1. Opinion

My daughter should not have died

Dr. Carl Flatley holds a photo of his daughter, Erin, who died of sepsis a decade ago. He has devoted his life to sepsis awareness, wanting medical professionals to adopt a Code Sepsis that would call out for specific treatment just as Code Blue does.
Dr. Carl Flatley holds a photo of his daughter, Erin, who died of sepsis a decade ago. He has devoted his life to sepsis awareness, wanting medical professionals to adopt a Code Sepsis that would call out for specific treatment just as Code Blue does.
Published May 5, 2012

It's been a decade now since my daughter died. She was a beautiful 22-year-old woman who was taken from us at that fleeting stage in a young person's life when they see nothing but potential, promise and opportunities to help.

Erin was about to complete her master's in elementary school education and was looking forward to life as a teacher. We mourn her loss as if it happened yesterday, but I also often wonder about all the young lives she would have touched and changed for the better. Our lives reverberate that way: all the good she would have done for others and the good they would have paid forward. Had she lived, all of this would have happened.

And she should have lived.

She died of sepsis, resulting from a minor outpatient surgical procedure. Sepsis is a very dangerous, acute condition caused by a systemic infection, but death from sepsis is almost always preventable — if doctors take proven and simple steps to avert it.

Erin's doctors did not take those steps: IV fluids, vasopressor drugs to increase blood pressure, and, most important, antibiotics. This simple process has saved thousands of lives in hospitals that use it. But believe it or not, most U.S. hospitals have no sepsis protocol.

Since Erin died 10 years ago, sepsis has killed more than 2.5 million others in the United States alone. Many other millions have suffered from amputations, post sepsis organ problems and cognitive issues. We lose more than 700 people every day, which is like a Airbus A380 crashing every 19 hours.

How long would the public allow that to continue? Where is the urgency and government support? Can you imagine the uproar that would be going on?

We've been here before. Cardiac arrest was once treated in a wide variety of ways with a wide range of outcomes. That's been changed for the better. Today, every critical care clinician in every hospital, nursing home, urgent care and ambulance crew instinctively understands the call to action: "Code Blue."

Those two simple words trigger a reflexive series of interventions that have saved untold numbers of lives from cardiac arrest worldwide.

A "Code Sepsis" is long overdue. We know what steps to take — we just all need to be on the same page to implement these steps nationwide.

Part of the problem is the mystery that shrouds sepsis. Many don't know what it is. Many think it's an exotic condition caused by some rare infection, but chances are, you know someone who died of sepsis. In 2009, 1.6 million people were admitted to U.S. hospitals for sepsis. Often, these patients are being treated for an underlying condition such as cancer, pneumonia, or other conditions that suppress their immunity.

One of every six patients who develop sepsis does not survive — it's hard to say for sure, though, because hospitals do not have to report their sepsis fatalities. Those who survive often suffer from cognitive disabilities and lower limb amputations. This deadly acute condition kills more Americans each year than prostate cancer, breast cancer and lung cancer combined.

The numbers are staggering. In fact, this is part of the problem. Big numbers overwhelm us and disconnect us.

It's the small numbers and the personal stories that break through. So, I'm willing to bet that you know a person who died of sepsis. If you know someone who died of cancer, they probably actually died of sepsis. If you know someone who died of pneumonia, sepsis is likely what killed them. If you know someone who died of an infection, H1N1, a urinary tract infection, or postsurgical infection, there's a very good chance they could have survived their underlying condition if they were treated properly to survive sepsis.

Ironically, I developed sepsis following surgery several years ago. I must admit, until my daughter died, I had never heard of sepsis — even after a career as a dental surgeon. When I realized I had the symptoms of sepsis following that surgery, I refused to let the hospital discharge me. It was my own daughter's death that taught me a lesson that ultimately saved my life. She was looking out for me.

At her bedside on that dreadful day in 2002, she asked me to help her, but I couldn't. All I could do was make myself a promise when she left us that early April morning: "No more Erins!"

We started the Sepsis Alliance in order to change clinical practice in the United States so that there would be "No more Erins." No more senseless loss of life. I've spoken to thousands of family members who lost loved ones unnecessarily to sepsis.

These people should have lived, should have been at baptisms, graduations and weddings of their grandchildren. There's simply no good reason why they were robbed of these moments.

Today, the Sepsis Alliance has grown dramatically. We're now part of the Global Sepsis Alliance. We held the first U.S. Sepsis Month in September 2011, and I just returned from Europe where I participated in the announcement of the first World Sepsis Day to be held Sept. 13.

I encourage you to go to and to spend time reading the stories of those who died and those who survived sepsis. But more important, I encourage you to question your hospital, ICU, cancer center or the nursing home where your mother or father lives.

Ask them if they have a sepsis protocol. Health care practice changes course like big cargo ships at sea. It needs a lot of time, a wide berth, and especially power to change course. In health care, you — the patient — are the power. You can change the course of sepsis management in the United States and worldwide.

Tell your doctor that if and when you need to be admitted to the hospital, you want to go to one that has an institutionalized rapid response protocol for sepsis. Don't compromise. Keep the pressure on and let's realize the goal of a national "Code Sepsis" by 2015.

Carl J. Flatley, an oral surgeon who lives in Dunedin, is a founder of the Sepsis Alliance.