From Health 201FailSystems

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Incident

Sepsis alert nearly led to fluid loading of a dialysis patient

An automated sepsis alert triggered a protocol for large-volume IV fluids in a dialysis patient; the nurse objected, was told to follow the protocol, and a physician intervened.

Sources checked when written 26 September 2026

TierThe automation stayed up and kept producing output that was wrong or went unchecked; there was no outage to fall back from. How tiers are assigned.

What happened

The Associated Press reported in March 2025 that emergency nurse Adam Hart's hospital computer system flagged a newly arrived patient for sepsis, and hospital protocol called for an immediate large dose of IV fluids. Hart recognised that the patient was on dialysis with kidney failure, for whom fluid loading is dangerous. His supervising nurse told him to follow the protocol, and a physician intervened. Nurses in the same AP report described frequent false alerts. Scientific American (February 2026) named the hospital as St. Rose Dominican in Henderson, Nevada, and described the alert as coming from an AI system; the AP account says only that the computer system flagged the patient. The two accounts differ on what followed: AP says the patient received a slow infusion of IV fluids, while Scientific American says the physician ordered dopamine instead of fluids.[1,2]

Documented harm

None; averted by the nurse and physician.

What it teaches

Sources

  1. As AI reshapes patient care, human nurses are pushing back against its creeping influence (AP). Associated Press via Euronews, 18 March 2025. Secondary Journalism · link checked 2026-09-26
  2. AI enters the exam room, and nurses are left to manage the fallout. Scientific American (Hilke Schellmann), 17 February 2026. Secondary Journalism · link checked 2026-09-27

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