Friday, April 06, 2001

Family accuses hospital of lax controls

Woman got infection at Christ Hospital

By Tim Bonfield
The Cincinnati Enquirer

        Federal and state health regulators are investigating allegations of poor infection control and poor housekeeping at Christ Hospital.

        The concerns were raised by the family of Mary Anderson, an 86-year-old Milford woman who contracted an antibiotic-resistant infection after a cardiac bypass operation.

        Instead of staying in the hospital the typical few days, she spent two months at Christ Hospital, a month at Drake Center and several months recovering at home.

Mary Anderson
Mary Anderson
        Karen Ashcraft, Mrs. Anderson's daughter, detailed the family's complaints in a March 21 letter sent to state health regulators, a national hospital accrediting organization and several media outlets.

        “All through her stay the family observed filthy conditions, poor hygiene and a lack of consistent rules regarding infectious disease,” Ms. Ashcraft wrote.

        “It is our belief that without extensive family intervention and the hiring of round-the-clock sitters to keep the hospital staff on its toes, our mother would have never lived through this ordeal.”

        Christ Hospital is part of the Health Alliance of Greater Cincinnati. Health Alliance spokeswoman Gail Myers said she could not comment on the allegations because of privacy laws but said the hospital is investigating.

        “We take all complaints very seriously,” she said.

        Nationwide, more than 2 million people a year suffer hospital-borne infections, according to the Centers for Disease Control and Prevention.

        But Christ Hospital ranks among the nation's best at preventing them, Ms. Myers said. According to 1999 data from the Centers for Disease Control and Prevention, Christ Hospital was among the 25 percent of hospitals nationwide with a hospital-borne infection rate under 2.14 percent.

        The family said it spent more than $16,000 to hire a sitting service to keep watch on Mrs. Anderson.

        The family was so upset with Mrs. Anderson's treatment, they taped three poster-sized pages of notes about her care on a hospital room wall to remind staff of problems she suffered.

        Ms. Ashcraft alleges that the infection was contracted in the hospital. Her letter also complains:

        • Mrs. Anderson fell out of a bed. The sitter later discovered the bed rail was broken.

        • A nurse placed a washcloth used to clean a bowel movement on a cart used to carry patient meals.

        • Soiled linens and bandages were tossed on furniture and floors and overflowed from garbage cans.

        • The floor in Mrs. Anderson's room went unmopped “for weeks.”

        • During cleanings, infectious waste was sometimes placed in clear plastic bags instead of the red hazardous waste bags used to route the waste for special disposal.

        • Staff took two hours to respond to several requests for mouth swabs to soothe sores on Mrs. Anderson's mouth and lips.

        • Doctors and nurses who entered Mrs. Anderson's intensive care room sometimes did not wear gloves and gowns.

        “While in intensive care, all family members were required to wear gowns and gloves when entering her room. However, not all doctors and nurses followed this procedure,” Ms. Ashcraft wrote.

        Mrs. Anderson has not filed a lawsuit against Christ Hospital. Her daughter said she wrote the complaint letter after several meetings with Christ Hospital nurse managers, doctors and patient relations officials failed to improve service.

        “I don't know how much more we could have complained,” Ms. Ashcraft said. “If this happened to us, I wonder what happens to other people.”

Post-surgery problems

        Mrs. Anderson underwent quadruple bypass surgery March 1, 2000. She didn't heal well after the surgery.

        By March 14, doctors diagnosed an antibiotic-resistant staph infection and moved Mrs. Anderson into intensive care, according to medical records kept by the family.

        She spent a week in intensive care, much of it on a ventilator. She received heavy antibiotics and other medications. Treatment included a feeding tube and two surgeries to remove infected tissue (including one operation that involved removing her sternum).

        Mrs. Anderson went home May 24, 2000. She was largely self-sufficient before her illness but afterward moved from her house in Norwood to a condo in Milford.

        She received regular home nursing visits until recently. But she still uses a walker and relies on health care aides who come twice a day to prepare meals and provide personal services.

        “I'm beginning to feel pretty good now,” Mrs. Anderson said.

State receives complaint

        Official investigations of Ms. Ashcraft's complaint have just begun.

        The Ohio Department of Health confirmed last week that it received Ms. Ashcraft's letter. Following standard procedure, the state referred the letter to the regional office of the Health Care Financing Administration (HCFA) in Chicago.

        HCFA oversees Medicare, the federal health plan for the elderly and disabled. Medicare requires hospitals to follow numerous regulations and guidelines. HCFA has a contract with the Ohio Department of Health to enforce those regulations, including inspections to investigate complaints.

        HCFA spokesman Bob Daly confirmed last week that his agency received the complaint and is “looking into it,” he said.

        If the allegations appear serious enough, the next step would be to instruct the state to conduct an unannounced inspection of the hospital.

        Should the inspection detect any violations, the hospital would get a chance to respond and to correct problems.

        Even when problems are found, fines or other penalties against a hospital are rare. HCFA's ultimate penalty — which is rarely invoked — is to suspend or revoke a hospital's ability to treat Medicare patients.

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