First Do No Harm: How “Prestige” Nearly Killed Me
By Aviva O’Brien
Aviva O’Brien is a homemaker and volunteer at her church in the San Fernando Valley area of Los Angeles. She is also a grandmother of six and an active member of various local charities. Mrs. O’Brien contacted Interscan, based on an Internet search, after her near fatal hospital infection. We agreed to post her article.
I never thought I would have to write these words, a painful recounting of a medical procedure gone horribly wrong. I thank Interscan Corporation, a company I found via the Internet, for listening to my story, and posting this article. So accept this cautionary advice as a plea for you to become an informed health care consumer. That’s the very best way for you to avoid what I experienced.
Without divulging the exact nature of my condition, which could have been fatal (and sadly, continues to claim the lives of thousands of women each year), I will simply reiterate my profound gratitude to be alive, even if there were a number of precarious moments along the way. Which is to say, the news about my disease, and the doctor’s urgent call for surgery, left me saddened, depressed, angry and just plain fearful. Would I leave my children and very young grandchildren behind? Would this energetic woman, who was so invested in the lives of others, become simply a dim memory? Would the disease recur, ravaging my body with an intensity no narcotic could lessen or medicine could cure? I sought the counsel of my priest, a man who taught me about strength and the genuine power of faith. And then the doctors and nurses—my children at my side—wheeled me into the operating room.
I never bothered to ask if the instrumentation for my surgery was sterile or high-level disinfected, or anything about how it was processed. After all, I was at a prestige hospital, a place renowned for its facilities, endowment and internationally recognized personnel. People the world over come here for treatment, kings and prime ministers included. Besides, what lay person would even think about these matters?
But, as I was to find out, bacteria do not discriminate, and no facility—no matter how fancy the zip code—is immune from the kind of problems that, wholly independent of my condition, nearly took my life. You see, I was one of the more than 2 million victims of a so-called nosocomial infection—an infection caused by medical procedures or personnel. The Centers for Disease Control keep the statistics, and note that at least 80,000 of these infections are fatal.
Since there is no enforced uniform reporting standard in place, these figures are probably low.
As I found out from my Internet research—and Internet research was my only option since the hospital was less than forthcoming in explaining what could have happened—medical device processing can be divided into three categories or levels: low level, intermediate level, and high level. As the level of disinfection increases, the probability of patient infection from processed instruments decreases.
Low-level disinfection is neither sporicidal nor tuberculocidal, but is effective in killing vegetative bacteria. Intermediate-level disinfection is tuberculocidal, but may have limited virucidal and sporicidal activity. High-level disinfection destroys virtually all known pathogenic microorganisms, including mycobacteria and low numbers of highly resistant bacterial endospores. Sterilization, however, is defined as the complete destruction of all microbial life, including viruses and high numbers of bacterial endospores.
I can only conclude that one or more of the devices used on me were simply not sterile, and probably not even high-level disinfected. Whether this was the result of an accident or a purposeful flouting of procedure to save time will never be known. If it was the latter, sacrificing patient safety on the altar of cost savings would seem unconscionable to most people, but I have been assured that it occurs every day.
My research indicated that sterilization with ethylene oxide (EtO) is the preferred method for devices that cannot take the heat of steam. When I finally contacted Interscan (whose name came up in some of my searches) I spoke to a few of the people there about sterilization, nosocomial infections, and ethylene oxide. My near lethal infection could have been prevented, had the devices been sterilized with EtO!
So what have I learned from this horrific tale, a story that still leaves me angry at all those “prestigious” doctors, nurses and hospital administrators? I now know that a hospital’s fame or wealth is, for all intents and purposes, meaningless. The real criteria of success is a hospital’s passion for excellence, its commitment toward all people—its track record of personalized care and informed treatment. Never confuse prestige for standard of care, and never be afraid to ask questions.
After all, your life could be at stake.