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Family blames UMMC for inadequate protections against potentially deadly bacteria

By Howard B. Owens

An elderly member of one of Batavia's most prominent local families lies in a United Memorial Medical Center bed tonight gravely ill, and family members are fairly confident UMMC is responsible for her serious condition.

The aunt of local business woman Lois Gerace, and the great-aunt of Town of Batavia Board Member John Gerace, Margaret Wagner, 86, contracted clostridium difficile, more commonly called "C diff," after being treated for a fractured hip at UMMC.

She's been in the hospital for two weeks and medical personnel, according to Lois and John, have told the family she will likely succumb to the bacteria.  

"They have her in what's called 'comfort care,'" Lois said.

UMMC CEO Mark Schoell acknowledges that there has been a slight spike in the incidents of C diff at the hospital, but said it's a common infectious bacteria at hospitals and UMMC takes every standard precaution to prevent its spread.

"I believe our infection controls procedures and policies are excellent," Schoell said. "They comply with all of the standards of the industry and all of the requirements of the health department of New York State. In fact, when we saw the spike in our absolute numbers of C diff, we immediately got the health department involved in the effort to manage those cases."

C diff most commonly strikes elderly people while hospitalized, especially when they're on antibiotics, but according to the Mayo Clinic (link above), C diff can make even healthy people not on antibiotics ill. While it is treatable, C diff is potentially fatal for anybody who contracts it.

Annually, more than 480,000 people are diagnosed with C diff. Of those, 28,000 die as a result. Not quite half of those deaths occur after people contract C diff in a hospital. The majority of deaths occur in nursing homes.

Schoell said typically, UMMC  has a count of 40 to 45 patients and with that number of patients, at least two or three contract C diff.

The Geraces believe Wagner contracted C diff when, after her surgery, she was placed in a third floor recovery room with a C diff patient. At least, they say, that's what a nurse told them, though Lois admits they don't have lab tests or hospital records to support the assertion.

Recently, the hospital had 65 patients and currently has six C diff patients, Schoell said.

Up until yesterday, John Gerace said, his aunt was in a room on the third floor, but after he let a head nurse know that he had notified the media of the situation, the hospital removed all patients from the third floor and sterilized it from top to bottom.  

"Now, if there wasn’t a problem, or if I didn’t say anything, there would still be people up on that third floor," John said.

Schoell said the decision to vacate the third floor and clean it was made well before the media was contacted by Gerace. He said the hospital could only make the move after the number of patients dropped, which typically happens on a weekend, so beds could more easily be relocated and all the C diff patients could be consolidated in the same wing.

"We would have done that, taken the same actions whether there was media involvement or not," Schoell said. "It was the right thing to do."

Schoell said by consolidating C diff patients in one wing, hospital staff can do a better job of controlling who enters and who leaves rooms, but on Sunday evening, two reporters were able to walk right up to the second floor, ask for a family member of a C diff patient, and be escorted down the hall to the area of the room (though the reporters made no attempt to enter the room). No staff members offered any objections or warnings.

John Gerace also disputes the assertion that there are only six C diff patients at UMMC. He said he's counted at least a dozen of the red "stop" signs similar to one placed outside his aunt's room on the second floor. 

The Geraces are especially concerned for the sake of the community that there is no security on the second floor warning visitors that a potential lethal bacteria is present, nor are there adequate warning signs and information posted when you arrive on the floor warning of the danger.

"If you come in and you’re having a bad stomach day and your antacids aren’t kicking in, you’re done," said Robert Gerace. "In three or four days, you’re going to be in the same bed."

The Gerace's first learned of Margaret Wagner's condition when they came to visit her a few days after her hip surgery. They started toward her room, John said, and a nurse stopped them and said, "You don't want to go down there."

The nurse said they didn't know what was wrong with Wagner, but it was potentially communicable. Family members were eventually allowed into the room, but only after donning gowns and masks. They told Wagner they were dressed up for Halloween.

After visiting with Wagner a couple of times while wearing masks, another nurse pulled John aside and said the masks weren't necessary because C diff is not airborne.

All along the line, John said, communication from the hospital about how to protect themselves from C diff has been spotty and inconsistent.

"I'm leaving one day and a staffer says, 'Oh, by the way, you want to wash the bottom of your shoes off with chlorine and water,'" John said. "Nobody told us this before. You could be tracking it into your house with small children. Nobody is telling us this stuff. Why wouldn’t somebody come in and say, ‘oh, by the way, these are all the things you guys need to do'?"

Family members have been concerned about some of the sanitary practices they've observed over the past two weeks. They said they've seen janitors cleaning out contaminated rooms, sweep everything into the hall and then use ungloved hands to pick up the waste and put it in a trash can.

Lois's husband, Joe Gerace, is partners with her in Bob Harris Realty and he operates Gerace Hair Care (he's also chairman of the City of Batavia Republican Committee). She said she doesn't understand why the state requires barber shops and beauty salons to keep all trash in covered receptacles but all around the hospital, she's seen open containers used to dispose of potentially contaminated materials.

The Gerace family has a history of supporting UMMC and said one of the things they've valued about living in Batavia is that the city has a local, nearby hospital. Now all they want, each of them said, was to ensure that local residents get safe, quality care at their local hospital.

"I really don’t want to get into lawsuits and stuff like that," Lois said. "What I want to see is protection for the patients here."

This story produced in cooperation with The Batavian's news partner, WBTA.

Steve Ognibene

This has been a story that MANY people have been telling me in passing and is really alerting our community on all sorts of levels.

I just hope in the end everyones heals from this. Great post Howard !

Apr 17, 2011, 10:34pm Permalink
Denise Bull

My boyfriend also has had the C-Diff at UMMC and RGH in the past. The hospital and staff do what they can to get the visitors who come to see the patient wear a gown, mask, and glove up prior to entering the patients room. However, like Howard reported, it is common in hospitals for patients to get it.

Apr 17, 2011, 10:48pm Permalink
Lorie Longhany

My father in law was susceptible to MRSA and picked that up almost every time he was hospitalized. We had the orders to don the gowns.

Apr 17, 2011, 11:05pm Permalink
shelly mathers

This is terrible. I understand that it is a possible thing you can get while at ANY hospital but it seems like UMMC has slacked on a lot of very simple precautions as well as after the fact.

Hope she has a fast recovery!

Apr 17, 2011, 11:34pm Permalink
Robert Gerace

Just wanted to add a note to what Howard said about the antacids. If you are taking antacids or you are on antibiotics and if your immune system may be in a weakened state. Your are more at risk for getting this bacteria.
There were no warning signs posted as to the threat to anyone entering the hospital or on the 3rd floor where my Aunt was taken after her surgery. We were not told anything about this bacteria until after she had started to show signs that something wasn't right. The hospital knew of the threat, well before my Aunt Marg got infected and was continuing to put everyone at risk.

From what we have seen over the past 2 weeks, the hospital did not do what is needed to stop the spread of this. Proper cleaning proceedures!!! and being proactive in stopping the spread of these bacteria.

I do want to thank all the nurses at UMMC who are caring for my Aunt Marg. They do a great job. But they need the support of the Management to stop this from happening again.

Apr 18, 2011, 12:49am Permalink
C. M. Barons

...Citing my father's experience (he was in his 90s, suffering from congestive heart disease) admitted to UMMC on numerous occasions from 2005 until his death in 2008. Although UMMC staff were generally pleasant and accommodating, I found the operation of the hospital to be astonishingly inept when it came to infectious issues, communication of patient status and building upkeep. On one occasion my father had contracted a contagious infection, and visitors were allowed in his room with no precaution.

During a UMMC-stay in 2005, he had temporarily lost use of his hands- subsequent to a heart attack. I came to visit him and his dinner had been left on a hospital bed-stand. Clearly he could not eat independently. I fed him, and later asked a nurse why dietary hadn't been informed of his need for assistance; to which the nurse asked ME if he had suffered a stroke. ...So much for SOAP notes.

The 'Hospitalist' is an inaccessible ornament. In fact all of the doctors are inexcusably inaccessible. In this age of email, pagers, cell phones and internet, the only mode of contacting a doctor at UMMC must involve tee-time at Stafford Country Club. Ask a floor nurse when a doctor might be available, and he/she shrugs his/her shoulders. The one UMMC department with an apparent mastery of communication skills is Accounts Receivable.

The last week of my father's life- his doctor described his condition as (paraphrasing) he had a virus, we've knocked it down; he should be better and discharged in a couple days. It was evident he hadn't even seen the patient he was referring to. My father died four days later, succumbing to major organ failure.

His stay at UMMC (that final week) included being in a saturated bed. He wasn't moved to another room until I advised a nurse of water dripping from the ceiling.

I understand that ALL hospitals (in this age of antibiotics made useless by over-use) have problems with infectious bacteria.

Addendum: My father was a voting member of the UMMC Board. I'd hate to see how everyone else fares. To head-off any second-guessing, I was person of record: documented health care proxy and power of attorney for my father.

Apr 18, 2011, 8:16am Permalink
Dave Olsen

"Schoell said the decision to vacate the third floor and clean it was made well before the media was contacted by Gerace." Howard, was his nose growing when he said that? Honestly, does anybody actually believe that?

Apr 18, 2011, 8:31am Permalink
Thomas Mooney

My heart goest out to the family . Does it matter who one is or related to or what they own for this to matter . I would hope it wouldn't matter your social status for someone to take action .This is very much how Batavia works .

Apr 18, 2011, 8:44am Permalink
Michele Case

I too feel sorry for this patient and her family. While this is an unfortunate incident, many comments above are uncalled for. C-diff is present in all hospitals. UMMC appears to be following accepted protocol. As more cases were confirmed they took more action to group affected patients in one area. This sounds like protocol as well as this is typically done in other facilities. I don't know if they actually vacated the entire 3rd floor at once, individual rooms can be emtied and thoroughly cleaned and patients placed back in them one room at a time, also accepted practice. I do not work at UMMC but have faith in them and their staff. This lady was placed in a recovery bed on third floor, this we know. Mr Gerace says a nurse told him the room-mate had c-diff. Maybe, maybe not. Maybe the patient was not yet diagnosed? Did a "nurse" say this to him? Often patients and family think every woman in scrubs is "a nurse" no matter what they are. I understand the Gerace family is upset. Of course they are going to be accusatory. Those of us reading the above should not jump to conclusions when we don't know the whole story. The media has put their spin on this. I just don't think it is fair to our local hospital and it's staff. Clearly the notices were up on the doors and appropriate equipment provided: gowns and gloves. Ask a nurse for information on contact precautions and I am sure they will answer your questions and point you toward their infection control person if need be. Patients have a right to confidentiality as well which drives how things are done. This is a time for education, not for pointing fingers. Just my 2 cents.

Apr 18, 2011, 2:24pm Permalink
Howard B. Owens

The media has put a spin on nothing, Michele. The Gerace's had their say and the CEO of the hospital had his say. We have no agenda in this other than doing our best to peel away the onion and get to some sort of truth.

Apr 18, 2011, 3:42pm Permalink
Kyle Couchman

Sorry Michele

As Howard pointed out the story was very unbiased. However when I read Lorie and CM Barons accounts of actual experiences I have to say your opinions seem unfounded I have been in UMMC and notices arent always posted and sometimes the nurses arent very co-operative.

Like any facility there are good and bad people at the job, I know there are some very good people but I also know that ther are some that arent. If these things are happening then they (UMMC) have to show us they are addressing the issues or they will face more "lumps" and us jumping to conclusions, and rightly so.

Apr 18, 2011, 4:39pm Permalink
Frank Bartholomew

What good will wearing slippers over your shoes do, if all the staff going in and out of the affected rooms aren't wearing them as well?

Apr 18, 2011, 5:04pm Permalink
Frank Bartholomew

I have a hard time believing a nurse told Mr. Gerace any medical information regarding the roommate, as this would be a clear violation of HIPA laws.
UMMC is a JACHO certified facility. C-Diff could have gotten in from multiple sources, using the restrooms at malls and busy retail stores are examples. Even handwashing doesn't remove the risk, you don't sanitize your shoes when exiting.
If by chance this was preventable, The Infection Control personell will most certainly work with staff and admininstration to assure patient safety during visits to this hospital.

Apr 18, 2011, 6:02pm Permalink
Michele Case

I meant nothing personal, Howard. I am talking about all media reports combined. With the Geraces threatening possible legal action I am sure everyone at UMMC is required to keep quiet, so basically all the reports are coming from the Gerace family. I have yet to see any investigative reporting with statistics and comparisons. This is not a trial and people making comments to convict UMMC without both sides are being unfair. Of course the hospital has a chance to add their side but they do not have to devulge everything as this is not a trial. The accused are always supposed to keep quiet, right Chris? Some information is better to save for trial.

Apr 18, 2011, 10:07pm Permalink
Howard B. Owens

Where have the Geraces threatened legal action? They've said the exact opposite. Did you even read the article? Mark Schoell, the CEO of the hospital, is quoted at length. We quoted UMMC's own statistics on the matter.

Apr 19, 2011, 8:00am Permalink
Jason Crater

John Gerace also disputes the assertion that there are only six C diff patients at UMMC. He said he's counted at least a dozen of the red "stop" signs similar to one placed outside his aunt's room on the second floor.

-Those stop signs are used for any illness where there are any contact precautions. It could be C Diff, MRSA, or a variety of other communicable diseases.

Apr 19, 2011, 8:49am Permalink
Michele Case

Not saying it was your article, Howard. And Jason, just would like to add to your comment: Those signs are also put up for reverse precautions, where visitors are at risk of infecting immune compromised patients.

Apr 20, 2011, 5:38am Permalink
Frank Bartholomew

With the addition of the new surgical unit, this is a very busy hospital, nurses are dealing with more patients,and in some cases are pushed beyond the limit of safely caring for patients. Some nurses have to be the nurse, the aide, the secretary, and a source of information to patients families. I do know that any nurse assigned more than 6 patients creates safety concerns. Nurses on the 11pm - 7am shift on the second floor are caring for 9, 10, and sometimes more. With this in mind, do you think they have time to glove, gown and mask, and follow all safety precautions?
Anyone complaining about the nurses should walk a mile in their shoes, most of us couldn't handle the pressure.

Apr 20, 2011, 6:38am Permalink

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