Hospital superbug deaths: coroner seeks intervention A coroner has repeatedly cited the need to curb superbug infections arising at a Dublin hospital, writes Georgina O'Halloran
THE DUBLIN county coroner's call for HSE intervention at St Columcille's Hospital, Loughlinstown, to reduce the incidence of deaths related to superbugs at the facility is the latest in a series of requests by his office seeking action on the matter.
Dr Kieran Geraghty has voiced his concern at the number of deaths involving patients with Clostridium difficile(C diff) and MRSA at the hospital on no less than five separate occasions over the last six months.
Speaking at inquests, he has continually stressed the need for the appointment of a consultant microbiologist at the hospital.
Over the same six-month period, two doctors at the hospital and a hospital manager have reiterated the need for a microbiologist to co-ordinate an effective infection control policy at the facility.
On October 9th, 2007, the consultant physician and geriatrician at the hospital, Dr Morgan Crowe, told an inquest into the death of Mary McDonald - who died from C diff - that "consultants . . . have been calling for the appointment of a consultant microbiologist for the past two years".
In the same month, hospital manager Tom Mernagh told an inquest into the death of Sarah Leonard from bronchiectasis with MRSA that the services of a consultant microbiologist were needed and that the stated policy of swabbing patients who come into the hospital for MRSA was not being done because the hospital did not have such an expert.
He said he had been informed by the HSE that funding was to be made available to allow the appointment of a microbiologist.
Ms Leonard (72), of Bayview Drive, Killiney, Co Dublin, died on February 7th, 2007.
Ms McDonald (87), of Berryfield Lane, Fassaroe, Bray, Co Wicklow, died on June 1st, 2007.
The pleas for a microbiologist continued in January this year, with consultant endocrinologist Dr Donal O'Shea reiterating the need for a microbiologist, while a frustrated Dr Geraghty announced he would be writing to management at the hospital on the matter.
"There have been a very significant number of C diff cases in the hospital," Dr Geraghty said. "We're concerned with circumstances which might prevent other deaths. I'm concerned with preventing the occurrence of infections."
A HSE spokeswoman said funding has been made available for the provision of consultant microbiologist sessions to St Columcille's, but "it has proved more difficult to establish than anticipated".
"In the meantime, however, consultant microbiologist advice is available from St Vincent's Hospital, Elm Park, Dublin," she said.
Currently at the hospital there is just one infection-control nurse with responsibility for the infection control policy at the facility.
In January, the coroner recommended the inclusion of the nurse at a monthly multidisciplinary meeting of doctors and consultants, as the only contact between the doctors and the nurse was on ward rounds, and informally once a week.
It is unclear whether this recommendation has been introduced.
According to the HSE the nurse, "liaises with clinical staff as appropriate".
Consultant microbiologist at Beaumont Hospital and with the Health Protection Surveillance Centre (HPSC), Dr Fidelma Fitzpatrick, said preventing and controlling the spread of C diff in hospital was multidimensional and required the presence of certain personnel on an infection-control team, including a microbiologist, who was crucial to co-ordinating an overall infection-control programme in hospitals.
"The microbiologist directs the lab, as well as seeing the patients. We oversee and work as part of an infection-control team which meets together on a weekly basis. We give advice to hospital managers on infection control," she said.