When a Surgical Site Infection Sends a Friend Through Hell

Cheryl Clark, for HealthLeaders Media , February 16, 2012

"For those 12 days I was either writhing in agony, and crying—the first time I have ever cried in public—or drugged to the eyeballs on Dilaudid," Muncie told me.  He became drug-dependent. As the pain abated and dosages were reduced, he went into a drug withdrawal so frightening hospital personnel thought he was having a heart attack, his wife said. He was put back on Dilaudid.

"This was a psychological as well as a physical nightmare," Muncie said.

"Martha Jefferson doesn't deny that I got these infections at the hospital," said Muncie, who continues his recovery at home. "But what they do say, what all hospitals say, is that there's no way of knowing who's to blame." 

Muncie and Jaffe don't understand how hospital officials can say that. His life-threatening ordeal might have been avoided if appropriate infection control personnel and procedures had been in place, they say.

For example, Jaffe says her husband was never given a pre-surgical self-scrub kit that she now knows is standard.  And they say the hospital does not have a full-time infection control professional, which they think it should.

Michael Ashby, MD, vice president for medical affairs at Martha Jefferson, spoke with me at length about infection control practices at his hospital. He declined to discuss Muncie's case in particular, but he did say this:

"I feel awful that there was an infection after surgery at our hospital. And it's taken a re-hospitalization, a reoperation, and prolonged antibiotics. It's terrible. And I'm sorry."

However, Ashby insists that his community hospital appropriately preps all surgical patients before their procedures.

"Do we follow sterile technique? I believe we follow sterile technique.  Do we give them prophylactic antibiotics within an hour before incision? I believe we give them prophylactic antibiotics before the incision.  Do some patients still get infections?

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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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