NECROTIZING FASCIITIS AND MEDICAL MALPRACTICE
A SUMMARY OVERVIEW

What is a necrotizing fasciitis?

Necrotizing fasciitis is a severe, acute, rapidly progressive, and potentially life-threatening condition caused by bacterial infection of the soft tissues. It can be caused by different types of bacteria, although the most common is Group A Streptococcus. If allowed to run its course, necrotizing fasciitis can destroy soft tissue, such as fat and fascia at the subcutaneous level, and also produce toxic shock syndrome.  Since loss of limb and life can result, timely and proper medical diagnosis and treatment is essential. 

How does necrotizing fasciitis occur?

It is rare that a bacterial infection ever progresses to the level of necrotizing fasciitis. However, when it does, it has been found to occur, for example, in connection with: surgery; penetrating injuries; minor cuts; burns; splinters; childbirth; chicken pox; poison ivy or oak; blunt trauma; invasive medical procedures; abrasions; sinus infections; and the like.

What are the symptoms of necrotizing fasciitis?

In most cases, there is first some trauma that has occurred to the body, even if it is minor. Then, there is usually a reaction by the body that is inconsistent with the nature of the injury. For example, if the wound site is known, there seems to be more pain, tenderness, redness, streaking, and/or swelling than one would anticipate at the site or near it, despite application of topical antibiotics or pain medicines. Rather than improvement, the patient notices that these symptoms begin getting worse. Further, the patient may notice that they are beginning to develop flu-like symptoms such as dizziness, vomiting, diarrhea, nausea, fever, confusion, weakness, dehydration, or listlessness. As untreated necrotizing fasciitis progresses, the affected area of body may begin to develop a purplish rash or dark marks that become blisters filled with bluish/blackish fluid, while the flu-like symptoms continue to worsen.

How can there be medical malpractice related to a necrotizing fasciitis victim?

When medical malpractice occurs related to necrotizing fasciitis victims it usually relates to the failure of the healthcare provider to make a timely diagnosis of this disease and/or the failure to timely and properly treat this condition.  It can also result, although more difficult to prove, from inadequate  infection control.  More specifically, some of the issues to examine are whether there was a:

  • Failure to perform an adequate history and physical examination of the patient.
  • Failure to provide appropriate infection prevention and control.
  • Failure to consider and appreciate the patient’s risk factors for necrotizing fasciitis.
  • Failure to appreciate and recognize symptoms of necrotizing fasciitis.
  • Failure to obtain and properly interpret imaging studies, such as MRI’s, CT’s and soft-tissue x-ray films.
  • Failure to timely intervene surgically with debridement, as needed, and sometimes even with amputation.
  • Failure to timely institute appropriate antibiotic treatment.
  • Failure to use supportive medications and modalities to control the effects of necrotizing fasciitis as it produces systemic toxic shock.
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