Urgent Care Sepsis & Infection Misdiagnosis Expert Witness
Evaluating the Failure to Recognize Severe Infection and Sepsis
In an Urgent Care setting, patients frequently present with common infections like influenza, UTIs, or cellulitis. The critical challenge for the provider is distinguishing a routine infection from Sepsis, a life-threatening response to infection that requires immediate emergency care.
Dr. Max Lebow provides expert witness analysis for cases involving missed sepsis, severe wound infections, and delayed antibiotic treatment. He evaluates whether the provider missed the early "red flags" that separate a simple illness from a medical emergency.
The "Vital Sign" Trap
Dr. Lebow identifies that the most common error in missed sepsis cases is "not heeding an abnormal vital sign."
Tachycardia (Fast Heart Rate)
Often dismissed as 'fever' or 'anxiety,' a heart rate over 100 bpm can be the earliest sign of sepsis.
Hypotension (Low Blood Pressure)
A subtle drop in blood pressure is a critical warning sign that requires immediate fluid resuscitation and transfer, not discharge home.
Fever Protocol
Dr. Lebow evaluates if the provider followed protocols for high-risk patients (elderly, diabetic) presenting with fever.
Wound Care & Foreign Bodies
"Wound infection" is a specific category of litigation Dr. Lebow frequently reviews.
Inadequate Irrigation
Failure to properly clean a wound, leading to severe infection.
Retained Foreign Bodies
Missing glass, wood, or metal in a wound because the provider did not explore the wound or order an X-ray.
Antibiotic Stewardship
The balance between over-prescribing and failing to treat a dirty wound.
The "Follow-Up" Failure
The most common general mistake in urgent care is "not to provide time specific and place specific follow up." In infection cases, this is deadly.
Vague Instructions
Telling a patient to 'come back if worse' is often insufficient.
The Standard
Prudent care requires telling the patient exactly what to look for (e.g., 'return immediately if red streaks appear' or 'if fever exceeds 102') and where to go (ER vs. Clinic).
Why Urgent Care Sepsis Cases Are Different
In the ER, a "Sepsis Workup" involves lactate levels, blood cultures, and broad-spectrum IV antibiotics. Urgent Care centers do not have these tools.
The Decision Point
The negligence is rarely "failure to treat sepsis" (since they cannot), but "failure to recognize and transfer."
Triage Errors
Dr. Lebow analyzes if the front-desk triage correctly prioritized the patient. "See all patients who are... bleeding" or have unstable vitals immediately.
Case Example: The "Flu" That Was Not
A common malpractice scenario involves a patient diagnosed with "viral syndrome" or "flu" who actually has early sepsis from a urinary source or pneumonia. Dr. Lebow reviews:
- Was a lung exam performed?
- Was a urine dipstick ordered?
- Did the vital signs support a viral diagnosis, or were they alarming?
Did the Provider Miss the Warning Signs?
Sepsis moves fast. Dr. Lebow determines if the provider had the information necessary to stop it.
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