My father, Dermot, died from septic shock aged 77 in the in Dublin on 29th September 2019. Dad had a number of ailments over the previous 3 and half years. He had SBS (short bowel syndrome), which meant he had no bowel and no ability to absorb food. He also had an ileostomy (the bane of his life). As a result of the SBS dad was on TPN (total parenteral nutrition). His TPN involved him being connected 7 nights a week for 12 hours to a 3 litre bag of fluid through a central line which was his life line for the last 3 years. (Sepsis and Invasive Devices) We managed his condition and tried to keep Dad motivated throughout as there were times when he would tear his hair out at his condition. As a result of his condition, Dad was susceptible to infections, primarily pneumonia. (Sepsis and Pneumonia) When in hospital, he generally contracted sepsis. This we feel was due to poor sterility while administering his TPN which is a highly sterile process. To the point where we witnessed a very poor administration process and complained to the hospital. Believe it or not I only received a response from the hospital today about this (11th November)
Then on Saturday, 31st August, Dad felt unwell at home experiencing high temperature and shivers. He was also coughing quite a bit. We really didn’t want to take him to hospital due to the fear of infections and sepsis. We called his GP to visit who started Dad on antibiotics for a chest infection. Dad started to feel better on the Sunday and even got up and dressed himself to watch the infamous all-Ireland football final. However, on the Monday, Dad didn’t feel well again with no improvement from the antibiotic. We had his blood taken by the TPN nurse who called to change his central line dressing. We also called the GP again who changed his medication to one that treats for pneumonia. On the Tuesday, 3rd September, the hospital phoned to say Dad’s potassium levels were raised and they wanted to admit him. This we did – driving him from our hometown of Dundalk to his hospital in Dublin that specialised in the TPN. The doctors did x-rays etc., and confirmed that Dad had pneumonia and started him on IV antibiotics immediately.
On admission we expressed our concerns about the sterility of the TPN process. The A&E doctor agreed to allow us to administer it as there were no nurses there qualified to do it. On Wed, 4th September, we were advised that Dad was moved to a ward and were assured they were ‘au fait’ with administering the TPN. Dad seemed stable from then until Saturday afternoon when I was visiting. He was very disorientated and sleeping a lot. At one stage I called the nurse to say he wasn’t right and luckily they checked his blood and he was having a hypo due to extremely low blood sugars (Dad was not a diabetic). Dad was terrified and I will never forget the look of fear in his face. However, they regulated his sugars and he seemed to calm down.
Then on Monday, 9th September, my other sister was working from home and decided to do so in the hospital with Dad. When she was at the hospital she said that Dad was not well at all. The registrar on call was called and they prepared for Dad to be admitted to HDU (high dependency unit). However, the registrar had called Dad’s consultant who, when she arrived minutes later, said that Dad was for ICU immediately. It was confirmed later that day that Dad had gone into septic shock. He was put on dialysis and was hooked up to several other monitors. On visiting Dad every day we were told that he was improving and that all his vitals were going in the right direction. However, the fact that they had tried to take him off the dialysis and this didn’t work rang alarm bells to me – but I figured that we could still manage Dad with another machine though it wouldn’t be ideal.
But things worsened for poor Dad as the days progressed. He had a bleed on the spleen but he was too ill to treat it. He regained semi-consciousness after about a week in ICU and gave myself and Mum one of his cherished smiles before slipping off to sleep again. Then on Saturday, 21st September, we were told Dad had had a terrible night and his body had once again gone into septic shock. His consultant advised they were going to try one more ‘missile’ of an antibiotic. We had Dad anointed and stayed with him over the next 48 hours. We were told by the ICU nurses that he was steady – but at no point were we told that he wasn’t responding.
Then on Friday, 27th September, I got a call from Dad’s ICU nurse to say they were considering removing the ventilator and that they wouldn’t do so until myself and Mum were there in case Dad spoke. Little did we know that this was going to be a decision we were making to say goodbye to Dad. The ICU doctor advised us that Dad was in multi-organ failure and there was no coming back from it. As there are 3 others in the family, we called everyone up to decide on when it would be best to do this. We agreed to remove it at 12pm on Saturday, 28th September, when we were all present.
Before removing it we called the priest to anoint Dad one last time. Heartbreakingly, Dad opened his eyes when this was happening, making me think he knew what was happening – this makes this even harder for us. Dad slipped away from us at 7.40pm on Sunday, 29th September.
The cause of the septic shock we don’t know and probably never will. Did the hospital do everything they could – yes. However, I feel hospitals should be more honest and up front with families of patients with septic shock. Dad was in ICU for nearly 3 weeks and I just feel that the doctors had more insight than they let on.
Source: Louise - daughter