Infections and Sepsis in Pennsylvania Nursing Homes

The case is about the delay

Infections happen in nursing homes and not every one is negligence. What is actionable is the failure to recognize and escalate.

Sepsis progresses in hours. The records show whether the temperature, heart rate, respiratory rate and blood pressure were being taken, what they showed, and how long the abnormal readings sat in the chart before a doctor was called or the resident was transferred.

A resident with a documented fever and rising heart rate over two shifts, with no escalation recorded, is the pattern these cases are built on.

Where the infections come from

• Pressure sores, which become infected and can reach bone as osteomyelitis.
• Urinary tract infections, frequently linked to catheter care, hydration and toileting.
• Pneumonia, including aspiration pneumonia where swallowing problems were not managed.
• Cellulitis from untreated skin breaks.
• Post surgical infection after a transfer back from hospital.

Each has a preventable component, which is why the origin of the infection matters as much as the response to it.

What the chart should show

Vital signs at the required frequency and more often once abnormal. Nursing notes describing changes in condition. Notification of the physician and the family, with times. Antibiotics ordered and actually administered, with the medication administration record showing doses given rather than merely prescribed. Transfer decisions and their timing.

Gaps in vital signs during the critical period are common and telling.

Hospital records complete the picture

The receiving hospital’s emergency department records frequently document the condition on arrival in stark terms, including how advanced the sepsis already was and what the family was told. That record is independent of the facility and is often the most persuasive document in the case.

What to request

The full chart including vital sign records, nursing notes, physician notification logs, the medication administration record and transfer documentation, plus the hospital records for the admission. Ask for both, in writing.