A 47 yo female was awarded $30 million to recover past and future medical costs, lost wages and pain and suffering for complications of treatment of septic shock by a Florida court.A plastic surgeon performed a "tummy tuck" (abdominoplasty) in 2001, soon after that the patient began to to have fever. According to the newspaper story, she went to the ER and the on-call surgeon "removed some fluid from her stomach area and... she was given medicine that focused blood flow to the inner part of her body to protect her vital organs.
Yerrid said this medicine can be given only after fluids have been administered; otherwise, the flesh in the extremities will die. Haedicke never ordered fluids for Lucia.
Haedicke's attorney said Lucia's kidneys were shutting down. Had he administered fluids, she could have died.
The lack of blood flow to her extremities had caused severe damage to her hands and legs. Doctors at Tampa General were forced to amputate fingers from both hands and her legs below both knees."
Of course, it is difficult to impossible to comment on a medical case without examining the patient and reviewing the chart but we usually give IV fluids (IVF) before and during pressors administration.
The rationale of "filling the tank" before using pressors (which can cause peripheral ischemia) is well-illustrated in this clinical case: Pneumonia and Septic Shock. As you can see from the labs, this patient also had acute renal failure which actually improved with IVF.
Early rapid and appropriate treatment of septic shock is extremely important in order to decrease morbidly and mortality in this very sick patient population.
References:
Patient Wins $30 Million. The Tampa Tribune, 5/2007.
Pneumonia and Septic Shock. ClinicalCases.org.
Link via Kevin, M.D.
Image source: CDC, public domain.
