Editor’s note: This story was published first in the New Jersey Monitor.
West Orange-based attorney Steven Martino first learned about sepsis when his 19-year-old daughter Alyssa was hospitalized for a possible urinary tract infection in spring 2010.
Martino said he and his wife were at their daughter’s bedside at midnight, joking with her about the fast food meal they were sharing. The next morning, sepsis caused first her lungs, then her kidneys and eventually her heart to shut down.
Alyssa was transferred to a more specialized hospital, but she died within a week despite the staff’s best efforts, Martino told New Jersey Monitor.
Credit: (Facebook)“It happened so quickly,” Martino said.
Martino is now urging New Jersey to adopt a law that would require all acute-care hospitals to adopt a sepsis protocol and regularly train staff on how to quickly diagnose and treat the condition, a systemic reaction to infection that can start with a seemingly minor wound or cough and rapidly spiral into multi-organ failure and death.
Sepsis occurs in some 1.7 million people annually and results in roughly 350,0000 adult deaths nationwide, including around 2,000 in New Jersey, according to the Sepsis Alliance, a national advocacy organization. Even survivors often face harsh complications.
Despite recent declines, New Jersey’s sepsis mortality rate historically exceeds the national average of roughly 10 deaths per 100,000 in recent years. New Jersey reported a death rate of 16 per 100,000 in 2023, down from 18 three years earlier, according to state health data. The rate for Black residents is 25 per 100,000, more than double that for white New Jerseyans.
Thomas Heymann, president and CEO of the Sepsis Alliance and a Maplewood resident, said a handful of states have passed measures like one under consideration by the New Jersey Legislature, including New York, whose Rory’s Law was named in memory of a 12-year-old boy who died of sepsis after suffering a cut on a playground in 2012.
‘Full arsenal’
Sepsis is the No. 1 cost of hospital care and hospital deaths, according to Heymann, who said health-care providers and the public should be more aware of it.
“It’s kind of not on the radar,” Heymann told New Jersey Monitor. “We need to make the case better.”
Cathy Bennett, president and CEO of the New Jersey Hospital Association, said sepsis is very much on the radar of the facilities she represents. Bennett served as state health commissioner in 2017 when the state adopted regulations that required hospitals to adopt a sepsis protocol.
“Across the state, hospitals have deployed a full arsenal of strategies to improve sepsis care: standardized protocols; learning collaboratives; and advanced data and technology tools. That sustained commitment is saving lives,” Bennett said in an email.
From 2018-2024, hospitals have experienced a 38% increase in sepsis diagnoses, according to Bennett, a statistic that she said means more people are getting treated for it. Pre-discharge deaths dropped 58% during that time, she said.
“Sepsis can be hard to spot early because it often looks like a common illness.”
– Karen Schill, advanced clinician at Rutgers School of Nursing
New Jersey’s patient population tends to be older, with higher levels of chronic disease and other health challenges than the nation’s overall, and that makes it more susceptible to sepsis, she added.
Bennett said her group supports the goals of the New Jersey lawmakers behind the sepsis bill, though it has reservations about codifying sepsis protocol requirements in statute, in part because of reporting mandates that the group fears could lead to data that is misinterpreted or misunderstood by the public.
The legislation, called the Stop Sepsis Act and sponsored by Sens. Joe Vitale (D-Middlesex) and Raj Mukherji (D-Hudson), cleared the Senate health committee in mid-March. An Assembly version has yet to get a hearing.
The New Jersey Hospital Association and its national counterpart, the American Hospital Association, do support federal legislation championed by U.S. Rep. Donald Norcross (D-01) that calls for additional sepsis education for hospitals.
‘Stick with us, stick with us’
Sepsis was a near-death experience for Norcross last year.
He felt fine over the course of several days of events in Florida, Norcross told New Jersey Monitor. Something wasn’t right, though, when he arrived at the Key West airport on April 7 for his flight to Philadelphia.
He called his wife in New Jersey and told her he might see his doctor, then boarded the plane. By the time the flight departed, Norcross said he had started shaking violently. The last thing he remembered was going to find a flight attendant before he passed out.
Credit: (Cooper Health)“When I came through, I was on a stretcher coming off the plane and, I assume it was the ambulance attendants were yelling at me, ‘Stick with us, stick with us,’” Norcross said. “I had no idea what was going on.”
Norcross later would learn that the Philadelphia-bound plane was diverted to North Carolina, where he was immediately brought to a hospital that had a sepsis protocol in place to quickly diagnose and treat his condition. He needed a heart pump and mechanical help to breathe, and he was soon transferred to Cooper University Hospital in Camden, where he remained for nearly a month.
Norcross wants more hospitals to have sepsis awareness and training. In January, he partnered with U.S. Rep. Tom Kean Jr. (R-07), who is being treated for an undisclosed from an unknown health issue of his own, to introduce the federal legislation, which would require the federal Centers for Disease Control and Prevention to create a sepsis education program for hospitals and to increase reporting on the condition. Sen. Andy Kim (D) is among the sponsors of a Senate version of the bill. Neither bill has advanced.
The Sepsis Alliance is advocating for state laws, like New Jersey’s proposal, that require hospitals to adopt these protocols and regularly train key staff in how to respond. The group also aims to educate the public on sepsis.
“We want them to be enlightened, not frightened,” Heymann said.
Everyday risks
While sepsis is often connected with hospitals, Heymann said 87% of cases originate outside a health care facility with something like a urinary tract infection, bronchial condition or a dental treatment. If someone is also experiencing a high temperature, mental decline, or other signs of illness — all of which can emerge quickly — they should seek treatment immediately, the alliance warns.
Karen Schill, an advanced clinician who teaches at Rutgers School of Nursing, said not all infections lead to sepsis and, while some bacteria are more aggressive than others, it can be hard to predict who will be impacted. The elderly, newborns and people with diabetes or other chronic conditions are more susceptible, she said.
“Sepsis can be hard to spot early because it often looks like a common illness,” Schill told New Jersey Monitor.
No one test
Sometimes called blood poisoning, sepsis is not an illness on its own, but occurs when the body’s immune response overreacts to an infection and starts to cause damage to tissues and organs. She said people suffering from it can look as though they have the flu or are fatigued, and their lab results may appear normal at first.
“And there is no single test that confirms sepsis,” Schill said. “We look at the whole picture — the individual’s symptoms, past medical history, vital signs and lab tests — to make the diagnosis.”
If clinicians do suspect sepsis, they are trained to act quickly, Schill said. That means obtaining blood culture samples within an hour and immediately treating the patient with intravenous fluids and broad-spectrum antibiotics. Lab results help clinicians narrow the cause — bacterial, fungal or viral — and fine-tune the treatment, a process that can take days.
Some patients may also require ventilators or dialysis, Schill said. Medications used to maintain blood pressure are common, too, she said.
Sepsis costs hospitals and nursing homes some $62 billion annually, according to the Sepsis Alliance. Roughly half of survivors face complications, the group notes, including amputations in an effort to protect blood flow to the heart, brain and other essential organs.
Norcross said he now realizes he was lucky to not only survive sepsis, but also to recover the way he did. But the journey was long and hard, and a year later, he said he’s still not 100%.
“By the time I was released, it was close to six weeks later. When I entered into rehab to learn to walk again, I had lost close to 40 pounds,” Norcross said.
He required dialysis every other day and was so weak he could barely hold an iPhone, he said.
The origin: a gallbladder infection that Norcross said he never knew he had.
