We have been working with care homes to update their contracts and advise on the risks of charging the resident a regular “top-up” or additional fee where a resident is funded through NHS CHC
Necrotising Fasciitis, more commonly known as the ‘flesh-eating disease’, is a significant medical condition that requires urgent treatment. Without timely intervention, most people will not survive the condition, but even when the condition is diagnosed and properly treated, 20-40% of people will not survive, and many people will suffer permanent, debilitating injuries.
Often, the bacteria that cause necrotising fasciitis live in the gut, throat or on your skin, and most of the time they do not cause any problems as they are not able to enter the body or bloodstream.
Relatively insignificant injuries can allow the bacteria to enter the body. Initially, the symptoms can be misleading and may appear more like the flu or gastroenteritis. Sometimes what appears to be a minor skin problem, such as redness or a scratch or cut, will be much more painful than you would normally expect. The bacteria rapidly multiply between the skin and muscle if the early stages of the condition are not recognised. In the later stages, the affected area may be swollen and covered with a rash or dark blisters, and a patient may experience vomiting or diarrhoea. Towards the end of the condition, a patient can fall unconscious and develop toxic shock, leading to death.
Despite being called the ‘flesh-eating disease’, necrotising fasciitis is an infection in which the bacteria release toxins that cause damage to surrounding tissue. Without treatment, the spread of toxins will continue, causing further damage and potentially spreading to other areas of the body. Treatment methods include administering intravenous antibiotics and surgical excision of the affected areas. Depending on the stage of condition, this may result in the need to amputate limbs or remove extensive areas of skin, muscle or other tissues to save life followed by lengthy admissions to ITU.
It is therefore important that patients presenting with signs of necrotising fasciitis are taken seriously and properly investigated, particularly important when the early symptoms may be misleading, as any failure to adequately diagnose could result in loss of life or limb. One of our clients attended Accident and Emergency where the medical staff misdiagnosed cellulitis. Our client returned and subsequently underwent emergency life-saving surgery to remove a substantial amount of muscle in her leg. As a result of our client’s injuries, she needed plastic surgery and suffered from ongoing reduced mobility, affecting her ability to work.
Although necrotising fasciitis is a significant and relatively rare condition, there are no national public health guidelines for clinicians to follow. Unfortunately, the absence of guidelines and lack of practical experience can result in medical staff not being aware of the early warning signs and missing a narrow window of opportunity to commence lifesaving treatment.
For further information about any of the issues raised in this briefing, or to find out more about clinical negligence, please contact Christoper Frankling. We are happy to talk to you on a free no obligation basis.
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