Beware of infections caused by a hospital or surgical center
Experts: Some types of infections are caused by bad cleaning and sterilization of surgical instruments
As a Houston medical malpractice attorney, I have handled a lot of cases for people who developed hospital-acquired infections after a surgery. And in each and every one of those cases, the hospitals and surgeons tried to wiggle out of responsibility by pointing to a consent form that the injured patient signed.
Before any type of surgery, the surgeon or nurse will go over a consent form with the patient, including an area that deals with the risk of infection. The reason is simple. When it comes to surgery, some infections are unavoidable, even with good quality care.
The key word, though, is “some.”
There are some infections that would never happen if the hospital, nurses, and surgeons used good procedures and provided standard care. And despite what some hospitals and doctors seem to believe, when a patient signs a consent form, he or she does not sign away the right to receive that quality of care.
If either your or a family member of friend has gone through an infection after surgery, call 281-580-8800, for a complimentary consultation with the Texas medical malpractice attorneys at Painter Law Firm.
Laparoscopic surgery and infections
In recent years, there has been a dramatic development in laparoscopic surgical techniques. Instead of having to make one or more large cuts on the body for an open surgery, the surgeon makes a handful of small incisions, up to about a half an inch in length. The surgeon then inserts ports, surgical equipment, and cameras through the small incisions, and does the surgery on another part of the body.
There are now standard laparoscopic surgical techniques for a variety of procedures, including bariatric (weight loss) surgery, gallbladder removal (cholecystectomy), and appendix removal (appendectomy), as well as surgeries on the liver, pancreas, and bile duct.
There are a lot of benefits of laparoscopic surgery, one being a lower risk of infection. But, once again, all infections are not created equally—some may be unavoidable, but others would never happen with proper care from the hospitals, doctors, and nurses.
Skin and port infections
Our skin is a protective barrier to infections. Our skin is also the home to a lot of bacteria that do not cause harm as long as they are on the skin. But once the skin is cut open for a surgery—even laparoscopic surgery—about one to three percent of patients will develop an infection at the site of the incision or cut.
These are often called surgical site infections, and in laparoscopic procedures may also be called port infections.
You have probably heard of a Staph infection before (it is pronounced “staff,” and more formally called Staphylococcus). Staph) is a type of bacteria that is normally found on the skin and it also is the most common type of surgical site infection.
Staph infections after a surgery usually show up within days or a week or two of the surgery. The symptoms include things like redness, pain, and swelling at the surgical cut or incision area in the abdominal area. These infections are usually pretty easy to treat with normal antibiotics.
While surgical and infection experts agree that these infections can be caused by bad techniques of surgeons and nurses, they also tell us that Staph bacteria can be spread in the air. In other words, a patient can get this type of infection without negligence or surgical malpractice.
Other infections can develop deeper in your abdominal cavity (belly) and have nothing to do with Staph or skin bacteria. Patients typically start experiencing pain and other symptoms from these infections two, three, or more weeks after a laparoscopic surgery.
These are typically hospital-acquired infections. Almost no one gets this type of infection without negligence on the part of the hospital, surgical facility, surgeon, doctor, nurses, or techs. These infections are caused by mistakes by the health care providers in not following standard cleaning and sanitation procedures for surgical equipment.
And, as it turns out, in some situations, laparoscopic procedures have an increased risk of this type of infection, because of the type of surgical equipment used.
I am currently working on a case for a client, Tamara, who had a lap band surgery done by a surgeon affiliated with the now out-of-business True Results weight loss group. The lap band surgery was done at the Physicians Surgicenter of Houston, located at 7515 Main Street, which was also affiliated with True Results.
Tamara was initially diagnosed with a Staph infection around the surgical incision and port site. The doctors drained some infected fluid and gave her antibiotics, which took care of that infection.
About three weeks later, though, Tamara started having severe, intense abdominal pain. Doctors at University General Hospital, in Houston, diagnosed her sepsis and ordered appropriate medications to treat it. Later, lab cultures revealed had a mycobacterial infection inside the belly, called Mycobacterium fortuitum.
Mycobacterial infections are rather hard to diagnose because they develop from endospores that take a long, long time to grow. Published medical literature shows that Mycobacterial endospores contaminate regular tap water and soil.
If surgical facilities, like Physicians Surgicenter of Houston, do not properly sterilize the surgical equipment, then when a surgeon inserts it into a patient’s abdominal cavity, it can cause a Mycobacterial infection. That can happen when contaminated soil is not cleaned from the surgical equipment, or endospore-containing tap water is used in the cleaning process.
This type of infection is tough to treat because standard antibiotics do not work on them.
Some hospitals and surgical centers use dirty equipment
Experts say that the gold standard for laparoscopic surgeries is to use disposable equipment. That way, all of the surgical tools are sterilized and safe before they are even opened in the operating room. After the equipment is used on a patient, it is thrown away.
Some surgical centers and hospitals do not use disposable equipment, though. Painter Law Firm hired an expert surgeon to review Tamara’s medical records, and he gave a written opinion that Physicians Surgicenter of Houston failed to follow standard cleaning and sterilization procedures for the laparoscopic surgical equipment used in her lap band surgery.
When hospitals and surgical centers reuse surgical equipment, their techs and nurses must pay careful attention to a multi-step procedure clean and sterilize the equipment between each and every use. And sometimes that just does not happen, which presents a very dangerous risk of infection to the next patient.
Based the expert’s opinions, we believe that Physicians Surgicenter of Houston caused Tamara’s Mycobacterial infection. This hospital-acquired infection left Tamara in terrible pain, with open abdominal wound, and many hospital admissions over a year of healing from the infection.
Other sources of surgical equipment contamination
Mycobacterial endospores are not the only source of contamination for surgical equipment.
In 2011, a patient sued Houston Methodist Hospital and others over a hospital-acquired Pseudomonas bacterial infection after a shoulder surgery. The expert internal medicine doctor and microbiologist in that case gave the opinion that the patient developed the infection because of reused surgical equipment that was contaminated with a prior patient’s body tissue.
The expert in that case explained that when the uncleaned, unsterilized surgical equipment was inserted into the new patient at Houston Methodist Hospital, the Pseudomonas bacteria spread and found a new host where it could grow, thrive, and infect.
What you can do about surgical infections
Remember that conversation with your surgeon or nurse, when they go over the pre-printed informed consent form and ask you to sign in so many places? Consider asking if the hospital or surgical center uses disposable surgical equipment. Better yet, if it is not an emergency surgery, ask your surgeon this question at his or her office, before the surgery is even scheduled.
After a surgery, I recommend that you keep an informal journal about how you are feeling, any fevers, what medications you are taking, and how you respond to them.
Your surgeon will probably tell you that you should expect some pain and discomfort, but that with a matter of days it should start to improve. If, instead, you begin to have a fever, or redness, hardness, or pain at the site of the surgery, jot that down in your journal and tell your surgeon or doctor immediately.
If you are diagnosed with and treated for a superficial or Staph infection at the surgical incision or port site, continue to take notes in your journal. Are you feeling better or worse each day? How? Do you have a fever? If so, what is it, and how does it respond to medication.
Just because your surgeon or doctor caught this type of infection does not mean that are not also suffering from a more serious hospital-acquired infection. If you feel that you are not moving in the right direction, call your surgeon or doctor and share specifics from your journal.
Call Painter Law Firm for a free evaluation
If you or someone you care for has been harmed by a surgical infection, call 281-580-8800, for a free consultation with the experienced medical malpractice attorneys at Painter Law Firm.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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Published in the July/August 2018 edition of "The Houston Lawyer" magazine