Echoing a couple points - this was a normal 12 year old playing basketball two days before being UNABLE TO BEAR WEIGHT. Bad shit is going on. Tachycardic AF, which is a harbinger of freaking doom in pediatric sepsis and the bandemia meant something foreboding was in the mix, even if the CRP was only 18. The expert indicating a lack of hypotension means no sepsis...kids compensate until they fall off the cliff. This poor family deserves every penny, if not more. Just makes my blood boil.
I found the defense's first expert's opinion the most disturbing part of the whole case. He wasn't hypotensive? Well he was, first of all, relative to the amount of pain he was in, but putting that aside, who the hell thinks in this day and age that you have to be hypotensive to be septic? Or you have to have a fever? Come on, my dude, do better.
It's also important to note that children become hypotensive from shock shortly before they enter cardiac arrest. They do not tolerate hypotension. Hypotension in a child should, in simplified terms, make you shit your pants unless the patient is anesthetized or sleeping and has normal peripheral perfusion.
Also there was no mechanism of injury! Doesn't recall the onset of pain! It didn't come up in the court case, but if I were the provider wrestling with the outcome of this case in the small hours, I would ask myself if I had paid too much heed to a CT report and not enough to the patient's words.
Echoing a couple points - this was a normal 12 year old playing basketball two days before being UNABLE TO BEAR WEIGHT. Bad shit is going on. Tachycardic AF, which is a harbinger of freaking doom in pediatric sepsis and the bandemia meant something foreboding was in the mix, even if the CRP was only 18. The expert indicating a lack of hypotension means no sepsis...kids compensate until they fall off the cliff. This poor family deserves every penny, if not more. Just makes my blood boil.
I found the defense's first expert's opinion the most disturbing part of the whole case. He wasn't hypotensive? Well he was, first of all, relative to the amount of pain he was in, but putting that aside, who the hell thinks in this day and age that you have to be hypotensive to be septic? Or you have to have a fever? Come on, my dude, do better.
It's also important to note that children become hypotensive from shock shortly before they enter cardiac arrest. They do not tolerate hypotension. Hypotension in a child should, in simplified terms, make you shit your pants unless the patient is anesthetized or sleeping and has normal peripheral perfusion.
Also there was no mechanism of injury! Doesn't recall the onset of pain! It didn't come up in the court case, but if I were the provider wrestling with the outcome of this case in the small hours, I would ask myself if I had paid too much heed to a CT report and not enough to the patient's words.
I agree. Treat the patient, not the lab.