C. difficile rates at Burnaby Hospital worst in B.C.—84 deaths in two years
The rates of a highly contagious and antibiotic-resistant bacteria at Burnaby Hospital are so high and badly managed that it risks becoming the subject of legal action, according to a letter hospital doctors sent to Dr. Nigel Murray, CEO of Fraser Health Authority (FHA).
The letter is dated Jan. 9 and signed by Dr. Shane Kirby, chair of Burnaby Hospital's infection control committee and six of the hospital's department heads and Dr. Jerry Vortel, an infections disease consultant at the hospital.
It describes the situation that has led to Burnaby Hospital having the worst rates of Clostridium difficile associated diarrhea (CDAD) in the province.
C. difficile is a highly contagious bacteria that infects the intestines and can cause illnesses ranging from diarrhea, nausea, vomiting, fever and colitis and in some cases, result in death.
The rates have ranged from two to three times the national and provincial averages for over two years. From 2008 to mid-2011, Burnaby Hospital alone saw 473 serious cases of CDAD colitis, of which there were 84 patient deaths, the letter said.
The letter noted that after a review of Burnaby and Royal Columbian hospitals in November, an internationally-recognized authority on CDAD infection control management has determined "80 per cent of these deaths were directly attributable to the complications of CDAD colitis."
The figures don't include numbers from two "locally unprecedented outbreaks" in the latter half of 2011 that led to one unit being closed for nine days and another for 12 days.
It noted that a specific request at Burnaby Hospital for enhanced cleaning of the medical units that saw high CDAD rates during the latest outbreak in November "has still not been implemented over a month later."
The letter states: "In summary, we would characterize current CDAD infection control management at Burnaby Hospital, at best, as a serious hazard to the patient population served by the Fraser Health Authority and describe the coordination of this activity at both the local and regional levels, at best, as chaotic.
"Such is the degree of the CDAD problem and the ineffectual response to it, that we believe it could objectively be considered medical negligence," it said, noting it believes FHA has "placed itself at significant risk of medical-legal action."
Burnaby-Deer Lake MLA Kathy Corrigan was among New Democrats who raised the issue in the Legislature Wednesday.
"For us in Burnaby this is our community hospital and to find out that there have been dozens of deaths and almost 500 serious cases associated with CDAD, it was shocking," she said in an interview.
Corrigan was also shocked to hear the problems had been longstanding, that administration at the hospital and Fraser Health were "trying to minimize the problem" and that the doctors who wrote the letter feel the hospital could potentially face legal action.
"The doctors had obviously become so frustrated that they were driven to the point of writing this, what I feel is a pretty extraordinary letter to the CEO of Fraser Health."
Health Minister Mike de Jong responded in the Legislature as if he was not aware of the letter, which is "pretty astounding," she said.
"Which begs the question, why has there been inaction on this? It's been two years."
Margi Blamey, spokesperson for the Hospital Employees Union (HEU), said the issue echoes a similar problem at Surrey Memorial Hospital in 2004.
"It's a complete breakdown of the infection control system."
Blamey pointed out that HEU members still do the cleaning at Burnaby Hospital but in 2003, hospital cleaning was contracted out and they are now employed by a private company, Aramark.
"Workload is a constant concern for our members that clean [Burnaby] Hospital, often that's connected to staffing levels," Blamey said.
Regarding complaints in the letter that cleaning was not happening quickly enough in the units that saw high rates of the antibiotic-resistant bug, she said that's a function of the privatized workplace.
"When everybody worked for the hospital, if something like this had to be done, they had the ability to reposition people. They knew when something was happening very rapidly," Blamey said.
"Now what you have is a private employer responsible for the cleaning ... You can't tell a private employer what to do with their staff, and staff can't take orders or direction from hospital staff."
A call to Fraser Health Authority was not returned before the NewsLeader's press time.
wchow@burnabynewsleader.com
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