Staph Infection After Surgery

[LOVEACHILD]

PA.
My husband had back surgery for a herniated disc with fragments 4 weeks ago. He was doing fine until one day, he was feverish and had chills.. he said his back felt funny and when i looked at it, it was draining fluid, we immediately took him to the ER where they admitted him . By that point he was vomitting and very very sick. They immiediately put him on an IV antibiotic which made him sicker. They called in a group of Infectious Disease Doctors and after running various tests they advised us that he had a staph infection. He was in the hospital for 10 days.. by day 3, they had to reopen the incision and "clean" it out and hope they were able to get most of the infection. Day 4 and 5 show him draining still, however they did not put draining tube in. so, they said they had to go in again and reopen the back and clean out the area again. This time they put a draining tube in and had kept him on an antibiotic Nafacil ... He is home now, but in alot of pain, he is on vicadan and an IV Antibiotic 24/7 that is ran thru a pickline in his arm, he has a nurse that comes to the house 2 times a week.. My question is can we file a claim (legal ) with the hospital ... He didn't have staph prior to the surgery, and i want to why he contracted it in the first place.. They say, diabetics sometimes under the right conditions are more septable to contract staph.. However, i find that to be used as a crutch.. Many many diabetics have surgery every day and don't come out with a staph infection.. I feel the hospital, which already has a record of staph infections should be liable. someone didn't follow the procedures and maybe the o.r. wasn't as "clean" as it should of been. Any help would be greatly appreciated.. My husband has been suffering for too long, and has 6 weeks of IV at home now he can't work.

 

[ellencee]

LOVEACHILD
More likely than not, your husband developed the infection after he was at home and the reason for it is his diabetes. The treatment he received was appropriate as is the treatment he is receiving now. He would have a virtually impossible task of proving negligence and not diabetes caused the infection.

Just for your own information, so you can use the term correctly in the future, your husband has a PICC line (peripherally inserted central catheter).

Best wishes,
EC

 

[panzertanker]

LOVEACHILD
More likely than not, your husband developed the infection after he was at home and the reason for it is his diabetes.
I am at a loss as to how his diabetes suddenly made him have a staph infection??? The treatment he received was appropriate as is the treatment he is receiving now. He would have a virtually impossible task of proving negligence and not diabetes caused the infection.

Just for your own information, so you can use the term correctly in the future, your husband has a PICC line (peripherally inserted central catheter).

Best wishes,
EC

I will disagree and state that a majority, (and I will give you the percentages in a few) of staph infections postop are nosocomial infections (meaning they arrrived through exposure from the hospital setting.) Is there negligence, I cannot tell you. I would suggest you gather the post-op infection rate from the surgeon who performed your husband's surgery and then compare it to the naional average. ALL surgeons experience post-op infections, hoewever, that does not necessarily mean that they did something incorrect. This is simply a hazard of undergoing major invasive surgery.
Research th infection rates and keep us posted.
Panzertanker

here is the link from the CDCP
http://www.cdc.gov/ncidod/hip/ARESIST/ca_mrsa_public.htm

"Who gets staph or MRSA infections?
Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems. These healthcare-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia."

 

[rmet4nzkx]

Just to add to the above posts, even the best available medical care doesn't eliminate the risk of post-op staph infections, or in high risk groups.
From CNN:
Assassination attempt

On March 30, 1981, John Hinckley opened fire on President Ronald Reagan as he was exiting a Washington hotel. One of the bullets lodged near Reagan's heart. After surgery, he contracted a dangerous staph infection, but he returned to the White House after 12 days.

 

[LOVEACHILD]

staph

I disagree that because my husband is a diabetic that this is the reason why he has a staph infection.. Does this mean that every diabetic that goes in the hospital for surgery will come out with a Staph Infection? I highly doubt that.
I find it to be used as a crutch if you ask me. I agree, that with Diabetics it does take them longer to heal and that is a known fact but to put blame on his diabetes doesn't seem to be a fair statement. He did not get the staph once he was home, the staph was where the surgery was, under the skin, so he had to be opened up twice to clean the inner area. How would he get that at home? Please explain!

 

[rmet4nzkx]

My MIL had type II diabetes, she was in the hospital following surgery on her neck, she would become dehydrated and faint, they would give her an IV, orders were for saline because she would have a fever and infection within hours otherwise.

A diabetic is at higher risk for infections and longer time for healing. Staph infections can start easily even without a surgerical wound as the micro organisms are found everywhere. An infection may exacerbate within hours. The infection is opportunistic. While it is likely he picked up the infection in the hospital, it may be impossible to prove. Even President Reagan got one following surgery and he wasn't diabetic, he didn't sue the hospital. Your husband could have picked up the infection at home. Were you monitoring his blood sugar? was he taking a shower daily upon return from the hospital? Was it hot? How frequently was the dressing changed? How long after he returned from the hospital did the infection appear?

 

[LOVEACHILD]

Staph

He is 41, monitors his sugars 3x / day. He did conduct personal hygene as prescribed by the doctors. The information that was given to us, is that he most likely had the Staph since surgery however it was not showing signs until a week or so into it.. He had aches and pains, but the fever, and sweats did not occur right away. That is why we were not sure if it was spinal fluid leaking from the site, He had no signs of a Spinal Headache which is very painful. He eventually did get very sick from the Staph and was treated immediately for the infection. I don't think its fair to say or assume that his diabetes contributed to it. I also am aware that Staph is everywhere. However, if hospitals follow the CDC guidelines and procedures for maintaining a clean operating room alot of these infections could be eliminated. If he was diagnosed with Methicilin Resistant Staphylococcus Aureus does that imply that it was hospital related? I'm not looking to blame anyone, however i don't feel he should have gone thru all this pain either.

 

[ellencee]

LOVEACHILD
The best advice I can give you is to contact a diabetes association and learn as much as you can about the disease and the effects of illness, surgery, etc. on the diabetic patient. I assure you, diabetes played a primary role in your husband's developing an infection and in the length and type of treatment he required.

Home Health nurses can attest to diabetic surgical patients who develop signs and symptoms of infection after discharge from the hospital. Causative organisms vary but surely staph is the most common. The patients reenter the hospital for various treatment measures, return home with Home Health services, and the pattern often repeats more than once before the diabetic patient is infection free and the wound(s) heal.

For there to be a valid claim of medical malpractice, your husband would have to prove that his infection and treatment were the direct result of negligence. In the presence of diabetes, the chances of proving negligence as the proximal cause are virtually nill.

Discuss your concerns with a medmal attorney in your area and obtain information regarding the statute of limitations that will apply and information on the merits of your claim.

EC

 

[LOVEACHILD]

thank you for your input. I have found an attorney in my area, that is willing to listen to our case and claims we do have a claim with the hospital and the doctor. Apparently this isn't the first case of staph in this hospital.. I also contacted the AMERICAN DIABETES ASSOCIATION. Please know I am aware of the complications with Diabetics and the healing process as with the chance for infection. I'd be curious to see how many Diabetics end up with Staph and or other infections. I think the most important thing right now is to find out what type of Staph it is.. and take it from there. Its a shame that everyone labels diabetics as they do, but again, that is one's opinion. One should not say, well since he's a diabetic i bet that is why he ended up with staph, or since he's a diabetic its okay for him to have it, or he should expect to be sick everytime he has surgeries... This hospital has a record of staph infections and i think that is the point that needs to be made. Being a diabetic or not it doesn't change the fact that he has a serious infection.
Thank you again, and we have found legal assistance in our area, that will represent us regardless of his diabetes..

 

[ellencee]

LOVEACHILD
The attorney will send your husband's records for review by a medical expert or more than one expert and you will hear the information about diabetes again. It is not labeling and it is not saying "well since he's a diabetic i bet that is why he ended up with staph, or since he's a diabetic its okay for him to have it, or he should expect to be sick everytime he has surgeries.."; it is recognition that the presence of diabetes impacts every health issue the diabetic has. There is a signficant incidence of serious infection in diabetic patients because of the nature of the disease. No one can prevent diabetics from developing serious infections or infections that in nondiabetics would resolve quickly.

It is impossible for a hospital to be free of infectious organisms and naive to believe otherwise. The CDC, JCAHO, and all other regulatory agencies require that which can be done to reduce the incidence of nosocomial infections; nothing more. Negligence in harboring infectious organisms must be proven by the hospitals lack of attempting to isolate the cause of a "problem" area or worker or the lack of proper methods to control infectious organism populations. Regardless of how many incidences of nosocomial infections the hospital has had, chances are there is no negligence that is responsible.

During Grand Rounds last week, the case studies presented were of diabetics who developed serious wound infections while in the hospital and within 30 days of discharge and requiring readmission. Endocrinologists are exerting every effort to come up with a diabetic management routine that reduces such events. Some progress has been gained in managing fasting glucose levels at the lowest possible level while maintaining the patient without symptoms of low blood sugar. Current trend is focusing on basal insulin dosages/management. Basal insulin would be the Lantus or similar insulin that the patient takes every day regardless of fingerstick blood glucose levels. Endocrine Today has some articles that may be of some informative value to you and to the attorney. You will find that as of yet, no standards of insulin management for the hospitalized and/or surgical diabetic patient have been set; therefore, you will not find any standards from which your husband's diabetic management deviated.

As for what type of staph infection--it will either be staph aureus or methicillin resistant staph aureus, possible vancomycin resistant staph aureus. As for the treatment of any of the above, I believe you will find that your husband received the appropriate antibiotic coverage and nothing more could have been done. As for the source of the organisms, it will be found to be from the patient's own skin.

I hope that you make every effort to learn that diabetic patient is not a label but a set of difficult to manage healthcare issues, all of which are brought on by the disease of diabetes and not other factors. Your husband is a relatively young man and he will need a wife who understands the complexity of his health needs.

Best wishes,
EC

 

[rmet4nzkx]

Last week an entire college in Pittsburg Ca was closed down due to Staph infections in 4 members of the Basketball team.
Posted on Fri, Feb. 18, 2005

Staph infections close athletics department

By Rowena Coetsee

CONTRA COSTA TIMES

PITTSBURG - Los Medanos College closed its athletics department Thursday after four students were diagnosed with the same bacterial infection.

"We just want to make sure we keep students as safe as possible," said college spokeswoman Nancy Chinn.

The infected students, all on the men's basketball team, had contracted MRSA, a type of bacteria that can spread rapidly if not properly treated and is resistant to certain antibiotics.

The disease is a form of Staphylococcus aureus -- staph -- that can result in a variety of illnesses and, in serious cases, cause the skin to blister and slough off.

An infected person can transmit the bacteria to others through skin lesions as well as contaminated objects such as towels, workout areas and sports equipment, Chinn said.

One sign of infection is a reddish area resembling a mosquito bite, pimple or ingrown hair.

Staph also can cause a skin rash that doesn't respond to antihistamines or anti-itch creams.

The first case came to light last week after a hospital confirmed that one of the athletes was infected and that student contacted Los Medanos College's athletics department, Chinn said.

The college canceled classes and closed the entire building, which houses a dance studio, gymnasium, weight room and locker rooms.

Maintenance workers are disinfecting the restrooms, furniture and equipment, and Chinn said he hopes to reopen the facility Monday.

Student Allan Grissette said he suspected something was up when he noticed a couple of employees spraying basketballs with a foam cleanser on Tuesday.

Two days later he was in the middle of a swimming class when a Los Medanos College employee came by to announce that the athletics department was canceling the session.

In the weightlifting class that followed, Grissette's instructor said the men's locker room was off-limits.

Grissette said he's not overly concerned.

"I washed my hands good," he said. "I'm kind of a picky guy anyway -- I don't touch door knobs."