The Seattle Children’s Hospital will reopen all of its operating rooms Thursday, just two days after the Seattle Times reported one child died and five others developed infections because of mold in operating rooms in the past year.
The news reverberated across the state, with Spokane hospitals offering public assurances they routinely check operating rooms and other air quality systems for mold.
“We are taking extra precautions to ensure particulates are limited in our own operating rooms. We are committed to the safety of our patients and preventing any type of harm while they are in our care,” said Kevin Maloney, a spokesman for MultiCare, which runs Deaconess and Valley hospitals.
The Seattle Children’s Hospital had self-reported air quality issues in its operating rooms to the Washington State Department of Health on May 20, shutting down some operating rooms at the time and eventually closing all remaining operating rooms on May 24. At the time, the hospital sent 3,000 letters to patients and families who had surgery in the past four months to watch for signs of infection, a statement from the hospital said.
Aspergillus, a fungus, does not normally cause sickness. However, in operating rooms where a patient has an exposed cavity, there is a possibility for infection.
Mark Knapp, the director of plant facilities at Shriners Hospital for Children in Spokane, said his team regularly monitors the operating rooms at the hospital for temperature and humidity.
“The purpose for that is to make sure we stay in the humidity range where we make sure we don’t promote the growth of mold, and that’s continuously monitored, and if it goes out of range, we’re alerted by an alarm, and we act immediately to get it back in range,” Knapp said.
Despite the Seattle Children’s letters sent in May, the number of patients infected and the one patient who died were disclosed to the Department of Health but not to the public until the newspaper confirmed the problems late Tuesday night. Three patients with infections related to aspergillus were diagnosed in 2018, when the hospital first had problems with the mold. The hospital thought it had solved that problem, Dr. Mark Del Beccaro, chief medical officer, explained at a news conference Wednesday.
“We did those remediation efforts and interventions, and we did not have another infection for nine months, so we felt that we had done what our internal and external consultants told us to do,” Del Beccaro said at a news conference in Seattle.
But when routine air testing May 18 detected aspergillus, it became clear the operating rooms were not the problem. Del Beccaro said the air handler systems were at fault, instead.
Since closing operating rooms for more than a month, Seattle Children’s has switched to an entirely new air handler and installed a new humidification system.
“We are very sorry for the impact the air quality issue in our operating rooms has had on our patients and families,” a statement from the hospital says.
The Department of Health is responsible for conducting routine inspections of hospitals throughout the state, but infections caused by aspergillus are not on the “notifiable condition” list that health care providers are required to report to the department. Additionally, mold problems at Seattle Children’s Hospital came to light after the hospital self-reported its air quality issues, not through a routine inspection or audit. Seattle Children’s is in the midst of finishing a corrective action plan based on deficiencies found by the health department in May.
At Shriners in Spokane, Knapp’s team notifies the operating room if humidity reaches high levels. Shriners has two operating rooms, and the last time the state came to inspect the hospital was in 2018, Knapp said.
The health department conducts inspections on behalf of the federal Centers for Medicare and Medicaid regularly. Shriners is accredited by the Joint Commission, which accredits all Spokane hospitals.
Knapp said routine hospital inspections occur about every 18 months, by either the state or the Joint Commission.
MultiCare Mary Bridge Children’s Hospital in Tacoma took pediatric patients from Seattle Children’s Hospital in May when it began closing operating rooms, and MultiCare Deaconess released a statement saying it plans to hire an industrial hygienist to examine all of its locations as a result.
“We are working with an industrial hygienist on a plan to examine all locations and will follow up with precision testing to ensure we retain the utmost levels of cleanliness by ensuring that minimal particulates, of any type, are entering our ORs,” Maloney said in a statement. “We want to emphasize that these measures are being taken out of an abundance of caution – our analysis so far indicates that the presence of mold is unlikely at any of our locations.”
Providence Sacred Heart Medical Center has 28 operating rooms, with two primarily used for pediatric patients.
“Providence Sacred Heart Medical Center & Children’s Hospital actively follows rigorous infection control procedures to ensure the safety of patients and employees. These include routine testing, monitoring and maintenance of air handling and purification systems,” said Jennifer Semenza, spokeswoman for Providence. “Other factors, both environmental and structural, are closely monitored, including humidity, air pressure and air exchange rates. In addition, all operating rooms are cleaned by employees who have received additional education and training, and possess specific competencies related to operating rooms.”
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