Summary: A 52-year old women presented to the emergency department with a necrotizing soft tissue infection (necrotizing fasciitis) after undergoing cosmetic abdominoplasty (‘tummy tuck’) at another facility. A lack of communication and disputes between the Emergency Medicine, Emergency General Surgery and Plastic Surgery teams about what service was responsible for the patient’s care led to delays in treatment. These delays allowed the infection to progress, ultimately requiring excision of a large area of skin and soft tissue.
The associated commentary discusses the importance of prompt evaluation and debridement for necrotizing soft tissue infections, describes systems-level changes to clearly designate physicians responsible for particular clinical problems and to clarify how disputes should be adjudicated in real time, and explores how physician burnout can contribute to patient safety problems.
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