Sepsis kills an estimated 11 million people a year worldwide, accounting for one in every five deaths globally. Early recognition and treatment can dramatically improve survival, yet delays in diagnosis remain far too common, particularly after invasive procedures like a transrectal ultrasound-guided prostate biopsy (TRUS). This article explains how failure to diagnose sepsis after a biopsy occurs, key warning signs to watch for, and steps you can take after a failure to diagnose sepsis.
How Often Does Sepsis Follow a Prostate Biopsy?
A recent Australian study of 648 men found a 3.9 % sepsis rate when patients received only ciprofloxacin (a fluoroquinolone antibiotic). Adding a single IV dose of another antibiotic, gentamicin, lowered that figure to 0 %. This demonstrates that ciprofloxacin alone is inadequate amid rising fluoroquinolone-resistant E. coli.
Failure to Diagnose Sepsis Case Overview – “M’s” Story (2012)
M, an adult male, had been under a urologist’s care for ten years. A series of tests revealed a four month increase in M’s Prostate-Specific Antigen level (“PSA”), an indicator of prostate cancer. Accordingly, M’s urologist recommended a transrectal prostate biopsy.
Prior to the biopsy, the urologist instructed M to take 500 mg of an antibiotic, Ciprofloxacin, and perform a fleet enema (an over-the-counter saline laxative used to prepare the lower bowels for medical procedures such as rectal examination). Following the biopsy, the urologist again instructed M to take 500 mg of Ciprofloxacin. The next day, an onset of flu-like symptoms including chills and nausea prompted M to contact the urologists’ office.
Ciprofloxacin is a commonly prescribed prophylactic antibiotic for transrectal prostate biopsies. Although Escherichia coli (E. coli) is a well-recognized bacterium associated with post-biopsy infections, the medical community has long acknowledged the increasing prevalence of ciprofloxacin-resistant strains of E. coli. Upon learning of M’s symptoms the day after the biopsy, the urologist should have promptly admitted M to the hospital, ordered emergency blood testing, and initiated treatment with an antibiotic effective against E. coli. Instead, the urologist ordered a routine blood test, prescribed a 10-day course of ciprofloxacin, and advised M to seek emergency care only if symptoms worsened. The ciprofloxacin proved ineffective against M’s resistant E. coli infection, constituting a failure to diagnose the post-procedure complications.
The urologist was not the only healthcare provider who failed to provide standard medical treatment. The blood test, conducted that afternoon, showed a white blood cell count of 19.3—well above the normal range of 3.8 to 10.6—indicating a severe infection. Despite the critical risk posed by a potential E. coli infection, the pathologist did not immediately notify M or the urologist of the results, opting instead to fax them shortly after 2 a.m. the next day. This delayed any timely response from the urologists’ office, who made no effort to follow up on the results that day.
Before the urologist received the test results, M reported to the office that his symptoms persisted and visited the emergency room as previously instructed. There, physicians diagnosed M with sepsis—a life-threatening condition involving widespread inflammation triggered by infection.
M’s health deteriorated rapidly after admission. Medical professionals transferred him to the intensive care unit where he developed acute renal failure and acute respiratory failure. Among other serious complications, M’s lower legs became gangrenous and required bilateral amputation. Perry Calder vigorously pursued a medical malpractice case against both the urologist and the hospital on behalf of M, successfully recovering damages for M’s lost wages, his pain and suffering, his loss of life’s pleasures, his emotional distress, and his disfigurement.
This real case still speaks volumes: a rising PSA, biopsy, ciprofloxacin prophylaxis, flu-like symptoms the next day, and office delays resulted in full-blown sepsis, renal failure, respiratory failure and bilateral leg amputations. The medical team’s failure to diagnose and escalate care constituted textbook negligence.
Warning Signs of Sepsis After a Prostate Biopsy
Patients (and busy offices) often chalk up the following symptoms to “normal post-procedure discomfort,” but they demand immediate work-up:
- Chills or shaking (“rigors”)
- New or persistent fever > 100.4 °
- Nausea or vomiting unrelieved by diet
- Confusion, slurred speech, or dizziness
- Urinary burning or pelvic pain
- Shortness of breath or chest tightness
- Persistent or heavy bleeding from the rectum
- Declining urine output or dark urine
Why Ciprofloxacin May Fail
E. coli remains the leading culprit in post-biopsy infections, but over 70% of E. coli samples are now resistant to fluoroquinolones (the class of antibiotic that includes ciprofloxacin) in some U.S. cities. Combining gentamicin (another antibiotic) or switching to a transperineal biopsy approach cuts risk, yet many clinics still default to ciprofloxacin alone.
If you experience any of the above symptoms or simply feel “off” after a biopsy, go straight to the emergency department and say the words “prostate biopsy + possible sepsis.” Delays of even six hours raise the odds of organ failure.
When is There Medical Negligence? Four Elements We Must Prove
- Duty of Care: Your urologist accepted you as a patient.
- Breach: They missed obvious signs, ordered the wrong tests, relied on outdated antibiotics, or committed some other error that deviated from the accepted standard of care.
- Causation: The delay allowed sepsis to progress.
- Damages: Hospital bills, lost income, amputations, injuries, or wrongful death.
What Compensation Can Cover
- Medical expenses and future rehab
- Lost wages and diminished earning capacity
- Pain, suffering, and disfigurement
- In tragic cases, wrongful-death damages for the family
Real-world verdicts run from six figures for extended ICU stays to multi-million-dollar awards when amputations or death occur.
Common Questions about Failing to Diagnose Sepsis
Is infection after a prostate biopsy common?
Minor infections occur in 5–7% of men. Sepsis is rarer but rising with antibiotic resistance.
Does Pennsylvania cap medical-malpractice damages?
Pennsylvania does not cap economic or non-economic damages. Punitive awards are possible in egregious cases.
Talk to a Pittsburgh Lawyer Who Handles Sepsis Cases
If you or a loved one developed sepsis after a prostate biopsy and suspect a failure to diagnose occurred, call Perry Calder Law at 412-281-4200 or fill out our secure free consultation form. We specialize in medical malpractice in Pittsburgh and throughout PA.