WRAL Investigates

Hospital infection rates go unreported to public

Posted March 18, 2009
Updated October 12, 2011

— Living on 54 acres outside Benson, Frances Lee doesn't take any of the credit for the success of Max Lee Farms.

There are blueberries, blackberries, raspberries, peaches and flowers – as far as the eye can see when they are in season. Her husband, Max Lee, was responsible.

WRAL Investigates Bill would require hospitals to report infections

"Nothing could make him happier than to say, 'I've got to plow the lower field,'" Lee recalled.

The two met a day after she graduated high school. They married in 1958 and had four children, who in turn have had 10 grandchildren. In September, the couple celebrated their 50th wedding anniversary.

Her husband, Lee says, worked the fields practically every day, until November, when he was diagnosed with lung cancer.

In early December, Max Lee underwent surgery to remove a portion of his lung. Initially, his wife says, it went well.

"We thought he was coming home," Frances Lee said. "'Oh, he'll be home for Christmas,' we said."

He never left the hospital, however. At age 79, he died the day after Christmas. According to his death certificate, he died of the bacterial infections methicillin-resistant staphylococcus aureus and sepsis.

"You go to a hospital to get better – you think. Then, this happens," Lee said.

According to the federal Centers for Disease Control and Prevention, approximately 90,000 patients like Max Lee die each year in the United States from hospital-acquired infections – more deaths than those from breast cancer and AIDS combined. More than 2 million patients develop an infection during their stay.

"It's about 5 percent of all hospital admissions," said Dr. Jeff Engel, North Carolina's state health director.

Five percent, Engel said, is "disturbingly high" because 30 percent to 70 percent of hospital infections are preventable.

MRSA, for example, is a leading cause of potentially life-threatening bloodstream infections and surgical-site infections. According to a 2007 CDC report, it was responsible for an estimated 94,000 life-threatening infections and 18,650 deaths in 2005.

About 85 percent of those infections could be traced to a hospital stay or some other health care exposure, according to the report. Two-thirds of those occurred among people who were no longer hospitalized.

Nationally, studies show the rate of all hospital-acquired infections is down. Locally, it is unclear, because North Carolina is one of 24 states that do not require hospitals to report or make that information public.

Rex Healthcare, WakeMed and the hospitals in the Duke University Health System indicate rates have dropped, although they declined to provide times or specific numbers. (View statements from the hospitals.) UNC Health Care did not respond to WRAL News' request for the rates.

Rep. Lucy Allen, D-Franklin, is sponsoring House Bill 296, which would require all hospitals to track, report and make the information public. The statewide program would cost approximately $1.2 million in the first two years to develop and implement.

The measure, she says, will save lives.

"Oh, definitely, it's a patient-safety issue," she said.

Engel does not think a mandated statewide program is worth the investment. He believes each hospital needs to track the data, but says it should be up to the hospital to decide what to report and to whom.

"All I can say is that there's no evidence that when those reports are published for the public's consumption that they work to reduce rates in hospitals," he said.

He says there are unintended consequences of a mandatory surveillance and reporting system because there are no standards for tracking infections. Each hospital has its own.

If one hospital does a better job at tracking its infections, it might be perceived as having a higher rate of infections than a hospital that tracks its infections a different way.

Don Dalton, a spokesman for the North Carolina Hospital Association, says that creating a uniform system in which hospitals can track and monitor infections can help eliminate many hospital-acquired infections.

The association established a voluntary reporting system in December to develop a methodology and training program so that data are consistent among hospitals.

He says 66 of the 105 member hospitals participate in the program. If Allen's bill, as it stands now, becomes law, it would become mandatory for every hospital in the state beginning July 1.

Dalton says that when hospitals are required to provide the results to everyone, doctors share best practices and patients are better informed.

Engel also says that a reporting system doesn't take into consideration how risks vary from hospital to hospital. The types of patients and procedures at hospitals could keep them from wanting to perform procedures or treat patients if infection is a possibility.

Allen disagrees. She thinks doctors would work harder.

"I don't think many doctors would keep from doing a procedure that was necessary to save a person's life because of that possibility," she said.

Dalton says the public needs access to the information to have another piece on which to judge the quality of care in hospitals in the state. He also believes that when patients become more involved in their care, their quality of care is going to improve.

"The ultimate goal is to eliminate hospital-acquired infections," he said.

At Max Lee Farms, Frances Lee says her son now takes care of the crops. And she is helping foster support for Allen's bill.

She says she devotes most of her energy to telling people her story and hopes that hospital infection rates will be disclosed. She believes the price of not doing so is far too great.

"Not a day passes I don't cry, think about him," Lee said. "I accept that it's over. But I'm saying: 'Does it have to happen to somebody else?'"


This story is closed for comments.

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  • cschumacker Mar 20, 2009

    I feel very badly for Mrs. Lee. Unfortunately this woman is under the mistaken belief that her husband died of some mysterious infection that can only be contracted in a hospital. She does not acknowledge he had lung cancer. And that he was 79 years old. And that he had a big open heart surgery with his lung resected. I wonder if Mrs Lee and the WRAL reporter are suggesting this man would have lived longer and happier without surgery? Really?

    MRSA is a common skin bacteria that can probably be cultured from your skin...right now, even if you just showered or washed your hands. In the hospital, a single microscopic bacteria can become opportunistic in people who have open wounds and/or people who have reduced immunity. The source of this bacteria is often from self.

    That said, I always think hospital staff should always strive to reduce disease transmission. Open reporting does not strike me as overly onerous if it has the intended end results of fewer infections.

  • stopsheeple Mar 19, 2009

    "the American Journal of Medical Quality published three studies, providing new evidence that hospitals could prevent many of the growing number of infections if they practiced better hygiene. The studies independently concluded that, despite hospitals' claims, it's not true that infections are inevitable in the sickest patients."
    "Rigorous adherence to hand hygiene and sterile procedures can almost eradicate many types of infections."
    "He and his team reduced central line-associated bloodstream infections 90% in 90 days."

  • DrJ Mar 19, 2009

    ((( My dad's hospital acquired MRSA infection cost medicare over $300,000. Much cheaper to track, report and prevent than to treat.
    March 18, 2009 9:46 p.m. )))

    stopsheeple, if it were that simple, hospitals would have already wiped out infections long ago. They already track and try to prevent infections. And every hospital would love to have a zero rate. But reread the article here. "30 to 70 percent can be prevented" means that the opposite amount (up to 70 percent) CAN'T be prevented.

    I'm all for hospitals reporting hospital acquired infection rates. A certain level of them can't be prevented, and it's time the general public understands that medical facilities and providers, no matter how dedicated, OR MOTIVATED, are incapable of "perfection."

  • affirmativediversity Mar 19, 2009

    lilybel posted, "American patients admitted to hospitals in Europe, .... , are considered bio-hazards and isolated because our medical system has done nearly nothing to tackle the ever-growing MRSA problem.


    Thanks for the laugh... I needed that this morning!

    American patients are NOT "isolated"...they are GIVEN PRIVATE ROOMS because THEY HAVE PRIVATE INSURANCE!!!
    If you are a citizen of a European country and rely on THE GOVERNMENT for your healthcare then YOU ARE PLACED IN A WARD (that's a room with minimum one other patient but usually three other people)!

    Yeah buddy, sharing a room with 3 perfect strangers and their various and sundry visitors, now that's "aggressive infection control procedures"...ROTFL!!!!

  • justwondering2 Mar 19, 2009

    The reality is MRSA is everywhere. The poor man probably had it in his nose and when he became compromised(open wound from lung cancer) it showed its ugly face. But why did he have lung cancer? Did he lead a lifestyle that put him at risk for lung cancer? If so one could argue that if he didn't put himself at risk for lung cancer from smoking or pesticides perhaps(i don't know just examples) then maybe he would not have gotten cancer, so then he would have never been in the hospital having a lung removed and come in contact with MRSA. Point being.... everything is not the hospitals and Dr. fault there is personal responsibility. JMO

  • Daiseymae1955 Mar 19, 2009

    Because I've had MRSA and struggled with the sores and eruptions for 2 years on and off, I understand every comment that I've read thus far, but, the best answer is the sanitation that you use before entering a hospital/clinic/medical facility and the same sanitation that you follow up with as you leave and after you leave. Hibicleans isn't that expensive and washing with that in the shower once a week and using that after shaving once a week will hold down on the bacteria developing on your skin.
    Dr. Engel, you are a politician thru and thru - definitely time for "a change" in your position. I believe that you would not be quite so inflexible concerning the tracking and reporting if you were personally affected. I have been one of the lucky ones. There are thousands out there that have not been fortunate enough to survive the infections. We in the US seem to have to learn our lessons the hard way!

  • jajs Mar 19, 2009

    most of you people act like the hospital is a death trap. The reality of it is your local supermarket, walmart, target, even the artificial turf and wood flooring of the precious sports you watch have the same (if not more) bacteria on it. so what are you gonna do? live in a bubble if it makes you happy.

  • lilybell Mar 19, 2009

    American patients admitted to hospitals in Europe, where they have had aggressive efforts to battle MRSA for several years, are considered bio-hazards and isolated because our medical system has done nearly nothing to tackle the ever-growing MRSA problem.

  • this is my Screen Name Mar 19, 2009

    Everyone, be it visitors, patients,doctors, nurses - everyone needs to wash their hands. When a patient is admitted, their hands aren't washed by the staff, so they bring in all kinds of who knows what. Unfortunately housekeepers don't have the time to wipe down every door handle, every chair and item that is frequently touched by people. It's everyone's responsibility. The hand sanitizers are all over the hospitals for a reason.

  • ConcernedNCC Mar 19, 2009

    Next time you're in a hospital, count how many times you see the nurse or doctor wash their hands before or after touching the patient. They're supposed to do it both times. In the past two years, when I've been to the hospital with two different relatives, the number was zero unless one of us questioned the person about their practice.