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A health-care worker at a Toronto hospital. An estimated 75,000 cases of sepsis occur every year in Canada, leading to thousands of deaths.Chris Young/The Canadian Press
Hospitals in Canada’s most populous province will be required by Ontario Health to establish protocols by early next year to identify and respond to sepsis, which can be fatal if patients do not receive timely medical intervention.
A copy of a clinical memorandum, sent in the spring and obtained by The Globe and Mail, details how Ontario Health, a government agency designed to modernize the health care system, is working to set consistent provincial expectations for how hospitals respond to potential cases of sepsis. The new protocols must be in place by March, 2027, according to the memorandum.
There have been several sepsis-related deaths in Ontario hospitals in recent years that have sparked public outcry, including that of 16-year-old Finlay van der Werken. In February, 2024, he waited more than eight hours in an Oakville, Ont., emergency department to be seen by a doctor before he died of sepsis and pneumonia.
Nova Scotia’s approach to sepsis treatment offers life-saving lessons, advocates say
Sepsis is when the body kicks into overdrive in response to an infection. If it is not recognized early, it can lead to shock, organ failure and death. As of 2020, it was estimated 75,000 cases of sepsis occur every year in Canada, leading to 18,000 deaths.
The clinical memorandum, dated April 20, pegs the cost of sepsis to Ontario’s health care system to be more than $1-billion a year. The document, sent to chief medical executives and hospitals in the province, said institutions must have sepsis screening or warning mechanisms in place for inpatient units by March 31, 2027.
“Hospitals can fulfill this requirement by using a health information system (HIS) with an integrated early warning system or by implementing a routine screening process – either on paper or electronically – for acutely ill, high-risk patients,” it said.
The document also cites strong evidence that early identification and timely sepsis treatment improves patient outcomes, but that benefits can only be achieved when protocols are embedded in workflows and consistent.
Lily Barnes, a spokesperson for Ontario’s Health Minister Sylvia Jones, said the provincial government is working to promote standardized practices and clinical awareness.
“As per the Minister’s direction, Ontario Health has convened an expert panel of leading clinicians to review currently established sepsis guidelines and opportunities for improvement,” she said in an e-mail.
Last October, the van der Werken family met with Ms. Jones to call for changes to how emergency care is delivered in Ontario, including standardized maximum ER wait times for vulnerable pediatric patients.
The circumstances of Finlay’s death will be the subject of a future discretionary coroner’s inquest, but a date has not been set.
Ontario resident, Gurinder Sidhu, has also called for reforms to ensure early intervention and treatment of sepsis. He says his wife, Ravinder, with whom he has three children, developed postpartum sepsis that caused organ failure and led to her death in June, 2025.
Kassandra Costabile is also pushing for accountability following her sister’s death, which she believes was preventable. Rheanna Laderoute died in February, 2022, after showing signs of septic shock following an abortion.
Last October, Nova Scotia rolled out a provincewide approach that authorized emergency room nurses to administer antibiotics and IV fluids to anyone suspected of having sepsis.
The measure was applauded by advocates who want the approach expanded to other provinces and territories.
Nova Scotia’s changes were implemented following several prominent sepsis cases that resulted in legal action.
For its action plan, the provincial health authority drew lessons from NHS Scotland, the publicly funded health care system in that country, and the B.C. Sepsis Network, a clinician initiative in that province.
In New York State, sepsis detection regulations in place for the past 13 years have been credited with saving tens of thousands of lives. They include strict timelines for interventions, including early delivery of antibiotics.
The measures, known as Rory’s Regulations, were put in place after the April 1, 2012, death of 12-year-old Rory Staunton, who had undiagnosed and untreated sepsis. His parents, Ciaran and Orlaith Staunton, founded the U.S. advocacy organization, End Sepsis, the year of his death.
In a recent interview, Ms. Staunton said she has spoken with the van der Werken family and that she was heartbroken to learn Finlay waited so long before being seen by a doctor.
Finlay and Rory’s deaths were preventable, she said.
“I think it’s about time Canada got their act together. What’s stopping them?”