Research suggests there's an epidemic of hospital patients who are dying not from the initial ailments that brought them to the hospital, but from microbial superbugs acquired while there.
That's the finding of a new Los Angeles Times report, backed up by several studies showing that infections would be listed as the number one cause of death in hospitals -- surpassing cancer and heart disease -- if hospitals accurately reported the cause of patient deaths.
If a person is admitted into a hospital and treated for a physical ailment, then catches a superbug and dies from the infection, the hospital will in most cases list the physical ailment, not the infection, as the cause of death on the death certificate, the Los Angeles Times report found.
That's what happened to Sharley McMullen, a 72-year-old California woman who went to the hospital for surgery on a stomach ulcer. While there, McMullen was infected with carbapenem-resistant Klebsiella pneumoniae, a deadly and drug-resistant strain of bacteria.
A doctor wrote “CRKP,” an abbreviation for the infection, on McMullen's medical chart underlining it three times, the Los Angeles Times reported.
After five weeks in the hospital, during which doctors tried and failed to treat the infection with antibiotics, McMullen died. Her death certificate lists respiratory failure and septic shock from the stomach ulcer, not the CRKP McMullen caught in the hospital, as the cause of death.
Shawn Chen, McMullen's daughter, told the Times she was outraged that the hospital didn't take responsibility for the infection that killed her mother.
“It should say she died of an infection she got in the hospital,” Chen said. “She was so hardy. She would have made it through if it wasn’t for this infection.”
Hospital staff, however, say McMullen wouldn't have caught the superbug if she wasn't in the hospital to treat the ulcer in the first place.
Most hospitals aren't doing enough to stop superbugs, according to a 2015 study by researchers from the University of Michigan Medical School and VA Ann Arbor Healthcare System.
The study surveyed 398 U.S. hospitals on their infection control protocols, and found that almost half did not have antimicrobial stewardship programs, which limit the use of antibiotics to avoid hastening the development of drug-resistant bugs.
Worse, about 75 percent of hospitals did not have policies to test for certain superbugs in patients who exhibited symptoms of infection, according to the study.
Another study, published earlier this year by researchers at the University of Michigan, found that one in four seniors carried "at least one multidrug-resistant organism" after a hospital stay. Those patients, like McMullen, were admitted for unrelated issues and acquired the infections from the medical facilities where they sought care.
Citing statistics from the CDC, the Times report noted that patients who died of sepsis -- "just one subgroup of the infections" -- were undercounted significantly.
An employee at the Los Angeles County public health department told Chen that the CRKP bug is "everywhere," as an explanation for why it wasn't reported as the cause of death. But infection control experts say many hospitals and health departments are too quick to cede responsibility for infections when there are more things they can do to maintain a clinical environment.
Hospitals don't have the incentive to do better -- and the scope of the problem is difficult to establish -- if deaths by infection are not accurately reported and there is no way to count the total number of deaths, the Times report said.
“We, the community of physicians, had been watching these patients die and trundling them off to the morgue for years,” Dr. Barry Farr, former president of the Society for Healthcare Epidemiology of America, told the Times. “Now we’re in the eighth verse of the same song.”
Dr. Robert Moellering, an infectious disease specialist at Harvard, told Time that patients can do little to avoid drug-resistant infections. Hospitals, he said, must institute good practices and follow CDC guidelines, which involve simple things like making sure medical staffers wash their hands to following proper quarantine and isolation procedures.
"It isn’t what you have to do," Moellering said, "so much as what the hospitals have to do."