Epidemiology of Sepsis Among Adolescents at Community Hospital Emergency Departments: Implications for Rory's Regulations.

Abstract

In 2012, Rory Staunton, a healthy 12-year-old boy, presented to the emergency department (ED) of a community hospital in New York with symptoms that, in retrospect, were determined to be caused by sepsis. He was seen, discharged, and subsequently died of septic shock. Consequently, the governor introduced Rory’s Regulations, which mandated that hospitals in New York implement protocols to recognize and treat sepsis according to evidence-based guidelines. These efforts may result in large public health benefits for patients. However, crucial to Rory’s case was that his diagnosis was missed. Efforts to avoid missed or delayed diagnosis are greatly enhanced by knowledge of the frequency and course of similar cases, yet such data are unknown. We therefore examined the electronic health records of healthy adolescents who presented to 12 community hospital EDs in southwestern Pennsylvania during the same period (January 1, 2010, through December 31, 2012) with signs and symptoms similar to those of Rory Staunton.