Dirty Little Secrets
"The number of people needlessly killed by hospital infections is unbelievable, but the public doesn't know anything about it. For years, we've just been quietly bundling the bodies of patients off to the morgue while infection rates get higher and higher." That's what Dr. Barry Farr, a leading infection-control expert told The Chicago Tribune.
The Chicago Tribune's investigative series, UNHEALTHY HOSPITALS, penetrates the healthcare industry's long hidden facts about the rising rate of infection-related, preventable hospital deaths. This comprehensive analysis of 5,810 hospitals nationwide, examined the records of 75 federal and state agencies, plus internal hospital files, patient databases and court cases around the nation. The Tribune calculated 103,000 deaths in 2000 from hospital grown infections - 75% were pereventable. [Excerpt below]
A hidden epidemic of life-threatening infections is contaminating America's hospitals, needlessly killing tens of thousands of patients each year.These infections often are characterized by the health-care industry as random and inevitable byproducts of lifesaving care. But a Tribune investigation found that in 2000, nearly three-quarters of the deadly infections - or about 75,000 were preventable, simply the result of unsanitary facilities, germ-laden instruments, unwashed hands and other lapses.
Deaths linked to hospital bacteria represent the fourth leading cause of mortality among Americans, right behind heart disease, cancer and strokes, according to the Federal Centers for Disease Control and Prevention. Hospital infections often are preventable by adopting simple, inexpensive measures. Strict adherence to clean-hand policies alone could prevent the deaths of up to 20,000 patients each year, according to the CDC and the U.S. Department of Health and Human Services.
Hospitals provide ideal reservoirs for germs, with temperature-controlled environments and a steady stream of germ-carrying strangers pouring through the doors each day. Germs that wouldn't be harmful to healthy people in their homes or at work can turn deadly for patients too young, too old or too weak to fight the infection.
In Chicago in 1998, as fever-ridden healthcare workers tended to patients and as others worked without always washing their hands, eight children died of an infection that spread from the Misericordia Home on the Southwest Side into a hospital. The flulike outbreak, which the city of Chicago never revealed to the public, was halted weeks later after three dozen sick health-care workers were ordered to stay home. In a Detroit hospital, as doctors and nurses moved about the pediatric intensive care unit without washing hands, infections killed four babies in the same row of bassinets, according to court records and interviews. But it took three months for administrators to close the nursery for cleaning. Staphylococcus germs thriving inside a West Palm Beach, Fla., hospital invaded more than 100 cardiac patients, killing 13, according to court records. The survivors underwent painful and debilitating surgery, as rotting bone was cut from their bodies.
The health-care industry's penchant for secrecy and a lack of meaningful government oversight cloak the problem. Hospitals are not legally required to disclose infection rates, and most don't. Likewise, doctors are not required to tell patients about risk or exposure to hospital germs.
Even a term adopted by the CDC, nosocomial infection, obscures the true source of the germs. Nosocomial, derived from Latin, means hospital-acquired. CDC records show that the term was used to shield hospitals from the "embarrassment" of germ-related deaths and injuries.
To document the rising rate of infection-related deaths, the Tribune analyzed records fragmented among 75 federal and state agencies, as well as internal hospital files, patient databases and court cases around the nation. The result is the first comprehensive analysis of preventable patient deaths linked to infections within 5,810 hospitals nationally.
The Tribune's analysis, which adopted methods commonly used by epidemiologists, found an estimated 103,000 deaths linked to hospital infections in 2000. The CDC, which bases its numbers on extrapolations from 315 hospitals, estimated there were 90,000 that year.
The CDC links infections to patient mortality both directly and indirectly. Direct cases typically involve patients who specifically died of complications caused by an infection. Indirect cases involve infections that played a major role in a patient's death, but may not have been the primary cause.
For every death linked to an infection, thousands of patients are successfully treated each year. And many hospitals battle infections with diligence and the latest technology. But the Tribune investigation found that breakdowns occur more frequently than patients suspect and that the consequences often are deadly.
Government and hospital industry reports analyzed by the Tribune reveal that serious violations of infection-control standards have been found in the vast majority of hospitals nationally. Since 1995, more than 75 percent of all hospitals have been cited for significant cleanliness and sanitation violations.
In thousands of cases observed by federal or state inspectors, surgeons performed operations without washing hands or wearing masks. Investigators discovered fly-infested operating rooms where dust floated in the air during open-heart surgeries in Connecticut. A surgical assistant used his teeth to tear adhesive surgical tape that was placed across an open chest wound during a non-emergency procedure in Florida.
Hospital cleaning and janitorial staffs are overwhelmed and inadequately trained, resulting in unsanitary rooms or wards where germs have grown and multiplied for weeks, sometimes years, on bed rails, telephones, bathroom fixtures - most anywhere. The state of some of our hospitals is a shame. A dirty shame.
