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Deadly Hospital Infections Occurring More

Posted - Oct. 27, 2003 at 10:20 a.m.



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Well known to America as a television sports reporter and author, Dick Schaap's 50-year career brought him to the heights of prestige and privilege - until his unexpected death.

Two years ago, at age 67 and hampered by an arthritic hip, Schaap took a few weeks to have it replaced in what has become routine elective surgery.

But when he checked into Lenox Hill Hospital on Manhattan's Upper East Side on a September morning, few could have imagined that he would be dead three months later.

Within 24 hours of the operation, the vivacious Schaap was in trouble. His wife Trish Schaap said "His voice would trail off in the middle of a sentence and that was so unlike him. And then the following day he was spiking a fever."

The surgery itself had gone well, but Trish Schaap says the doctors told her her husband had gone into respiratory failure and picked up an infection.

Infections acquired in the hospital are becoming increasingly difficult, sometimes impossible, to treat because many strains have become resistant to even the most powerful antibiotics.

"The problem of antibiotic resistant infections is clearly out of control," said Dr. Barry Farr, the head of infection control at the University of Virginia Medical Center.

He compared the infection to velociraptors, the razor-toothed dinosaurs in the movie Jurassic Park. "Staph aureus is like a very tiny velociraptor that wants to eat the person alive from the inside out," he said.

Incredibly, there's no evidence in Schaap's medical records that the hospital ever identified the type of infection that Schaap had picked up.

A Preventable Death?

Karen Burnes, an ABCNEWS producer and longtime friend of Schaap who arrived at the hospital within days of the surgery said "it was clear he was being ravaged."

"His entire being was transformed, was gone, was taken, was robbed, he was lying there helpless, thrashing around with tubes coming out of him and emaciated, shrunken ... I wanted to cry," she said.

From September to October to November, through Thanksgiving, the hospital tried but could not stop the infection eating Dick Schaap alive.

The family is now suing the hospital and the doctors involved, citing the infection and what it calls other medical errors. It was a case study of what can go wrong in American health care today, said the family's lawyer, Tom Moore.

"If you ever speak to a surgeon, 'Doc, what can I expect with my hip replacement?' - at the top of the list is infection, post-operative infection," he said.

The Centers for Disease Control and Prevention estimates that as many as 100,000 people die in this country each year from infections they get in the hospital.

"It's the fourth leading cause of death in this country after heart disease, cancer and stroke," said Betsy McCaughey, the former lieutenant governor of New York, and a Ph.D. in public health policy.

Dick Schaap's family is convinced his death could have been prevented.

The CDC says "at least 50 percent of those infections are preventable by one change, getting doctors and other health-care workers to clean their hands in between treating patients," McCaughey said.

The hospital industry agrees, saying there is a need for better hygiene practices overall. But Dick Schaap's family and friends came to believe that was lacking as he lay dying in one of the country's top hospitals.

Hospital Secrets

Hospital infections are an ugly but well hidden secret in America's health-care system. McCaughey said.

"You can't get the information you need to avoid hospitals that have a serious infection problem or history of medical errors," she said. "Most hospitals don't report that information and state governments won't release the information they do have."

There was no information publicly available from the hospital on its infection rate when Dick Schaap was preparing for his hip replacement surgery.

"I don't think infection was ever really mentioned as anything that might be a problem," Trish Schaap said. "In fact, I was led to believe the opposite. That there was only like a couple of patients that had ever even had an infection."

Documents obtained by Primetime through a Freedom of Information request that took six months, show that for that year, Lenox Hill hospital reported only one serious case of post-operative infection, one out of almost 16,000 surgeries.

McCaughey said the number was "probably not credible ... The hospitals are not reporting the truth."

Even the infectious disease expert at the American Hospital Association, Dr. Don Nielson, appeared surprised any hospital could have the low number Lenox Hill reported.

"It's remarkable if it's occurred, and it would be something," Nielson said.

Conditions Questioned

As part of an investigation of what happened to Dick Schaap, Primetime went to the hospital a year and half later with undercover cameras.

When Trish Schaap was last there with her husband, she said the hospital was often a mess. What Primetime found was hardly better: stains, soiled bathrooms, food trays, eaten and uneaten, dirty and clean, stacked together.

Several patient advocates and health policy experts, including Betsy McCaughey, said such conditions could be found in most big city hospitals, even if it's not hospital policy.

"Hospitals were cleaner places 50 years ago. Way back before the liberal use of antibiotics, doctors and other health-care workers learned the principles of hygiene and practiced them seriously," McCaughey said.

Health officials say the poor hygiene practices are what cause the invisible, deadly germs to be spread through a hospital, by patients, by visitors, and especially by doctors and nurses on their rounds.

They're spread "right there by your own doctor and your own nurse," Farr said. "On blood pressure cuffs, unwashed hands, contaminated stethoscopes and contaminated white coats as doctors and nurses walk from room to room."

But when his hospital in Virginia suffered a major infection outbreak of the antibiotic resistant strain, known as MRSA, Farr said he managed to get it under control by adopting methods being used in Europe.

What he did was to test each patient on admission so those with the germs could be put in isolation wards.

"And then it was totally controlled over a year and a half. Totally eradicated from the hospital," he said. "Just by seeing who had it and preventing spread."

The experts call it active surveillance, and despite its record of success in Europe and at a few hospitals in this country, the American hospital industry as a whole still resists it.

"There are better ways than screening every patient," said Don Nielsen of the AHA. "I think the jury is still out with regard to the evidence of its effectiveness."

However, the Society for Healthcare Epidemiology in America recently issued a new policy paper advocating active surveillance; Consumers Union has launched a national campaign on hospital infection; and the Pittsburgh Tribune-Review ran a series this month on the problem in that state.

"We need to fess up and to say, this is out of control and the reason it's out of control is that we can't be bothered," Farr said.

Love's Labor Lost

Schaap fought to the very end. "He only lasted that long because he wanted to live so badly," his wife said.

"The minute they removed any of the antibiotics, the key antibiotics, it would just come right back. And then it became clear that, of course, he couldn't keep taking that dosage of antibiotics for any length of time. So eventually you start to add it up and you know that it's looking pretty bad," she said.

It was the week before Christmas that the doctors called Schaap's wife to say the end was finally at hand.

Dick Schaap died on Dec. 21, 2001, leaving behind a loving family, thousands of friends, millions of fans. The hospital says he was provided proper treatment and care and that it follows all government guidelines for infection control.

To see more on this story, go to http://www.ABCNews.go.com

Copyright 2003 ABCNEWS.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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