Sepsis and Martha’s Rule

Martha was a bright, happy 13-year-old. She had been on holiday with her parents, enjoying the summer with days filled with books and memorising song lyrics, according to her mother, Merope, an editor at the Guardian.

Unfortunately, Martha had an accident whilst riding her bike, and she fell onto the handlebars with her abdomen, taking the full force of the fall. Although it didn’t look serious because she wasn’t bleeding or had any cuts, it appears that the pressure of the handlebars pushed against her pancreas, which, in turn, pushed her pancreas against her spine, causing a laceration in her pancreas.

Although it was a severe injury, it may not have been fatal. Martha was transferred to the children’s liver team at Kings College Hospital NHS Foundation Trust, a specialist hospital that deals with young people suffering from pancreatic trauma.

Martha remained in the hospital for a few weeks, but then she developed an infection that caused her condition to worsen drastically. She developed signs of sepsis, which was not appropriately managed.

Martha should have been transferred to intensive care once her condition worsened to give time for treatment to support her organs as they became overwhelmed with sepsis.

Following an Inquiry into Martha’s death, the Coroner said: “If she’d been transferred properly and had appropriately been treated, the likelihood is she would’ve survived her injuries”.

Merope, Martha’s mum, spoke to BBC Radio 4 Today program about the circumstances and events surrounding Martha’s unnecessary death. She made it clear that, as parents, they were not listened to and were disregarded by senior doctors on several occasions. Also, because her parents were not fully informed of Martha’s deterioration, they could not speak up or make informed decisions on her care.

As a result of this tragedy, Martha’s parents want all hospitals to engage in “Martha’s Rule” which allows parents, carers and patients the right, if they have concerns about the care they are receiving, to request an urgent second opinion from other clinicians at the same hospital.

The Trust said it “remains deeply sorry that we failed Martha when she needed us most”.

An NHS spokesperson said: “All patients and families are able to seek a second opinion if they have concerns about their care and, as professional guidance for doctors in England sets out, it is essential that any patient’s wishes to seek a second opinion are respected.”

Amanda Cavanagh, Associate in the Medical Negligence team at Ashtons Legal, comments: “Martha’s death was tragic and avoidable. I despair that despite the NHS’s own campaign to make lay people “Sepsis Aware,” they fail to heed their advice. This is not a one-off incident. Tragically, we hear of sepsis being overlooked all the time, and in many cases, the situation need not have resulted in such a terrible loss had sufficient regard been given to the concerns of parents or even the patients themselves.”

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