When a Surgical Site Infection Sends a Friend Through Hell

Cheryl Clark, for HealthLeaders Media , February 16, 2012

Once in a while, you hear a story that synthesizes all the talk about infection prevention and surgical checklists into a real-life horror that is as painful as it is urgent. That's when an arguably avoidable, and especially terrible, adverse event happens in a hospital to someone you know personally.

In this case, the patient is an editor and friend I worked with 15 years ago.

John Muncie is now a college journalism program administrator who lives with his wife, Jody Jaffe, on a Lexington horse farm braced against Virginia's Blue Ridge Mountains. But a few weeks ago, his life went from idyllic to horrific in just a few days.

Troubled with back pain from shoveling gravel and other ranching chores, on Nov. 28 he entered the brand new Martha Jefferson Hospital in Charlottesville for spine surgery. The $275 million facility's opening in August was a regional point of pride, with the facility's 177 beds set in soothing Craftsman-style architecture atop Pantops Mountain.

An elective, routine laminectomy with a 23-hour stay would fix his back, Muncie was told. He was discharged on schedule. Recovery proceeded until just before New Year's, when he became feverish, with renewed pain in his back.

Then the pain got worse.

Several calls to the doctor led to an MRI, but nothing conclusive. On Jan. 7, he was so sick he was rushed back to Martha Jefferson and readmitted.

Over the next 12 days Muncie was treated with multiple drugs—many of which failed—to see what worked as the lab tried to grow and identify the culprit bugs. He underwent two biopsies. A few days after readmission, he underwent a 2.5-hour surgery to remove an abscess that had amassed.

Later a propion acne bacteria and a candida-like fungus were confirmed.

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5 comments on "When a Surgical Site Infection Sends a Friend Through Hell"

jody jaffe (2/21/2012 at 2:23 PM)
According to the CDC, 70% of hospital acquired infections (HAIs) can be prevented. No one is saying all HAIs can be prevented, but 70%? That is shameful. So I have to disagree with Dr. Hirsch's premise that hospitals shouldn't be responsible for the costs of these HAIs until it can be proven they are all preventable. The bottom line is hospitals can do more, it just costs money. For example, Martha Jefferson Hospital, where my husband was infected and treated for THREE HAIs, defunded its two infectious disease nurses and refused to pay for an infectious disease doctor to be on its Infection Committee. According to Dr. Dan Sawyer, the infectious disease doctor at Martha Jefferson, infection rates went down when he was in the Operating Rooms, observing and gathering data. And the rates went back up when he stopped. Don't tell me Sentara, Martha Jefferson's parent company, can't afford to fund these positions. It posts net revenues of $3.5 BILLION and paid its CEO, David Bernd, $3.5 million in 2008.

Ray McEachern (2/20/2012 at 1:58 PM)
Rather than citing stats and making excuses, medical professionals must learn to take responsibility for possible mistakes that were the direct or likely cause of this type of infection. There should be a root cause analysis of this specific infection with the intention of finding how it could have happened. Unless there are documented procedures in this patient's record that establish beyond a reasonable doubt that all infection control procedures were followed during his entire stay, the hospital should take responsibilty. Just as airlines have black boxes to help determine cause when things go wrong, hospitals must have checklists and other records to prove their best practices were followed.

AHNguyen (2/17/2012 at 1:08 PM)
Physicians, nurses, and hospitals are not in the business of causing harm to patients. They do not celebrate complications/infections because they are getting paid extra for these events. This premise is idiotic. It is well known in the scientific community that a zero percent infection rate is an impossibility. There are myriad variables contributing to this process, most of which we do not have a complete understanding or comprehension in terms of identification, prevention, or intervention. We have identified the disparate variables contributing to SSIs. These include appropriate hair removal, skin decontamination, prophylactic antibiotics, body temperature, glucose control, and so forth. Adherence to proposed guidelines could reduce the incidence of SSIs significantly, but this rate is not ZERO. With regards to the author's claim of efficacy with preop washing, the current scientific data is "despite repeated demonstrations of a reduction in surface bacteria at the operative site using a CHG shower, meta analyses have shown only a NONsignificant reduction in wound infections in large number of patients." We all feel bad and horrible when someone has a bad outcome. However, without further information from this article, it is imprudent to assign accountability and culpability.




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