to be examined carefully.

“Breach and causation is separate.” — Dr Elora Mukherjee

For solicitors, this means looking not simply at whether treatment could have happened earlier, but at what difference earlier intervention would probably have made to the eventual outcome.

Key Medico-Legal Questions

When reviewing the records in a potential sepsis claim, Dr Mukherjee suggests considering:

• When did the patient's clinical picture begin to change?
• Were signs of deterioration recognised and acted upon?
• Were observations and abnormal results appropriately reassessed?
• Was treatment reviewed when the patient failed to improve?
• Was specialist or critical care input sought at the appropriate stage?
• Would earlier recognition or treatment probably have altered the outcome?

Read the Full Article

For a closer look at missed sepsis, delayed escalation, differential diagnosis and the three case examples discussed during the webinar:

Read the full medico-legal article here >