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Julie Rich must breathe with the assistance of oxygen as a result of a MRSA infection she contracted five years ago after an outpatient procedure at a local hospital. “They’re just not as careful as they should be. They’re not as dutiful as they should be as far as infections are concerned,” Rich says.
Sunday, Aug. 8, 2010 | 2 a.m.
Do No Harm: Hospital Care in Las Vegas, Part 2
- A hidden epidemic
- Hospital stay will stay with her always
- VA system stanching MRSA
- Hospital’s sanitation promises quickly forgotten
- Billing codes key to data analyzed on infections
- Where I Stand: Rise in infection rates, hospitals’ reticence are troublesome
- Editorial: Hospitals should do more to protect patients from deadly bacteria
- ‘We’re the ones who are in there. Our lives are entrusted to them.’
- Health board backs limits on disclosure of infections
- How best to stem spread of infection?
- St. Rose breaks ranks with disclosure on quality of care
Share your stories
Las Vegas hospital officials say they are doing enough to protect patients from becoming infected with deadly bacteria.
But hospitals are failing.
Just ask Ruth Lepper, whose 74-year-old husband, Darwyn, had hip surgery in 2008 and died within months of complications from infections. Or Julie Rich, who is 69 and relies on an oxygen machine because of an infection she contracted after outpatient surgery. And Marcia Friedman, whose 91-year-old mother, Eleanor, was recovering from a blood clot when she got infected and died.
What they say: Going to the hospital puts you in harm's way. Hospitals know this and avoid talking about it. And until now, the details have not been publicly known.
The Sun has spent two years investigating hospital safety in Las Vegas, including analysis of hospital billing records on file with the state.
Among the findings: In 2008 and 2009, patients became infected with lethal, drug-resistant "superbugs" in area hospitals 2,010 times.
Two hundred thirty-nine died — although it's impossible to tell from hospital billing records how or whether the infections factored in the patients' deaths.
The microbe Methicillin-resistant Staphylococcus aureus, or MRSA, was responsible for 647 cases of hospital-acquired infections during the two-year period. In the same span, Clostridium difficile, or C. diff, triggered 1,363 infections in Las Vegas hospitals.
No health agency tracks these cases. In fact, hospitals derailed proposed legislation in 2009 that would have required them to publicly report cases of MRSA in their facilities.
However, hospitals are required by law to submit to the state billing records based on each patient visit. The Sun obtained that information from 1999 to 2009 and analyzed the 2.9 million hospital billing records as part of its two-year investigation, "Do No Harm: Hospital Care in Las Vegas."
Because of how the records are coded, the Sun was able to identify the number of infections by the two bacteria, and for the years 2008-09 further identify the cases in which the records say the patients acquired the bacteria while hospitalized.
Jeanine Thomas, founder of MRSA Survivors Network, an Illinois-based national advocacy group, applauded the effort to draw attention to an epidemic that's being hidden from the public. She said MRSA should be reported to public health agencies because it's communicable, infectious and a national problem. That it's not reported "is shocking," she said.
"There should be transparency," Thomas said. "People have a right to know this information."
Not even Nevada State Epidemiologist Dr. Ihsan Azzam knew how many patients have been stricken by the infections until learning it from the Sun. He called the newspaper's analysis a wake-up call to the health care community to be more aggressive in preventing infections.
"Such a significant increase in these rates coupled with the threat of emerging resistant organisms in the health care setting should sound the alarm for all clinicians, hospitals, infection-control specialists and epidemiologists," Azzam said.
A COSTLY, DEADLY PROBLEM
Health care-acquired infections have long been the bane of hospital infectious-disease experts nationwide, costing $30 billion annually and being responsible for the deaths of about 100,000 people. That puts them among the leading causes of death in the United States.
University Medical Center was the only hospital in Las Vegas to accept the Sun's invitation to discuss its findings.
The other dozen hospitals in the valley provided a statement through their trade organization, the Nevada Hospital Association. None disputed the Sun's findings or its methods of identifying the cases.
The statement proclaimed an adherence to national standards that are intended to prevent the spread of bacteria among patients. All screen high-risk patients for MRSA when they are admitted, isolate infected patients and require anyone who enters their rooms to don gowns, gloves and face masks to prevent the spread of the bacteria. The hospitals also stress washing hands and cleansing surfaces with bleach to kill C. diff spores.
But examples of hospitals not following their own standards are plentiful — jeopardizing, even, their own employees. A Sunrise Hospital worker who complained to state officials about being infected with MRSA on the job told health inspectors in June, "This problem has been going on for a while, but has surged recently" and could cause an outbreak. The state forwarded the complaint to the Nevada Occupational Safety and Health Administration.
Infected patients, or their survivors, say not enough is being done to stop the spread of bacteria.
"My husband should not have died of a broken hip," said Ruth Lepper, after her husband died after contracting MRSA at a hospital. He also was infected with C. diff at another valley health care facility.
"They're just not as dutiful as they should be," said Rich, who also contracted a MRSA infection at a local hospital. She described the hospital as filthy.
"They killed her," Marcia Friedman said of the hospital where her mother contracted and died of complications related to a MRSA infection.
The Sun found that even as the hospitals focus on eliminating the infections, they proliferate. The combined rate of hospital-acquired MRSA cases at all 13 Las Vegas Valley hospitals increased by 34 percent to 1.74 cases per 1,000 hospital discharges from 2008 to 2009, state records show. The rate more than doubled at four facilities: Desert Springs Hospital, Spring Valley Hospital Medical Center, St. Rose Dominican Hospitals — San Martin Campus and Valley Hospital Medical Center.
MRSA infection rates are declining in some regions of the U.S. It's impossible to compare the Sun's findings of hospital-acquired MRSA and C. diff rates to those elsewhere because of the different ways the information is gathered and reported.
There is no national standard for an acceptable level of hospital-acquired MRSA or C. diff infections. But some facilities have all but eliminated them. In several European countries, rates have been reduced to almost zero, and within the Veterans Affairs Department, some hospitals go for a year or more with no cases.
"We're not satisfied when the rate is any higher than zero," said Dr. Rajiv Jain, head of the VA's MRSA prevention program.
In Las Vegas, the rate of hospital-acquired MRSA infections in 2009 ranged from 0.67 to 3.04 cases per 1,000 discharges at Summerlin Hospital Medical Center and North Vista Hospital, respectively.
The rate of hospital-acquired C. diff infections in 2009 ranged from 1.93 to 5.31 cases per 1,000 discharges at Spring Valley Hospital and Desert Springs Hospital, respectively.
The Sun asked the hospitals to voluntarily disclose their numbers of hospital-acquired MRSA and C. diff cases. UMC officials said they had 86 MRSA and 52 C. diff infections that were hospital-acquired in 2009.
St. Rose Hospitals promised to make the information available on its website soon. The other hospitals declined.
BACTERIA HAVE BECOME MORE RESISTANT
Penicillin was proclaimed a miracle drug when it came into use in the 1940s because it could defeat the deadly Staphylococcus aureus bacterium.
But the byproduct of that achievement was the evolution of more resistant bacteria. That's how MRSA and C. diff became epidemics.
MRSA appeared in hospitals in the 1960s. As it evolved, it spread into the community. Now patients who enter a hospital may carry MRSA but not be infected, which means they show no symptoms and can infect others unknowingly. Victims are infected through contact with contaminated health care workers, patients or medical equipment.
Hospital-acquired MRSA manifests itself as pneumonia or infections in the bloodstream or at surgical sites.
A recent Duke University study found MRSA surgical-site infections lead to a sevenfold increase in the risk of death, a 35-fold increase in the risk of hospital readmission and more than three weeks of additional hospitalization.
MRSA infections are treated with heavy doses of antibiotics — providing an opening for C. diff. The bacterium lives in the human gut and is harmless in healthy individuals because "good" bacteria keep it in check. But when a person is on antibiotics the good bacteria are destroyed, disrupting that balance and allowing C. diff to proliferate. It causes severe diarrhea, abdominal cramping, fever, nausea and blood in the stool.
C. diff spores are so hearty that hospital employees wash high-traffic areas with bleach to kill them. Like MRSA, it spreads through contact with infected patients, health care workers or equipment. Infected patients are supposed to be isolated.
Because of the intensive hospital care and expensive drugs required to treat these infections, the financial costs are staggering. Each MRSA bloodstream infection costs $27,083, according to academic research, and each C. diff case costs up to $7,100 in additional treatment. That puts the cost of hospital-acquired infections in Las Vegas in the millions of dollars annually.
Much of the cost of hospital-acquired infections is borne by taxpayers and the insured, through government insurance programs and private insurers.
The costs are also paid by the victims, people such as Carole LaRocca. She almost died from a MRSA infection she contracted at a local hospital in 2003, and was billed $3,676 for antibiotics that insurance refused to cover. It's an overwhelming and stressful debt for a 74-year-old woman on a fixed income. She faithfully pays $25 a month to a collection agency, yet still receives threatening calls.
"It's an awful thing," LaRocca said. "They need to make an effort to prevent their patients from going home with illness."
TESTS AT ADMISSION COST-EFFECTIVE
The Southern Nevada hospital that arguably does the best job combating MRSA is the O'Callaghan Federal Hospital at Nellis Air Force Base. (Because it is a federal hospital, it was not part of the state database examined by the Sun.)
The Veterans Affairs Department, which operates the hospital, has a zero-tolerance policy toward the bacterium. As at other VA facilities nationwide, staff members swab each patient upon admission and determine within two hours whether the person is colonized or infected with MRSA. Patients who are carriers are immediately isolated.
The hospital also tests each patient upon transfer elsewhere in the facility or discharge to monitor whether the bacterium is being contracted inside the facility.
Each test costs about $25, but VA officials say it's cost effective, given that the number of hospital-acquired MRSA infections has fallen to almost zero in many facilities.
No other Las Vegas hospital tests every patient for MRSA at admission, and none tests any patient at discharge. They say their methods — when followed carefully — effectively reduce the spread of bacteria in the hospital.
Still, a few facilities in other states have found universal screening works. In 2005, a three-hospital group in Illinois, comparable in size to the Southern Nevada hospital chains, started a universal MRSA screening program. Evanston Northwestern Healthcare officials discovered 6.3 percent of their patients arrived infected or carrying the bug. The hospital isolated them, a defensive tactic made possible with the screening. The hospitals also emphasized washing hands, decontamination of facilities and equipment, and contact precautions.
The annual cost of the Evanston Northwestern program was $600,000, mostly for laboratory supplies and personnel. The program was cost-effective in its first year, and MRSA bloodstream infections dropped by 80 percent.
The Centers for Disease Control and Prevention takes the lead on infection prevention in American hospitals. But the CDC has failed to prioritize for hospital officials the best prevention practices — from among almost 1,200 recommendations — and has not grasped "the extent of the problem," according to a 2008 report by the Government Accountability Office.
Dr. Bill Jarvis, who worked at the CDC for 23 years and led its hospital-infection program, said the federal government is sending mixed messages to hospitals on MRSA control: The VA system has rigorously attacked the bacterium, while the CDC has yet to give it proper attention.
CDC Epidemiologist Dr. John Jernigan said the agency is revising its guidelines, and he thinks the recommendations, if followed, will prevent MRSA's spread in hospitals. In fact, MRSA rates are declining in some regions, he said.
Jernigan does not recommend other hospitals pursue universal MRSA screening, because there is legitimate scientific debate about its necessity, he said.
In the joint statement they provided to the Sun, a dozen Las Vegas hospitals said screening only high-risk patients — including intensive care patients, anyone coming from another facility and patients who have wounds or are homeless — "is a cost-effective and efficient method to reduce the rate of MRSA in hospitals."
Still, the overall rate of infections at hospitals is rising, the Sun found.
The infection rate more than quadrupled for MRSA and doubled for C. diff from 1999 to 2009. In recent years, MRSA rates have continued to rise, while C. diff rates have leveled.
The Sun's analysis found more than 33,000 cases in which Las Vegas hospital patients suffered from the infections during the past 11 years — 18,563 cases of MRSA and 15,333 cases of C. diff.
Of those cases, 2,582 of the records showed the patient died while hospitalized, although it's impossible to tell how the bacteria contributed to the deaths.
Azzam, the state epidemiologist, was asked whether Las Vegas hospitals have succeeded at reducing infections. He said he thinks local hospitals "are on the right track" but conceded he was not sure.
SIMPLEST PRECAUTIONS OFTEN NOT TAKEN
The rise of lethal bacteria — combined with infection-control failures — has made being a patient, visitor or worker in Las Vegas hospitals increasingly dangerous.
Some doctors and hospital employees fail to take even the most simple infection-control precautions. Asked if all hospital staff consistently wash their hands, Dr. Eugene Speck, a respected Las Vegas infectious-disease specialist, said, "Of course not." He wasn't being glib. Every health care practitioner interviewed for this story agreed with his assessment, and national studies say the same. Hospital employees are too busy, distracted, apathetic, stressed or short-staffed to keep up with hand washing.
Registered nurse Christina Schofield said she has witnessed poor infection-control practices everywhere she has worked during a 23-year career in Las Vegas.
Schofield was recently assigned to monitor whether UMC nurses were practicing proper hand hygiene. She found nurses were dutiful in washing hands — but said "physical therapists, case managers, physicians, ancillary staff" were not.
Also at UMC, she said, patients known to have contagious infections were placed in rooms with uninfected patients. At St. Rose Hospitals — Siena Campus, she said, technicians who ran the department where intravenous catheters were inserted and angiograms were performed rarely cleaned the room between patients, resulting in contamination by bloody refuse.
"It's a multisystem failure," Schofield said.
St. Rose officials said rooms are always cleaned thoroughly after each patient visit. UMC officials said they did not know of any instances where infected patients were placed in rooms with uninfected patients. Dr. Alan Greenberg, medical director of UMC's infectious disease program, acknowledged that the failure to follow hand hygiene rules is a consistent problem.
Schofield has testified about problems in hospitals before elected officials. No one has followed up on her complaints, she said.
"This is important," she said. "We make an error and they're dead, and there's no changing it."
State health inspectors have documented numerous infection-control problems. A UMC doctor regularly wore street attire — pants and a long-sleeve shirt — while performing colonoscopies, when the hospital's policy requires surgical scrubs. A Sunrise patient infected with C. diff was observed walking the hospital's hallways. A company that did dialysis work at North Vista Hospital had infection-control problems and no oversight by a nurse.
Patients notice the same problems.
Harold Barling, who was infected with MRSA in 2005, said nurses and aides at Valley Hospital, where he was being treated for the infection, often came in and out of the room without masks, gloves or gowns. "I would think they would take every precaution to prevent any possible contamination between me and any other patient they might take care of," Barling said.
Some patients complain that hospital staff is not forthcoming in acknowledging the problem.
When David Spendlove, 51, contracted MRSA at a Las Vegas hospital, where he was admitted June 17 after a heart attack, no one told the family anything specific about the infection, his wife, Pam Spendlove, said.
"Oh it's just a virus they get," she said she was told. "It's common."
During that time, visitors were uncertain what precautions to take to protect themselves, Spendlove said.
"The MRSA was like a deep, dark secret," Spendlove said.
HOSPITALS KEEPING PATIENTS IN THE DARK
Transparency advocates argue that reporting infections by individual facility allows consumers to make informed health care decisions and spurs competition among the hospitals to improve.
But hospital lobbyists have worked for years to keep the information out of the public eye.
When legislation passed in 2002 requiring reporting of sentinel events — unexpected injuries or infections that take place in hospitals — the hospitals fought to prevent reporting by individual facility.
In the 2009 legislative session, Sen. Barbara Cegavske, R-Las Vegas, introduced a bill to require every hospital in Nevada to create a MRSA program identifying colonized patients, isolating them, enforcing hand washing and reporting infections to the state.
The effort took an abrupt turn when Ann Lynch, lobbyist for Sunrise Health System, spoke during a hearing. Lynch informed the senator that the hospitals keep MRSA information internally and have no convenient way of reporting it to state health officials, Cegavske said.
Cegavske, who received $6,500 in campaign contributions from hospitals in 2006, reduced the bill to a simple promise to discuss the subject.
In 2009, lawmakers passed a bill to strengthen reporting requirements for hospital injuries and infections, including more public reporting of hospital-acquired infections.
The hospitals have again lobbied against the information being made public in a way that would be meaningful to consumers.
At a March meeting to discuss implementing Senate Bill 319, Marissa Brown of the Nevada Hospital Association said the infections should be reported as a total for all Nevada hospitals without identifying individual facilities. The association also proposed limiting which hospital units would report infections.
The Nevada State Health Board is scheduled to discuss the matter Friday. As currently drafted, the regulations would not allow the state to report hospital-acquired infections by facility.
I see to many people in scrubs out and about. Generally, unless bleach is used to launder clothes bacteria spreads in the wash machine.
Didn't some of the multiple anti-biotic resistant bacteria come from Russia? where people didn't get, or didn't take a full course of antibiotics?
Can you still get over the counter antibiotics in Mexico, etc.?
With people like Dr. Desai being on health care boards, is there any wonder we have a system that is politically tainted. Also, with all the hospitals built in recent years, it is not surprising that quality control has suffered. Of course now, with less people working and insured, we will see more cuts at these hospitals so they can survive the economic downturn.
Hope you people who listened to the "tort-reform" mantra from the talk radio chorus, know what you got yourself into. No wonder they wanted a $350,000 cap on pain and suffering.
How do all these hospitals get their accreditation after all these reports? Why aren't they being heavily fined and then re-inspected .Where's JCAHO in all this ?
We are allowing these places to operate at third world country levels. Maybe we are trying to make the emergency room patients more comfortable with the services they receive. No one can really sue the hospitals as they are under the counties control. UMC is owned and operated by clark county and hemorrhages money. The amount of money you spend at a hospital you would think would command a good clean place. I guess cleaning is not in the union contracts. Our elected officials are failing us in all areas. As Rome burns, our officials are living the life of luxury, ignorant to our plight.
Families have to be their OWN advocates...it could be a matter of live or death to a family member.I've have too many personal experiences with what go on in hospitals to stand by and turn a blind eye.Be aware of your surroundings in a hospital and that of your love one.Know whats going on in the bed next to him/her.Watch the staff remove a needle from its sleeve before injection or TELL THEM to get a new needle.The gloves?...were they put on in front of you? a Million questions, but think about it all.I have NO PROBLEM raising my voice if I see the staff doing something wrong..NONE!!It's good that THEY know you're eyeing them.I only wish people would be more aware of what goes on while in the hospitals and visiting hospitals. MRSA spreads very fast if not contained properly.
UMC might be County, but the others aren't. If you can't get pain and suffering damages, the suit could be too expensive.
The VA is just as "Union" as the others, typical dittohead, "Unions and Government cause of everything.." Sounds like Glen Buck..."Paging Dr. Desai...Paging Dr. Desai...your private sector for profit clinic is caling you..."
Screw it all.
Let Vegas hospitals kill people all they want. Hey, just let Metro shoot them INSIDE the hospital! Double win!
The smart people will spend the money to go to other hospitals like the Mayo Clinic like I did.
Reading these stories makes me happy I did.
Great reporting. I worked in hospitals for many prior to the current profit making approach to medicine, and it is all about the bottom line. Of course hospitals don't want this information public. It will cost them money.
Have you noticed American citizens are dispensable?
Medically, financially, employed or unemployed, we now live in a country where those not in the top 2% are truly dispensable.
This problem is widespread in Seattle, according to a special investigate report done by the Seattle Times:
http://seattletimes.nwsource.com/html/mr...
During the Middle Ages (Dark Ages) hospitals were places to go to die because of the lack of sanitation within. It was Joseph Lister who developed the process of antiseptic procedures to prevent death from the filthy habits of surgeions at the time. It seems our medical personnel, well trained in all sorts of medical procedures have forgotten the protocals of antiseptics in care of patients. Our hospitals are once again becoming places to go to die because of filth therein. And for a one week stay in ICU they just might charge you, and your estate, over $1 million dollars!!!! Think about it! It could happen to you the next time surgery is required or recommended!!!!
There is an easy solution RIGHT NOW. The problem is most hospitals are more interested in there bottom line rather than a patients life. The Medizone company makes a product that makes an operating room or a patients room 99.9999% sterile. it can even kill anthrax spores and is used by the government in its bioterrorism battle. The object of the hospitals is to make money first. Patient health is secondary.
Here is a the problem and I know after spending 20+ years in hospitals in the environmental services departments.
1. Hand washing procedures need to be followed by everyone and I mean everyone. I can go back 7 years ago when you would be tested on the spot by a nurse etc with proper technique.
2. The biggest culprit in any health care situation starts with the doctors. They go in check a patient turn to the alcohol gel and then leave the room, that is not hand washing.
3. Better reporting by the patients when they arrive from home or other places. 2/3rds of infections begin at home or other non hospital locations. Everyone carries some sort of MRSA in their blood stream naturally, it doesn't become infection until your immune system allows it too.
4. Age restrictions in the hospital, as far back as 10 years ago a child until 16 was not permitted in patient areas. There was a reason for that and that was to control where they roamed and what they touched. In one of the hospitals I was managing I passed a patient room and witnessed 4 children all under 10 years old siting on the patient room floor eating fast food while the parents looked on without any worry.
5. Separate patient care areas from day services. If you were having a routine out patient e-ray why would you want to be next to someone who is very ill and potentially contagious laying in a gurney right next to you.
I can pinpoint 100 reasons why we get sick and why there are so many problems (nationwide) within our hospitals, it is basic common sense and everyone needs to follow the rules. Our hospitals are not playgrounds, they are not there to be babysitters they are for the sick.
p
Welcome to Corporate America!!!
Where Profit Taking takes precedence over EVERYTHING ELSE. NUMERO UNO!!! MUCHO DINERO!!!
Make Big Profits!!! You, as a patient, are a NUMBER. a "file". A "case" to have profit extracted from through insurance(s).
Of course, at the height of the boom, there was such a drastic shortage of "health care professionals" that they were literally BEGGING people from ANYWHERE to come here to fill slots, paying big bonus money and such. The same was true of METRO & CCSD.
When you have to beg and plead, just to get bodies in here to "fill slots", you are PLAYING WITH FIRE. READ; young & inexperienced, or folks looking for a "fresh start" in "vaygus"...washouts from everywhere else...
Not exactly a recipe for success, is it?
***There ARE some WONDERFUL health care professionals in Las Vegas. Unfortunately, they are greatly hindered by "the system".
Hippocratic Oath; HA!
"Entities" DON'T TAKE OATHS!!!
For skin MRSA's, try garlic.
Normally I wouldn't have read an article like this but thanks to the excellent reporting of the LV Sun I learned a lot. I know more about hospitals now than I did, and better understand why my former doctor is the squirrel he is,...and like EVERYTHING in America circa 2010, it's all about money.
Thank you for this informative series. I hope your readers who have experienced medical harm will consider visiting The Empowered Patient Coalition website at www.EmpoweredPatientCoalition.org to take our patient reporting survey to capture these events from the patient's point of view.
Our survey is unique in that all the data is being made transparent and will be publicly reported on our website. We have started to release preliminary results on our data page.
Please visit our website for information and resources to help the public stay safe in the health care system. Reporting medical events will show us where we need to focus our patient safety efforts and will ultimately drive quality.
Thanks again for your excellent investigative reporting on this important topic.
Julia Hallisy
The Empowered Patient Coalition
MRSA is nothing new,and is in every hospital, nursing home in the country. With anti-bacterial gels, wipes, soaps etc, these bacteria will grow only stonger over the years and wreck major havoc in the near future.
rrlv1,
You sound so resigned. The story points out that hospitals around the country, including the VA hospitals, are getting the upper hand in reducing the number of MRSA infections. With commitment, it can be done.
Infections "Hidden in Plain Sight"
I take strong exception to Christina Schofield, R.N.'s OPINION that "nurses were dutiful in washing hands -- but 'physical therapists, case managers, physicians, ancillary staff' were not."
Hospital nurses are no better at handwashing than most others, demonstrated in study after study nationwide. (Nurses are slightly better than physicians, but some ancillary staff do better than nursing, and physicians are more likely than anyone to wash up AFTER patient contact.) Nurses are very busy, so I am sympathetic.
However, EVERYONE must be vigilant to stop these terrible infections. Nurses are absolutely guilty in some cases, and no R.N. should be excusing them from responsibility in this story.
We all need to work much, much harder to protect the public, no matter how busy we are.
THIS is why on Wednesday evening I will be headed to SoCal. I have an 8 a.m. appt on Thursday at Hoag Hospital Women's Center to begin a series of diagnostic tests to determine if the cancer has returned. There are new lumps where there weren't any before. My doctor in Newport Beach was insistent that I see a local oncologist here in Las Vegas. I pushed back and got my way. If the cancer has returned, then I will figure out my next course of action. I have a really great job and a great house here, but without my health - it's all worthless.
Part 2
The Sun's articles about Las Vegas hospital-acquired nosocomial infections are precient. My son's father in law tells me he caught MRSA at Summerlin Hospital less than a month ago when he was there for heart surgery. He has not died from that infection yet, but as of today he is in horrific pain, at home, just as my friend Lynn Wessel was after catching the hospital acquired infection described above. If, God forbid, my son's father in law dies from MRSA it will be another big funeral, with lots of Las Vegas luminaries, because this man is a friend to past and current Senators, Governors, UNLV and UN senior officials, and other well known people in Nevada's Republican and Democratic parties.
Unfortunately, it's not just the well known whose nosocomial infection illnesses and deaths have an impact on Las Vegas. Las Vegas area artists will remember that the well known Las Vegas potter, who was the co-manager of Aardvark Clay died in the mid-2000's of complications from MRSA acquired in a Las Vegas hospital where he had back surgery. That death greatly saddened Las Vegas art community.
The bottom line is:
(1) The Nevada Legislature must require all hospitals and surgical centers to accurately report all nosocomial infections, on a monthly basis, to the State and the County Health Departments, so that regulators can jump on spikes in these infections, and new nosocomial infections such as "Bronx pneumonia" as they are occurring.
(2) The Nevada Legislature must require each hospital and surgical center to make a clear oral and written, plain English pre-admission disclosure to each patient about the potential risks (based on reporting data to the State and County) and the potential medical consequences of becoming infected in the hospital with MRSC, c.Diff, hospital acquired pneumonia including the new virulent, drug resistant strain commonly called Bronx Pneumonia, and other nosocomial infections which emerge from time to time.
(3) The Nevada Legislature must make hospitals, not patients, their insurance companies or Medicare/Medicaid responsible for all costs of treating nosocomial infections. The Sun's story of the older lady being dunned by a hospital's bill collectors for $3,500+ in MRSA treatment costs is simply ridiculous and an injustice which the Nevada Legislature must address and remedy.
(4) The Nevada Legislature must make hospitals and surgical centers specifically liable for general and special damages to patients and their immediate families when the patients are infected with nosocomial infections. That way, people like the wife and young daughter of my friend Lynn Wessel will not be left penniless by hosptial employees' basic negligence. The wisdom and feasibility of that law is amply illustrated by The Sun's story about how V.A. hospitals are able to maintain a virtual 0% MRSC and c.Diff rate in their patients.
Part 1
The public in Las Vegas cannot do enough to thank Marshall, Alex and the publishers of the Las Vegas Sun for their important work on this hospital acquired infection issue.
I want to raise another issue, which I will email to Marshall and Alex, in the hopes that they can get a definitive answer to the question:
Does Nevada case law specifically state that a hospital patient "assumes the risk" (whether willingly or not, knowingly or not) of catching a hospital acquired infection? Does Nevada law thereby bar the patient and his/her family from recovering the cost of treating the infection, let alone recovering for personal injury or death arising from the infection?
The reason I ask this question is very straight forward. In California all of these sorts of infections are called "nosocomial infections" and California case law provides that hospital patients cannot recover money damages from a hospital for a nosocomial infection. I learned this amazing piece of information in December 1992 when my friend Lynn Wessel Ph.D. lay dying, in abject agony, of Necrotizing Fasciitis at Los Angeles' most famous hospital for orthopedic surgeries, such as surgeries on all of Los Angeles' professional sports teams and on many star USC and UNLV athletes. For those who do not know, Necrotizing Fasciitis is commonly called "flesh eating bacteria". The facts were absolutely clear, that Lynn Wessel went into the hospital for back surgery without that bacterial infection, the bacteria infected him during his long hospital stay relating to the back surgery, and despite the efforts of his doctors he died in that hospital from that flesh eating bacteria. The reason I mention Lynn Wessel's death from a nosocomial infection is that he was the Los Angeles equivalent of Sig Rogich. Nearly 1000 people attended his funeral, including a huge number of elected officials. All of them were told about Lynn's death specifically due to the hospital acquired infection.
After Lynn's death, his wife and young daughter were left close to penniless after creditors (including the hospital) took its toll, losing their home, their vehicle and their lifestyle, let alone economic and emotional support of their husband and father.
I hope The Sun can enlighten us, by interviewing local Las Vegas lawyers, as to whether this "no recovery for nosocomial infections" case law or a similar statute exists in Nevada.
MRSA is a super bug created by the overuse of antibiotics now for many many years. Since Penicillin we have overused antibiotics. Having to come up with new generation antibiotics to fight the super bugs! Super bugs are in the community now and not just hospitals. Part of the fault of overuse of antibiotics is the public wants antibiotics, doctors give the public want they want, drug companies want us to use them. We have to cut back on using antibiotics.....especially for the common cold. It is so counterproductive.
Bleach is the best disinfectant around. Little bit of bleach in your dishwater, laundry and wiping down counter tops, tables, toilets, etc.....bleach kills everything, even a fungus.
We had bleach wipes in my hospital but management took it away because bleach also destroyed very expensive mattresses for gurneys.
Can't they make mattresses that are bleach resistant instead???
MRSA came here from the good ole USA over use of antibiotics...not from Russia or any other country.... medizone is probably an expensive way to disinfect.......don't be fooled.....a little bleach very inexpensive is enough disinfectant to kill bad bugs including super bugs resistant to all antibiotics....even fungi.....its not a mystery folks....
me2ca2nv
I shall pray for you. and hope that you will still have good health.
WebMD and other internet sources mrsainternational, do not say that MRSA was USA in origins (discovered in 1961), however multiple antibiotic resistent TB was first discovered in Russia.
It just takes time and money to prevent it, bleach will stop it, but it ruins products.
As "observer" states, the hospitals are not on the hook to pay for infections from their hospitals.
@ babyboomer.... JACHO is worthless. It's an accredidation body run by the hospital industry. There inspections are a joke.
Funny how the only hospitals that would provide information were government run (UMC and VA). And the BAD socialized medicine in the UK has all but gotten rid of it.
What did the public get from the GOOD private corporations (the Catholic system runs the same way).... a PR letter.
BTW... thank you SUN for this great investigative reporting. We sure can't count on the right-wing, corporate loving, RJ to help protect the average Joe.
Again, to repeat some other posts, Marshall Allen and crew: I hope to see another Pulitzer Prize for the SUN next year. You did a fantastic job of tracking these incredibly hard to trace diseases which are infecting our care facilities at an alarming rate. I was a patient at Mountain View Hospital in 2005 and a 5-day stay for a scar-tissue removal operation which followed a ulcer-removing, stomach-resection operation five months earlier, resulted in a 24-day stay brought on by first sepsis (blood poisoning) and then MRSA (in the form of pneumonia). I was relatively young at the time (45) and in otherwise excellent health. My initial recovery time from the scar-tissue removal surgery was estimated to be three to four weeks. It was six months before I was able to resume any semblance of normal activity and another two months before I could go back to work without collapsing in exhaustion at the end of each day.
At the present time, my mother is in a rehab facility in San Diego recovering from C.diff acquired after colon cancer surgery -- in April 2010. She has only been able to walk with assistance for the last two weeks. Before that she could not even raise herself out of bed. She was discharged from the hospital with the infection still in place and relegated to a rehab nursing home to continue her recovery. I pray every day that she gets strong enough to go home. I pray even harder that I will have her around at Christmas. She is only 75 years old. She was in excellent health before the colon cancer was detected. The hospital she was at in San Diego is supposedly one of the best, Sharp's. It only further illustrates that no place is immune to viruses and bacteria that have mutated beyond the scope of our current medical technology.
Handwashing is the most important first line defense to MRSA. Not many doctors in their care of patients in their visiting rooms in their offices wash their hands after seeing each patient. Some nurses stick the speedo themometer in your ear and all other patients w/o ever washing the probe with disinfect or using a probe shield. So does the trend follow through into the hospitals in most states; not only Nevada. Bet your bibby it does.
An impressive piece of journalism. Good work.
I suggest talking to the State Prison and local detention facilities and asking them about their MRSA problems. It might make a nice follow up.
Also look at the homeless shelters and homeless population. Many of them are infected and untreated until they find themselves in the ER.
I am a retired RN. My father died of hospital acquired MRSA in Jan 2009. The reason for his hospitalization was a minor fracture of his ankle and rehab. He died 3 months later from an infection that is never cured and that took away his body weight, his stamina and his life. It also took away his ability to live at home with my mother...he was a complete care, bed bound and isolated patient because of Hosptial acquired MRSA.
I have worked with the State of Maine legislature to pass a law to screen high risk patients for MRSA. The struggle with representatives from Maine hospitals AND the Maine Hospital association has been phenominal. They fought even high risk screening. Universal screening is a proven deterrent for MRSA, but Maine reps fought tooth and nail against it. And they manipulated and reduced my inclusive and excellent proposal for screening, isolation, precautions, and public reporting to almost nothing. Currently we are doing a so called prevalence study. Results of this study will be in soon.
The problem with CDC recommendations and hospital's claims that they are compliant with them, is that there are too many recommendations and they are not in the proper order priority wise. So, "compliance" can mean anything. Also, they are only recommendations, so hospitals are really not bound to do anything.
Mandates seem the only way to go in order to have consistency and accountability. My best to any legislator in NV who decides to take this on. It is a huge hurdle to get a States' hospitals to do what is necessary to stop MRSA and other hospital acquired infections. But the lives that will be saved will be worth it.
This doesnt surprise me one bit. My mom was at Mountain View hospital and contracted something similiar to MRSA I forgot what it was though. When I worked in nursing homes MRSA was common. Maybe if they did the VA hospital did and test when people come in there wouldnt be as many cases of MRSA. Also the medical staff needs to start using gloves not all do but come on isnt it common sense.
I'm not surprised, based on the huge volume of tests for C. diff, MRSA and other community-acquired infections that are processed at clinical laboratories in Las Vegas. There's a huge problem. I'll leave it at that.
the valley health system especially should be avoided. they are for profit and couldn't care less about anything other than their stock price (UHS.) good luck if you wind up in any of their hospitals.
This year, at Valley Hospital, my uncle was operated on to remove a non-cancerous tumor from his colon. Operation was routine and successful. A few hours after awakening, he was sitting up, laughing, joking with visitors. The following morning, I entered his room and found him half in and out of his bed, feet on the floor, holding on to the rails to keep from falling and pulling out attached IV's and catheter. He said he had been pushing the alert button and calling for help for several minutes. Later that day, his daughter smelled booze on the breath of his nurse, who begged in vain not to be turned in. That evening, he died from a heart attack. He had undergone a previous heart attack in Los Angeles just a few weeks prior and had a shunt installed and was on the blood thinner Plavix. There were no apparent comments or precautions taken for this condition.
My dad was a physician here for over 40 years and in 2005 developed an inoperable brain tumor. Unfortunately, he became very ill very quickly and we needed help taking care of him so we got him into HealthSouth rehab. The very first day he was there he fell out of hospital bed (and this was in the brain injury unit), the following morning he fell again. We were alarmed and reported it and were assured he would be fine. The next day a nurse rolled his wheelchair over his foot and broke his big toe. Then while checking his blood sugar a nurse cut part of his finger and he developed cellulitis and had to go to Summerlin Hospital where he needed a transfusion. When we got to the room after they had started the transfusion we dound my dad alone with blood all over the floor and no transfusion attached. The nurses were too short-staffed to watch him even for 5 min until we got there. We moved him to a long-care facility where the so-called nurses had no idea what to do with patients, and we heard people crying for help every time we were there (which became around the clock). Again, they were short-staffed. My dad got worse and his infection returned so he was brought to Sunrise and put on a vent. After spending 17 hours in the ER hallway on a vent, he was moved to the ICU floor and I noticed a large mass on his shin. An infectious disease doctor was sent in, did a culture, and they discovered he had MRSA and was septic. He died 24 hours later. We thought he would die from his brain tumor, but in reality, the hospital infections and poor care killed him! Pretty shameful for a man who spent his life caring for the Las Vegas community.
While in Desert Hospital in July, I contacted a
bacterial infection in my nose which until now was not responding to any medication. I was blowing blood from my nose for about six weeks. I think I finally have control of it, but it is
just another case of carelessness. When I was in the hospital in March, the bathrooms were deplorable in the heart surgery section of Sunrise Hospital. People had urinated on the floor and it was filthy! It did not get cleaned up for two days.