Death Rates Fell After New York Adopted 'Rory's Regulations' For Sepsis Care : Shots - Health News Sepsis, the body's overreaction to infection, strikes more than a million Americans a year and kills more than 250,000. Evidence suggests that regulations can improve its diagnosis and patient care.

Regulations That Mandate Sepsis Care Appear To Have Worked In New York

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Many doctors don't like their medical decisions to be directed by law or regulation. But a new study finds that a directive from the state of New York has saved lives. The directive has to do with sepsis, which is the most common cause of death in hospitals. NPR science correspondent Richard Harris reports.

RICHARD HARRIS, BYLINE: New York City resident Orlaith Staunton had never heard of sepsis before her healthy 12-year-old son came home from school one day with a scrape he got in gym class. It didn't seem like a big deal, but Rory's health quickly turned.

ORLAITH STAUNTON: During the night, I heard of him throwing up, and I went out, and he said, it's my leg, Mom. It's my leg.

HARRIS: His temperature spiked, and he couldn't keep anything down the next day, so she took him to the pediatrician. She decided he had the flu and sent him on to the hospital to get fluids. Staunton says doctors in the emergency room also decided it was a simple case of a stomach bug and sent him home. But Rory kept getting worse.

STAUNTON: We brought him back into hospital, that was on Friday night, and he died on Sunday evening. He went straight into intensive care when we brought him back in, and it was after he died that we were told that he had died from sepsis.

HARRIS: If the hospital had realized that during his first visit and treated him aggressively, he likely would have lived, she says.

STAUNTON: We were angry, and we wanted to do something that would bring about some change in how sepsis was being diagnosed and how people would know what sepsis was.

HARRIS: Thanks to their efforts, Rory's death in 2012 catalyzed action in New York state, which shortly thereafter imposed regulations for how to treat sepsis, which is essentially the body's overreaction to infection. The key is rapid diagnosis, a prompt jolt of antibiotics and fluids. Jeremy Kahn, a critical care physician at the University of Pittsburgh, says doctors like him don't like to be directed on how to treat their patients. But as is surprisingly common, doctors don't use best practices.

JEREMY KAHN: You know what? The decades of undertreating patients with sepsis has a bit weakened our position, and it's time to be a little more open about accepting these regulatory approaches.

HARRIS: But first, Kahn and his colleagues wanted to see whether the New York rules really did make a difference. Sepsis death rates are declining nationwide, so the question is whether New York's rules led to faster improvement compared with other states. Kahn concludes yes in a study being published in the medical journal JAMA.

KAHN: These regulations had their intended effects of reducing mortality.

HARRIS: But there's an asterisk. New York state started off much worse than many other states, so it's possible the regulations simply helped the state catch up with others, he says.

KAHN: It does call into question what kind of impact these regulations will have in other states that may have better sepsis outcomes at baseline.

HARRIS: That matters because a few other states have similar regulations or laws, and more than a dozen more are considering them. Orlaith Staunton and her husband started a foundation, which is now trying to push this nationwide. She is not sympathetic toward doctors who don't want sepsis treatment to be governed by regulations.

STAUNTON: It's not enough to say leave it to me and I'll recognize it when I see it because clearly it's not being recognized. I think good doctors will agree that this is something that needs to be regulated.

HARRIS: And she hopes the new scientific results will sway some of the doctors and hospitals who are resisting a government mandate.

Richard Harris, NPR News.


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