Necrotizing fasciitis is a spectrum of diseases with one common thread: rapidly progressive infection and potential necrosis of the skin, subcutaneous muscle tissues, failure or fascia. Necrotizing fasciitis is severe. It often leads to septic shock, multiple failures, extensive tissue loss and death. The key to avoiding death or serious injury is early diagnosis and aggressive surgical management.
Necrotizing fasciitis is usually caused by direct entry of bacteria into the soft tissues underlying the skin. Some types may also be caused by the spread of bacteria originating in the blood.
You do not see a lot of necrotizing fasciitis related lawsuits in Maryland because the condition itself is infrequent. It is listed as a “rare disease” by the Office of Rare Diseases of the National Institutes of Health (NIH). There are approximately 500-1500 cases of necrotizing fasciitis reported annually in the United States. So we are talking about one case per 250,000-500,000 people.
Necrotizing fasciitis is traumatic. It is a medical emergency, requiring prompt diagnosis, prompt surgical removal of the necrotic deep soft tissue, and immediate antibiotic therapy, Once a soft tissue infection has become necrotizing, antibiotics alone will not suffice.
This insidious bacterial infection may result from a lot of different things. It is usually from some sort of skin penetrating trauma. These cases often come from bed sores in nursing home cases. There are also cases from burns, skin lacerations, bites, blunt trauma injuries, and childbirth.
Do Victims of Necrotizing Fasciitis Have a Malpractice or Nursing Home Negligence Claim?
No one denies necrotizing fasciitis a challenge to diagnose and treat. But everyone also agrees that a quick diagnosis is critical to a successful outcome. We cannot expect doctors to spot NF in its infancy. But there are far too many cases where doctors fail to consider necrotizing fasciitis as a differential diagnosis when, given the fury at which this disease attacks, a reasonable, prudent doctor would have done so. There are also cases where a nursing home should know that something is awry and take further steps to get the patient some medical care by a doctor in the position to diagnose and treat the problem.
Who Is at Risk?
NF is technically an infection, so it’s not like you can just walk down the street and get it. In fact, it’s somewhat rare. However, those who have severe pressure sores on their body are at a higher risk of contracting the infection. Pressure sores, or bedsores, afflict those who are in nursing homes, hospitals, or any condition that requires remaining in the same position for a sustained period. Still, it’s possible to bring on NF by receiving blunt trauma, abrasions, going through childbirth, or really any injury that breaks the skin. But there are also instances where the cause of NF is unknown, which makes the task of making a diagnosis all the more difficult.
What Does Necrotizing Fasciitis Do to You?
Early on symptoms of NF are vague. They usually include some pain in the general area of injury or abrasion. Afterward, there might be flu-like symptoms: diarrhea, nausea, confusion, dizziness, and tiredness. This is a heads-up for doctors that the patient could have a lot of things, including NF. It gets worse quickly. It would feel like the worst flu you could have, and often involves a confluence of all of these symptoms in the worst possible way. Later on, you may experience a purple rash around the area of the injury with severe swelling. Plus, the wound will start to look necrotic. Then things go frenetically from bad to worse. Blood pressure will start to drop severely, and the body will go into septic shock because of all the toxins floating around your system. This eventually leads to unconsciousness because of how hard the body has to fight off this infection.
Once this happens, it is critical for a doctor to diagnose NF. CT scans, imaging scans, and blood tests are often performed on the area. Antibiotics need to be prescribed and administered through an IV to fight the infection. After the infection is gone, skin grafts are often needed to repair damaged skin. But this is often not enough and amputation may be required. Plus, you might need to spend time in a hyperbaric chamber. In the end, the prognosis depends on the type of bacteria, how the antibiotics reacted, and how quickly the infection spread. But really, the most important factor is how quickly a diagnosis happened.
The Final Analysis
Even after treatment, the infection can spread. And NF often results in permanent scarring, tissue damage, loss of function, and in some cases even death. The biggest thing to remember here is that the earlier the diagnosis happens, the better off you will be. Many doctors don’t make this diagnosis in time, and that can be the difference in someone suffering severe (and even fatal) consequences of their delay. Many nursing homes, hospitals, or care providers may suggest that NF is unavoidable or that it was going to happen regardless of treatment, but that ignores that fact that an early diagnosis can make a difference.
Necrotizing Fasciitis Settlements and Verdicts
- 2021, Virginia: $1,250,000 Settlement: A 39-year-old woman suffered right knee pain and tenderness with radiculopathy and lower right leg swelling. She presented to the emergency room. The woman also suffered tachycardia, hypothermia, and wide pulse pressure. Her lab studies showed poor kidney function. Imaging also revealed knee effusion. The woman was diagnosed with a knee sprain, knee effusion, and leg edema. She received a knee immobilizer, crutches, and pain medications. The woman was subsequently discharged. Twelve hours later, she presented to the hospital. The woman was diagnosed with necrotizing fasciitis, severe sepsis, and septic shock. She received saline and IV antibiotics. The woman also underwent serial debridements that failed to save her leg. She underwent an above-the-knee amputation. The woman also underwent multiple procedures, including a colostomy. She also underwent renal replacement therapy. The woman alleged negligence against the hospital. She claimed its staff failed to diagnose necrotizing fasciitis and prematurely discharged her. This case settled for $1,250,000.
- 2021, California: $532,521 Arbitration Award: A 73-year-old man underwent a left knee replacement. Seven days later, he returned to the facility. The man was diagnosed with cellulitis. Two days later, he underwent an irrigation and debridement procedure. The man received a necrotizing fasciitis diagnosis. He ultimately underwent an above-the-knee amputation. The man alleged negligence against the medical facility. He claimed its orthopedic surgeon failed to diagnose necrotizing fasciitis. Following arbitration, he received $532,521.
- 2020, California: $255,000 Settlement: A 34-year-old man underwent liposuction. During the procedure, the plastic surgeon made three bowel perforations. The man eventually suffered sepsis and necrotizing fasciitis. He underwent several repair procedures. The man alleged negligence against the plastic surgeon. He claimed he negligently perforated his bowel, provided substandard care, and failed to timely identify his condition. This case settled for $255,000.
- 2019, California: $950,000 Settlement: A woman gave birth. She developed necrotizing fasciitis around her perineum. The woman suffered septic shock and multi-organ failure. She died five days later. The woman’s family alleged negligence against the hospital. They claimed its staff failed to timely diagnose necrotizing fasciitis and provide appropriate care. This case settled for $950,000.
- 2016, Michigan: $2,
570,795 Verdict: A woman suffered bilateral arm pain, fever, and chills. She was admitted to the hospital. The woman received cellulitis and right arm wound diagnoses. She was put on Clindamycin. Her pain significantly worsened. Three days later, the woman was diagnosed with necrotizing fasciitis. She underwent extensive skin debridement and grafting. The woman sustained permanent scars and right arm disability. She alleged negligence against the hospital. The woman claimed its staff failed to diagnose necrotizing fasciitis, timely order tests, and perform a skin debridement. She received a $2,570,795 verdict. - 2016, Virginia: $750,000 Settlement: A 19-year-old man suffered severe groin pain and fever. He presented to the emergency room. The man was diagnosed with right inguinal pain, abdominal pain, and inguinal lymphadenopathy. He was prescribed antibiotics and pain medications. The man was discharged hours later. His condition worsened. Four days later, the man returned to the emergency room. He was responsible upon arrival. The man went into cardiac arrest. He died forty minutes later. The man’s autopsy reported that necrotizing fasciitis and pneumonia caused his death. His family alleged negligence against the hospital. They claimed its staff failed to recognize pelvis infection signs, order imaging studies, and make a specialist referral. This case settled for $750,000.
- 2013, Virginia: $7,650,000 Verdict: Plaintiff, a 47-year-old man, is hospitalized after suffering bone fractures in a car accident. He is discharged within a week of his admission. The man follows up with the Defendant orthopedist. By this time, Plaintiff has developed wound and thigh blisters, which have drained and left an open red, beefy area on his skin. However, the Defendant orthopedist never removes Plaintiff’s bandages to check for this. Several days later Plaintiff is transported to a hospital emergency room where he is diagnosed with necrotizing fasciitis. Numerous debridements are performed, but the man ultimately requires an above-the-knee amputation, hip disarticulation (amputation at the hip) on the same side, and a below-the-elbow left arm amputation. A jury awarded the man $7,650,000.
- 2012, U.S. District Court in Baltimore: $1,500,000 Verdict: A 38-year-old man arrives at Express Care of Bel Air with a red, painful cyst near his backside that had expanded to his testicles and swelled. He is referred to Upper Chesapeake Medical Center in Bel Air, where a CT scan is taken of his pelvis. The medical report on the CT notes air in the man’s right scrotal sac and perineum. The two Defendant doctors diagnose him with cellulitis. Two days later, an infectious disease doctor expresses concern over necrotizing fasciitis based on the air found in the CT scan. The specialist operates on the man the following day, 58.5 hours after the CT scan. By that time, the surgery required extensive removal of dead tissue, including that around the penis, as well as removal of the scrotal sac and the right testicle. As a result, the man lost a testicle as well part of his penis and now suffers from lessened sensitivity as well as pain upon erection. Doctors had to graft skin from his leg onto his penis, which is now one-third shorter. Four additional surgeries were required. The court found that the Defendant doctors failed to appreciate the likelihood of necrotizing fasciitis based on the fluid in the CT scan. It awarded the man a total of $ 1,530,313.27 in damages.
- 2012, Michigan: $750,000 Verdict: Plaintiff, a woman in her mid-40s, presents to the emergency room of the Defendant hospital multiple times during a 30-hour period. While her vital signs are within normal limits during the first visit, she exhibits worsening signs and symptoms that point to serious a bacterial soft-tissue infection during the second visit. These symptoms include an abnormal heart and respiratory rate, abnormal blood pressure, right-sided tonsil swelling with whitish-yellow puss, and right jawline tenderness and swelling. The Defendant PA negligently disregards these alarming abnormalities and does not ask the E.R. doctor to examine Plaintiff. Plaintiff is discharged. After that, Plaintiff’s bacterial infection develops into necrotizing fasciitis. She requires a lengthy hospitalization, is in a comatose state for over a month, and needs multiple surgeries to swallow again. A jury awarded her $755,000.
Getting a Lawyer
Miller & Zois has successfully handled many medical malpractice claims in Maryland. We know the excuses that the care providers try to feed patients and loved ones to excuse their negligence. And we know how to fight back for you. If you or a family member has suffered necrotizing fasciitis as a result of medical negligence, nursing home negligence, or care provider negligence, get a free online free case consultation or call Miller & Zois at 800-553-8082.