SCRIPPS MEMORIAL: ‘Lax’ Infection Controls Allowed Spread of Fungus, State Says

      Patients at Scripps Memorial Hospital in La Jolla were exposed to "potentially lethal fungus because of lax infection controls," according to state health investigators. After reviewing patient records and hospital reports, a team of state inspectors discovered 20 intensive care or surgical intensive care patients who tested positive for aspergillus, an airborne mold or fungus often found in insulating material and walls or ceilings. Only four were exposed to the material before admission to the hospital, and of the remaining 16, who all tested positive three or more days after admission, six died. Investigators said the "aspergillosis cluster," which occurred among patients stationed in Rooms 710 to 723, could be a result of the hospital's failure to "maintain a sanitary environment" during reconstruction and modeling projects. An autopsy performed on one of the patients revealed "severe aspergillus bronchopneumonia of both lungs," and investigators said that "[w]ithout an in-depth medical record review, it could not be determined if aspergillosis was the primary or contributing cause of death for the five" other patients. Chief Medical Officer Dr. Brent Eastman disputed the charges, arguing that most of the patients "brought the fungus with them when they were admitted rather than acquiring the mold inside the hospital." He added that "all cases mentioned in the state's report involved extremely elderly and sick patients, and those who died did so because of underlying illness."

Clean Enough?
      Chris Van Gorder, chief of health care operations, said, "The hospital has been clean and is always clean." But investigators claim they found numerous surfaces in the intensive care unit that "were heavily coated with a layer of white dust." The report notes, "The ICU had white powdery and dusty surfaces throughout on medical equipment, equipment holders, curtains/drapes, beds, counters and windowsills. Patient rooms that were 'ready' to receive a patient were noted to be dusty." The report adds that construction workers on the first floor failed to use "airtight barriers or HEPA filter vacuuming to prevent dirt and debris contamination," and no infection-control official was present on the construction crew. Chris Cahill, a state infection control inspector, said, "They failed to follow their own policies and procedures," adding that if the infection-control official had been present, "she could have instructed workers about proper barriers that should have been made when they have to get into the ceiling or do construction." Scripps officials say they have moved to "correct every deficiency mentioned in the state report" (Clark, San Diego Union-Tribune, 3/29).