Aspergillus at Scripps Memorial Hospital

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Scripps hospital defends cleanliness

Thursday, March 30, 2000

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(03-30) 01:06 EST SAN DIEGO (AP) -- Patients identified in a state report as

having been exposed to an airborne fungus at Scripps Memorial Hospital were

extremely elderly and sick people who died because of underlying illness,

hospital officials said.

A cluster of patients at the La Jolla hospital tested positive for the

common fungus aspergillus between Oct. 28 and Jan. 28, when the hospital was

remodeling. Six of the patients died, but an autopsy was done only on one

patient, who had severe aspergillus bronchopneumonia of both lungs.

State investigators said Scripps should have done more to protect seriously

ill patients from being exposed to a potentially lethal fungus that thrived

during construction and was also likely blown in from the helicopter landing

site.

Hospital officials defended the facility and said no patients have reported

having the fungus since the end of January.

``The hospital has been clean and is always clean, and, frankly, now it's

cleaner than it's ever been before,'' said Van Gorder, Scripps' chief

of health care operations.

All patients in the state's report were died because of underlying illness,

Scripps' chief medical officer, Dr. Brent Eastman, said Tuesday.

State investigators found a heavy layer of white dust coating many surfaces

in the intensive care units such as beds, emergency resuscitation equipment,

windows, curtains and nurses stations.

Construction crews remodeling the first floor did not use airtight barriers

or filter vacuuming to prevent dust and debris contamination, the report

said. Additionally, a door leading to the windy helicopter pad near the

surgical intensive care unit allowed dust to blow into the ICU.

The hospital ``failed to prevent and control aspergillus cases during

construction'' and ``failed to maintain a sanitary environment ... (which)

may have contributed to the increased incidence of aspergillosis cases,''

according to the state's 19-page report, which was detailed in a story

published Wednesday in The San Diego Union-Tribune.

State officials were unable to determine if the fungus was the primary or

contributing cause of death for five of the deaths, the report said.

Aspergillus is an airborne mold or fungus commonly found in decaying

vegetation, insulating material and walls or ceilings, and can be released

in dusty environments. It is harmless to healthy people but can be lethal

when inhaled by people with weakened immune systems.

Of the 20 patients who tested positive for aspergillus, 16 showed signs of

it three or more days after being admitted and four had the mold before

being admitted. Most of the 16 patients spent time in intensive care or the

surgical intensive care unit, the state report said.

Scripps should have had an infection-control official on the construction

crew and reported the fungus problem to the state sooner, the report said.

Scripps officials said they have taken steps to correct the deficiencies

mentioned by the state.