One of those things: A staph infection after spinal fusion

A story from Jeff Knott:
My publisher tells the story of going into a hospital for a spinal fusion procedure known as a lumbar laminectomy (an open decompression). He needed help due to severe pain caused by neural impingement. The surgery is designed to remove a small portion of bone over a nerve root and/or disc material from under the nerve root, giving more space for movement.

At admission, he was in generally good health. On the morning following the surgery, the patient felt comfortable and was encouraged to see if he could sit up, which he could thanks to the morphine blocking any discomfort. However, by that afternoon he began to run a fever and began hallucinating. The nursing team was attentive and eventually called in a doctor (not the admitting physician – he had gone skiing in Colorado) to evaluate the situation. Nurses and techs drew blood and administered fever-lowering medication.

The test results came back and the doctor returned to inform the patient that he had contracted a staph infection – most likely during or just after the surgical procedure. That explained the fever, the hallucinations, the swelling and redness around the wound, and the patient's irritability.

Antibiotics were started and after four additional days in the hospital, the patient was wheeled to his car. In addition to the routine bill for the surgery and hospitalization, there was an increase in the total by four additional and unexpected days of hospitalization – none of which were caused by the patient, but surely to be paid for by the patient and his insurance company.

The patient returned to the orthopedic surgeon's office for check-ups during the weeks that followed. He met with the doctor a couple of times, discussed the success of the surgery, the reduction or near-elimination of pain, and rehabilitation. But not once did the doctor bring up the staph infection. When the patient mentioned it, the discussion was brushed off as "one of those things" that can happen in a blue moon. It was obviously an embarrassment – but it didn’t slow down the flow of patients through his office.

Advice for people who have suffered a hospital-acquired infection: Ask the surgeon what s/he would do differently next time to prevent an infection. And don't pay that part of the bill.

Read a spinal surgery error story.

Thanks to Jeff Knott for the excerpt from his new book, Navigating the Healthcare Maze-What You Need To Know, published by DC Press.

Twice he was given last rites: Staph infection from a knee replacement

Robert Besse's painful journey began when he checked into a Cincinnati hospital a year ago to get his right knee replaced. The 60-year-old retired pharmacist had worn down the joint skiing and hiking and working on his feet for years.

Ten days after leaving the hospital, his knee was still oozing bits of fluid. "The pain was off the scale," he said. One of his surgeons took a look and immediately had him admitted to a different hospital, where he declined rapidly. Twice during the first night he was given last rites. But he survived until the morning when the surgeon opened up his knee again and found a raging staph infection that took two rounds of surgery to clean up. He spent the next several months on infused antibiotics and pain medication. He was barely able to celebrate his 60th birthday with his family in Breckenridge, Colorado.

He might have fared better at a specialty hospital – one of 200 centers in the U.S. that focuses on the care of a particular body part like the heart, spine, or joints, or a specific disease such as cancer. A study by the University of Iowa on thousands of Medicare patients found that rates of bleeding, infections, or death ("complications") are 40% lower for hip and knee surgeries at specialty hospitals than at big community hospitals. A study funded by Medicare in 2006 found that mortality rates for orthopedic surgery, e.g., knee replacements, are 75% lower for orthopedic patients in specialty hospitals than for other hospitals.

Advice to patients about to have surgery: Consider having the surgery at a specialty hospital.

Read another knee replacement story.

Thanks to David Whelan for the source article in the March 10 issue of Forbes magazine.

If he'd give me a few good years, I'd work on hospital-acquired infections

Bill Percival of Greenville, South Carolina picked up five staph infections while in a hospital for cancer treatment. As he clung to life, he made himself a promise.

"I told my doctor that if he would give me a few good years, I'd spend them working on hospital-acquired infections," said the 64-year-old retiree.

He kept his word. Since his recovery, he has spent the past few months attending meetings of a group overseeing the reporting of such infections.

On Friday, the S.C. Department of Health and Environmental Control released its first report showing rates at hospitals around the state for two types of infections — those associated with the placing of a catheter deep into major blood vessels, and those associated with surgical sites. In this first report, the latter category includes only heart-bypass surgeries and hysterectomies.

DHEC will collect more data and will issue another report later this year. Other procedures will be added to the reports over time so the public can have an idea of how a hospital is doing overall.

"In the long run, we hope that we get the reports to the point that they are a useful guide to healthcare consumers so that you can look and see where you're more likely to be safe if you have to go in a hospital," said S.C. consumer advocate John Ruoff, who lobbied for the infection-reporting legislation.

"People need to be knowledgeable about this, and if these reports can increase public awareness of the danger of health care-associated infections, antibiotic-resistant infections in hospitals and in the community, that is a big help," said Helen Haskell, who helped form Mothers Against Medical Error after her son died in a hospital.

Sen. Ralph Anderson, D-Greenville, lead sponsor of the infection-reporting bill, said the requirement will get hospitals to work harder to lower infections.

Dr. Shawn Stinson, who is in charge of clinical quality and patient safety at Palmetto Health, said, "I have kids, and if they get sick and end up in somebody else's hospital, I want zero."

Advice: Join the efforts of citizens in many other states to file and pass state legislation to require the reporting of hospital-acquired infections.


Browse for related stories in the index at the very bottom of this page, or see a short video of one person’s hospital infection story.

Thanks to Czerne Reid for the source story in today's South Carolina state.com.