Sneaking sepsis warning: ‘If I was a single man, I’d be dead’

Saturday, 13 September 2025

David Trustrum still suffers fatigue and issues with talking from his damaged tongue after life-threatening sepsis.

Warning: Some images may be distressing

Three times doctors told David Trustrum’s wife to bring his son and daughter in to say goodbye.

His friends trooped in two by two, like the parade into Noah’s Ark. But Trustrum was already being carried away on the flood of his immune system’s toxic over-reaction to what started as a measly cold.

On Monday, the then 55-year-old woke with a snotty nose.

On Tuesday, his glands hurt, but “Who hasn’t had that?”

On Wednesday, he developed diarrhoea and vomiting, and tried to see his Lower Hutt GP, but they were booked out. “Try tomorrow,” they said.

Tomorrow almost never came. Trustrum’s wife slept in the spare room to give him space, but checked on him at 5am, when their daughter got up to smuggle the cat into her room.

Trustrum spent eight weeks in hospital, including 20 days in intensive care, after developing sepsis from what appeared to be a mild cold. Two years on, he’s only 80% recovered.

“I was making a horrible noise - like I was hardly breathing - and I couldn’t be woken. So in a short period, there were five paramedics in my room … If I’d been left much longer, I would have died, I’m sure. It happens very quickly. If I was a single man, I’d be dead.”

Trustrum, now 57, is one of about 15,000 Kiwis and Australians admitted to intensive care every year with sepsis. From 2009-19, 1663 Kiwis died from the condition, which happens when the immune system goes into overdrive trying to fight off infection, and instead damages the body’s own tissues and organs.

Even those who survive can suffer life-altering - and life-limiting - consequences.

ACC claims data shows sepsis caused 699 treatment injuries from 2020/21 to 2024/25. Most happened at public hospitals.

But that’s only cases resulting from health treatment, such as post-surgery wound infections, or bugs creeping in through medical equipment such as catheters. Community-sourced cases like Trustrum’s aren’t counted - or covered by compensation.

Trustrum suffered multiple organ failure. His kidneys stopped working. He spent 20 days in Wellington Hospital’s intensive care unit, in and out of consciousness.

They operated to clear the travel pillow-sized infection in his neck. His phone stopped recognising his fingerprint as tiny blood clots cut circulation to his extremities, his fingertips turning black and hard as the tissue died.

And just as Trustrum regained consciousness and seemed out of danger, a secondary infection sent him back under.

After almost eight weeks in hospital, and 20kg lighter, he was through the worst. But his ordeal was far from over. He had to relearn to walk, as his feet were so nerve-damaged and numb, they felt as though they were set in plaster casts.

He’s only recently got back to riding motorbikes, after eight months of bicycle balance training. And bedtime is 8.30pm, to stave off the exhaustion that sometimes robs him of entire weekends.

“Fatigue isn’t like being tired. It suddenly hits you and that's it - everything is too hard.’’

In many ways, Trustrum was lucky. His kidneys cranked up again, avoiding a lifetime of dialysis. And he lost only one fingertip to amputation, while some lose entire limbs.

The sepsis-sparking infection was identified as pneumonia, but he still doesn’t know why his body turned on him. While older people, young children and those with depleted immune systems - such as chemo patients - are more susceptible, Trustrum was none of those things.

“It’s bizarre that anybody can get this - anybody. I was fit and healthy, but through some quirk - some infection - all of a sudden life changed … I was told, in medicine, sometimes there aren’t always satisfactory answers, and this is one of those times.”

Two years on, he rates his recovery as 80%. “I’m aiming for 90.”

A constellation of signs

Anaesthetist and intensive care specialist Robert Martynoga rates sepsis as one of three or four main triggers for intensive care.

“It’s unfortunately very, very common.”

Martynoga co-founded the Sepsis Trust to increase awareness, so the condition could be identified and treated early.

Derived from the Greek word for rot, sepsis is the body’s immune system going into overdrive in response to a severe infection, which can be viral, bacterial, fungal or parasitic.

“In some circumstances, which we don’t fully understand, the immune system can sort of lose control of the situation and will result in an excessive response, which then results in collateral damage to the patient’s body.”

At the extreme end - called septic shock - that damage can include multiple organ failure - kidneys stop producing urine, the heart stops beating effectively, the gut stops absorbing nutrients. And around a quarter of septic shock patients die, even with ICU treatment.

What makes it more tricky is that early sepsis is easy to miss, Martynoga says. Like Trustrum’s, many infections start out mild.

“Poor GPs see patients who may just have the flu or may have a bad cold, but every so often, one of them will progress to having sepsis.”

Blood tests can check if the kidneys are working, but there’s no one definitive diagnostic test for sepsis. As it progresses, telltale signs include a racing heart, fast, shallow breathing, high fever or chills, muscle pains and slurred speech or disorientation. The rash typical of meningococcal disease can also indicate sepsis.

“It’s mainly a clinical diagnosis made by a constellation of signs.”

Once diagnosed, it’s treated with antibiotics. Time is critical, Martynoga says.

“Every hour of delay getting appropriate antibiotics results in an increase in risk of mortality for patients for septic shock.”

But while antibiotics can clear the root infection quickly, if it’s progressed to septic shock, treating flow-on effects takes much longer, Martynoga says. About one in five patients with severe septic shock need ongoing dialysis. And some lose limbs.

“You sometimes have to make a terrible decision about - is this patient going to survive, and are they unfortunately going to need amputations to help them get to that point of survival? It’s one of the devastating consequences of sepsis.”

The health system also does not offer great support for survivors, whose lasting disabilities and fatigue can jeopardise their jobs and livelihoods, Martynoga says.

“Survivors of sepsis face a long road to recovery … Many of these poor people struggle with their home relationships and getting back to work, and ACC often doesn’t support them.”

Sebby Chua died of suspected sepsis at Wellington Hospital in September 2022, four days after he was sent home from Kenepuru Hospital ED.

Martynoga has been pushing for the use of checklists to help health workers diagnose sepsis. But he also calls on patients and caregivers to raise it as a possibility.

“The message to the public should be just ask, ‘Could this be sepsis?’ ”

My son was not meant to die

Little Sebby Chua didn’t like farewells.

People always noticed the 4-year-old’s bright, beautiful eyes. His question-jammed chats were like talking to an adult. He would sing and dance, and pick wildflowers for his mum, Abegail.

Sebby’s family still think about him every day.

“Sebby was such a sweet boy,” says dad Arvin Chua. “He always hated it when it was time to say goodbye.”

Three years on from farewelling Sebby forever, Chua still wakes every morning thinking of his son. Wishing the sepsis that’s believed to have killed him had been identified and treated earlier.

Sebby first felt unwell on Wednesday, September 21, 2022, after visiting Te Papa with his brother. He had a sore neck and later developed a fever.

The next day, when the symptoms persisted and Sebby mentioned a taste of blood while swallowing, the family took him to Kenepuru Hospital ED. Chua says they were told it was wry neck and a viral infection.

For two days, they administered painkillers, love and rest, but Sebby failed to improve. On Sunday, Sebby reported joint pains, and Healthline recommended taking him to hospital if he developed swelling or a rash.

On Monday, September 26 - five days after Sebby’s first symptoms - he woke with swollen arms and legs, and the Chuas took him to Wellington Hospital, where he was quickly admitted, about 11.15am.

Health staff said Sebby would be referred for a blood sample, but Chua says that didn’t happen until after 3pm. Chua says Abegail - a nurse - tried to tell the doctors Sebby had never been sick like this before.

By 7.30pm, Sebby was dead. Despite September being sepsis awareness month, Chua doesn’t believe anyone considered it.

Chua can’t say if Sebby’s death was preventable, but believes if health staff had acted more urgently - and if the taste of blood Sebby reported at Kenepuru ED had been recognised as something unusual - he might have had a better chance.

“My son was not meant to die.

“I wish the healthcare workers had been proactive and aggressive in treating. Our approach should not be to wait for a condition to worsen before doing something …Clinicians and healthcare workers should genuinely listen to what a parent is saying … We know what normal and not normal looks like.

“I just hope that of all people, healthcare workers become more aware of what sepsis is.”

Sebby’s death is still being investigated by the coroner and Health and Disability Commissioner. Health NZ has reviewed what happened, but won’t say what the outcome was while restorative processes and the HDC investigation continue.

“It would be inappropriate for us to comment further on the Review’s outcomes and recommendations until these processes are complete,” says Jamie Duncan, Group Director of Operations for Capital & Coast and Hutt Valley. “We are committed to implementing any recommendations.

“We recognise the ongoing distress the family is experiencing and extend our heartfelt sympathy and condolences. We also acknowledge that the staff involved have been impacted by this tragic event.”

Meanwhile, Chua still thinks about his son daily.

“Whatever we do, wherever we go, we always wish he were here. When we go to the grocery store, we remember his favourite food, favourite jam, and favourite drink. When we go to restaurants and see our two kids playing, we can't help but remember him and wish he were here playing along with his siblings. Sebby is in - and will be in - our hearts forever.”

A healthcare emergency

A recent risk register for Wellington and Hutt Valley hospitals highlights “a trend of patients presenting through ED, with delays to diagnosing and treating sepsis”.

“Failure to diagnose and treat sepsis results in physical harm and poor patient outcomes,“ the register notes.

Duncan says sepsis is clinically complex and difficult to identify. However, the hospital is recruiting more staff to speed patient review, and an upgraded ED is due in 2029.

Emergency doctor and Sepsis Trust co-founder and trustee, Dan Dobbins says better access to GPs, and better patient flows through hospitals to prevent bed block in EDs, would help ensure sepsis is diagnosed and treated quickly.

But Waikato emergency specialist and Sepsis Trust trustee, Dan Dobbins, says overloaded emergency departments are a problem for sepsis diagnosis and treatment nationwide.

“That’s something we’re dealing with on a daily basis.”

When the hospital is full, patients needing admission clog ED beds, and ED waiting rooms blow out, Dobbins says.

“So you are playing a bit of a game of picking needles out of haystacks. And our nurses are super-good at it, but they can’t be completely perfect…It’s not that we’re missing it, but stuff has been delayed in care, which can affect people in the long term…There is increased risk, with the pressures being put on our health system currently.”

Dobbins sees five or six sepsis cases on an average 10-hour shift. Most stem from respiratory infections, like pneumonia, and urinary infections.

ED triage nurses have to make one-second decisions about who to prioritise, so they’ve invested a lot of effort to help them recognise sepsis signs, Dobbins says.

“Years ago, when we didn’t know much about sepsis, they’d give some initial treatment and then say ‘Oh yeah, they’re fine’, and then didn’t watch them to prevent them falling off their perch. So that’s a lot of what we do - really watching people closely.”

As well as overloaded EDs, long waits to see GPs risk worsening outcomes for sepsis cases, Dobbins says.

“When people don’t have access to GPs, either they’re going to come to the ED and flood the ED, or they’re just going to put it off for so long that they’re going to be really sick.”

While some sepsis survivors experience PTSD from their time in ICU, every time Trustrum drives past Wellington Hospital he feels a very different emotion.

“I feel a wave of joy almost. I’ve got a gratitude of debt that I can never repay.”