Life-Threatening Soft Tissue Infection Allegedly Caused by Contaminated Water Supply on Ship

This case involves a female who worked on a ship as a member of the galley crew. She had worked in the shipping industry on-board the vessel for 3 years at the time of the incident in question. At some point during an extended trip, the Plaintiff started having flu like symptoms. The ship returned to the seaport, where the plaintiff noted that her feet began to hurt, and that a small spot had developed on her foot. Eventually, the Plaintiff left the boat due to her foot pain and went home, shortly after which she presented to the ER due to her pain. At the ER, it was noted that the Plaintiff had high blood pressure as well as a low heart rate. She was referred to a specialist who diagnosed her with a vibrio infection, which required the amputation of the patient’s right leg below the knee. It was alleged that the ship had inadequately maintained its potable water tanks, which had allowed the bacteria that caused the Plaintiff’s infection to flourish.

Question(s) For Expert Witness

1. Do you routinely treat patients like the one described above?

2. Do you have familiarity with the subject matter described above?

3. Have you diagnosed and treated vibrio infections from exposure to contaminated water?

Expert Witness Response E-033060

The presentation describes a rapidly evolving skin and soft tissue infection (SSTI). From the description, she may have been diagnosed with a necrotizing cellulitis or fasciitis. It is not routine to see Vibrio infections outside of coastal zones. Vibrio are ubiquitous in coastal waters, and the patient's immune status usually dictates the outcome. Water contaminated with seawater could be a plausible mechanism for her infection and outcome. For this to happen, usually the person would have a preexisting wound which would get contaminated by seawater. However, there could be many other more common bacteria not associated with seawater which would cause the same disease. I would inquire why she needed an amputation, versus surgical debridement. In the end, without a wound culture there can be no confirmation of a Vibrio SSTI. However, it is reasonable to note that culturing of water in the water tank could be strong circumstantial evidence of a Vibrio SSTI due to seawater contamination.