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Michael J. Caralla, Sr.


It was to be a simple intervention while physicians collaborated to determine a permanent route to correct a “Christmas tree bladder.” Our father was diagnosed, by the urologist, with a broad, flat, and smooth-walled urinary bladder with a flaccid base and a jagged superior funneling into the posterior urethra, which is typical of spastic neurogenic bladder. This is a finding by cystography that may be mimicked by outlet obstruction with superimposed urinary tract infections – better known as a pine cone or Christmas tree bladder.

The immediate intervention was to insert an indwelling urinary catheter. The catheter was frowned upon, as it was an instrument being introduced into a closed system that opens a door for bacteria, like a wick in a candle, to enter. Within 40 days after the original plan of care and intervention, our father was diagnosed with urosepsis. (Sepsis and Urinary Tract Infections)

He was admitted through the ED, then to ICU, where the nightmare began. To briefly sum up the chain of events that took place over 45 days, it went something like this: One admission through ED at a local community hospital for 21 days – urosepsis, mechanical ventilation, skin breakdown on coccyx (stage III, which later tested positive for MRSA), central line fungemia, C. difficile. (Sepsis and C. Difficile)He was finally discharged to home for 24 hours, then transported with an external respirator to a medical center, which led to a direct admit to ICU. There our father was treated for all the above for another 24 days, where he recovered three times from the sepsis/respiratory complications, yet he passed away from what the death certificate read: multi-organ failure related to sepsis.

Each infection played a part into the breakdown of every system. The infectious disease physicians told us that there were micro-organisms, “superbugs,” growing that they could not identify, for that is how grossly infected this one body had become.

The entire ordeal could have been prevented, as many infections are preventable with sterile technique, good aseptic technique, and hand-washing by everyone, including the patient.

We send our heart felt condolences to the millions who have lost loved ones from sepsis. We empathize with the patients who have taken this journey and survived. I too am no stranger to sepsis, for in 2010, from an asymptomatic UTI, I was diagnosed with urosepsis and admitted from the ED directly to ICU for 14 days while out of state on vacation.

Everyone is prone to being diagnosed with any of the superbugs, and/or with an infection that can advance to sepsis. The education, and raising awareness the Sepsis Alliance, with fellow foundations worldwide, will help in witnessing a decline in newly diagnosed sepsis cases, which is a shared goal.


Nancy Caralla is the founder of the C Diff Foundation.

Source: by Nancy Caralla (Michael's daughter)

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