Eighty-four patients died and hundreds more suffered serious complications following outbreaks of a highly infectious superbug at a Metro Vancouver hospital over the past two years. Now physician whistleblowers are saying the lack of infection control borders on medical negligence.
The infection rates of the bacteria Clostridium difficile at Burnaby Hospital have been two or three times the national average over the past two years and on par with the deadly outbreak in hospitals in the Niagara region that led to government reviews and reporting changes in Ontario.
"Such is the degree of the [C. difficile]problem and the ineffectual response to it, that we believe it could objectively be considered medical negligence," pathologist Shane Kirby wrote in a Jan. 9 letter to the Fraser Health Authority. "This breach in duty resulted in injuries."
The doctors representing the hospital's Infection Control Committee say the contagion rate led to unprecedented medical unit closures – in July, 2011, and again in late November – yet requests for enhanced cleaning of the infected units were not implemented.
In all, 473 serious cases of infection were recorded between 2009 and mid-2011, and that does not include the outbreak in November.
"We would characterize current [C. difficile]infection control management at Burnaby Hospital, at best, as a serious hazard to the patient population," Dr. Kirby wrote in the letter, released Wednesday in the B.C. legislature.
Burnaby General is far from the only hospital in B.C., or Canada, to recently deal with a C. difficile outbreak, but the scale of the outbreak reported by the doctors is significant.
The Ontario government took control of the Niagara Health System in August in a bid to restore public confidence, after the system had 31 deaths linked to C. difficile in less than four months.
Also, seven people died of the infectious bacteria at Guelph General Hospital between May and September of last year. Six acquired the C. difficile while in the facility. Twelve cases of the infection were discovered at a hospital in Kingston last summer.
Nanaimo Regional General Hospital, on Vancouver Island, had 94 cases of C. difficile infection between July, 2008, and May, 2009. Five patients died as a direct result, while the bacteria was a contributing factor in nine additional deaths.
Dr. Kirby would not comment on the contents of his letter, which was released by NDP Leader Adrian Dix, who called on the government to order a review of the hospital's infection control procedures.
"The physicians in this case want a review of the facility housekeeping contract to break the chain of infection and to protect patients," Mr. Dix told the legislature.
"Will the minister today ask the Centre for Disease Control to take steps to review what is going on at the hospital … to address what he has to agree is a serious public health problem?"
Health Minister Mike de Jong did not rule out a review, but said planning is taking place to address the challenges that population growth have placed on the hospital. "There are challenges, but the master-planning exercise that is underway today is designed to ensure that the kind of care that people expect and deserve at Burnaby Hospital will continue," he said.
The site is being redeveloped to include more single-occupancy rooms for patients to reduce the transfer of disease.
Mr. de Jong also cautioned against linking deaths to C. difficile, noting that it is medically difficult to pinpoint mortality rates from the bug.
However Dr. Kirby's letter, also signed by six department heads at the hospital, cites a recent medical review that found in Ontario hospital outbreaks of C. difficile, 80 per cent of the deaths were directly attributed to the complications of the bug.
In his letter, Dr. Kirby suggests the heath authority has only been spared a raft of malpractice suits because the outbreaks were not publicly reported, whereas the cases in Niagara were widely publicized.
"We believe the only reason that such action has not already taken place is the lack of public transparency as to the extent of the problem," they wrote.
In a reply dated Jan. 23, health authority president Dr. Nigel Murray said the hospital has made progress with tackling the rate of C. difficile infections "and associated morbidity and mortality."
He added: "Although still unacceptably high, [C. difficile infection]rates at Burnaby have improved since the implementation of program management."
With reports from Sunny Dhillon and Carrie Swiggum in Vancouver