Sepsis can progress from an infection to organ failure in a short time, Edmonton physicians say, and delays in assessment or treatment can leave patients with lasting disabilities or prove fatal. A doctor who survived the syndrome after a perforated intestine and septic shock is urging people to recognize its signs and ask health-care providers whether an infection could be sepsis.

The condition can follow infections caused by bacteria, viruses, fungi or parasites. Dr. Alison Fox-Robichaud, director of Sepsis Canada, said the immune and clotting systems can overreact as the body tries to fight an infection. Small clots may form in blood vessels, larger clots can restrict blood flow to limbs, and organs can fail, she said.

“Your body’s system, in an attempt to fight that infection, overactivates the immune system and the clotting system, and so you start to form little blood clots in your blood vessels, or bigger blood clots that your limbs start to look like they’re not getting enough blood flow, and organs shut down. And imagine that happening in every organ in your body,” Fox-Robichaud said.

Sepsis ranges in severity, she said, from patients needing oxygen and medication to support blood pressure to people who are critically ill and require intensive efforts to stay alive. The guidelines call for action within an hour, according to the report, while doctors also cite studies that aim for appropriate antibiotics within one to 2.5 hours.

“Old, young” people can develop sepsis, the report says. The risks and consequences are illustrated by two cases involving young patients: an Alberta teen whose infection as an infant led to quadruple amputation, and 21-year-old Amalie Henze of Brantford, Ont., who lost all four limbs after septic shock in 2023.

In a landmark 2025 case, the Alberta Court of King’s Bench awarded $17 million in medical malpractice damages to the Grande Prairie teen and her care providers. The report described the sum as among the largest such awards in Canadian history. The court found that, despite hospitalization, the child’s condition worsened and a bacterial infection revealed by blood cultures went untreated.

The resulting sepsis caused catastrophic limb ischemia, a loss of blood flow to the limbs. Surgeons at Edmonton’s Stollery Children’s Hospital saved the infant’s life through quadruple amputation. The case is among the related stories highlighted with the report, alongside Alberta Health Services data indicating emergency patients in Edmonton wait longer and stay longer than elsewhere in the province.

Long waits can delay the first essential step, said Dr. Lynora Saxinger, an infectious diseases specialist at the University of Alberta Hospital: recording vital signs and assessing the patient. She said bottlenecks can impede that step in Alberta emergency departments, where delays have been repeatedly reported.

“That’s probably the weakest point in any healthcare system, which is the getting in to be seen and assessed … It’s the hours leading to that time that become very important, whether or not people have come in for care, if they’ve been seen in a timely way, and if the triage of the problem actually caught the signs of sepsis or not,” Saxinger said.

After vital signs are entered into the electronic record, warning signs can prompt a computer alert asking clinicians to consider sepsis based on the patient information entered. That screening depends on patients reaching assessment and on triage identifying possible signs, Saxinger said.

Dr. Brian Wirzba, president of the Alberta Medical Association and an Edmonton internal medicine physician, said attention has focused on how quickly emergency physicians see patients and start treatment. “That’s sort of where the focus is,” he said. “Many of the studies talk about trying to get patients onto the appropriate antibiotics within one to 2.5 hours, and if you’re waiting eight hours in an emergency room, and who knows how long you waited at home before you get there, you know, you could very well potentially be presenting late. So, yeah, the waits in the emergency room are quite concerning,” Wirzba said.

Delayed diagnosis can mean delayed treatment, a longer recovery and hospital stay, and added pressure on hospitals. Saxinger said more than 50 per cent of fatal hospitalizations are due to sepsis. Some patients cannot be stabilized, she said, and survivors can face severe long-term consequences. In some cases antibiotics cannot reverse the damage because the illness has progressed too far by the time the patient arrives.

“Sometimes they’re not able to be stabilized through the event … quite frequently those cases end up with pretty severe consequences long-term … Sepsis is one of those times where the antibiotics might not work … sometimes it’s just too far gone by the time they get there, and you can’t turn things around,” Saxinger said.

Henze was 21 and preparing for college while living with chronic Crohn’s disease when she became ill in October 2023. She experienced bladder pain, fever, extreme pain, dizziness and disorientation. A perforated small intestine led to septic shock. She woke about a month later from a medically induced coma and learned that quadruple amputation had saved her life.

Henze now has prosthetic legs and a bionic hand, with another planned for her left arm. She created Amalie’s Guide to Sepsis, which covers symptoms and common misconceptions, to help others identify the condition. The guide warns that an infection can take a dangerous turn in anyone from infancy through adulthood, and that awareness can save time and lives.

“If I had known prior to going into the hospital what sepsis was, I think that would have potentially saved my limbs … if I was able to link (symptoms) to sepsis, then maybe things would have been different,” Henze said.

Fox-Robichaud said the consequences can continue after a patient leaves hospital. “Death and limb loss are the worst, but people are often left with long-term disabilities, cognitive impairment, muscle weakness, can’t return to work, and often left out of supports of the healthcare system,” she said.

Preventing infections and reducing their severity are central to lowering the risk, she said. “Prevention is everything … If we have an infection that can be prevented or the severity of illness reduced by a vaccine, that is the first preventative strategy.” At the height of the pandemic, most beds in her intensive care unit were occupied by COVID-19 patients with sepsis; after vaccines became available, those numbers fell sharply, she said. Keeping skin wounds clean is another preventive measure. People whose immune systems are suppressed by steroid medication or biologics for chronic conditions, as well as people with cancer, face increased risk.

Fox-Robichaud said patients and loved ones should raise concerns when someone is not acting as usual, is confused, has a persistent cough, feels impending doom, has not urinated all day or develops mottled skin. Asking a caregiver, “Could this be sepsis?” may lead to blood work, blood cultures and tests to check whether organs are functioning properly, she said.

The report puts the global annual toll at about 166 million people affected by sepsis and 21 million deaths. About 12.5 per cent of sepsis deaths worldwide are attributed to antibiotic resistance. In Canada, 20 per cent of people who develop sepsis die; among patients requiring extensive intensive care support, the death rate rises to 35 per cent.

The 80 per cent who survive a hospital stay for sepsis still face a five-year mortality rate, according to the report. For people with diabetes, the risk of cardiovascular disease after sepsis rises to 40 per cent over five years. Sepsis is the fourth-leading cause of death in Canada.

The article included files from Cindy Tran and listed related coverage on Edmonton emergency department waits and the $17-million award to the Alberta teen. It also urged readers to bookmark EdmontonJournal.com and EdmontonSun.com, sign up for newsletters and support journalism through digital subscriptions, which provide access to The Edmonton Journal, The Edmonton Sun, the National Post and 13 other Canadian news sites.

Based on reporting by Edmonton Journal.