Outbreak blamed for death

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PHIL.HOSSACK@FREEPRESS.MB.CA Brenda Meyer, with her brother, Steven Robertson, holds a portrait of their dad, Dixon Robertson.

Health officials are investigating whether the death of a 77-year-old man who suffered severe complications from a blood infection is linked to an outbreak of Serratia marcescens at the Seven Oaks General Hospital emergency room.

Brenda Meyer's father, Dixon Robertson, was only supposed to be in hospital for two weeks to repair a hip fracture, but wound up spending eight months in hospital after he contracted Serratia marcescens at Seven Oaks hospital last August.

Meyer contacted the Free Press this week after an article on the Serratia marcescens outbreak said health officials reported no deaths were attributable to the outbreak.

In total, 47 patients who had a small intravenous catheter inserted in their hands or arms to administer fluids developed bloodstream infections at the Seven Oaks ER in 2009, including two patients who died. Health officials said their deaths were due to underlying health conditions.

Meyer said her father's health began to deteriorate after he arrived at the Seven Oaks ER on Aug. 6, 2009. She wants health officials to apologize for "downplaying" the impact of Serratia marcescens on patients.

Meyer said doctors discovered her father contracted the blood infection in his hip following surgery to repair a fracture and a hospital physician told her he was one of several patients who fell ill with Serratia marcescens.

She said her father's hip never healed properly due to complications from the infection and his condition continued to worsen until he died on April 4, 2010.

Robertson's relatives gave health officials permission to discuss details of his case with the Free Press.

Winnipeg Regional Health Authority spokeswoman Heidi Graham confirmed officials reviewed Robertson's chart on Thursday and have launched a critical incident investigation.

She confirmed Robertson's case is not one of the 47 original cases of Serratia marcescens included in the outbreak statistics, but said officials are reviewing it to see if it is connected to the ER outbreak.

Graham sent the Free Press an email statement saying, "We believe the cause of his death is not directly attributed to Serratia marcescens. Mr. Robertson was a very sick patient with a number of serious chronic underlying conditions."

She said officials are investigating "issues arising from his prolonged hospital stay as a critical incident."

The email statement said Robertson died from congestive heart failure and pneumonia. It said Robertson was diagnosed with a post-operative Serratia marcescens wound infection seven months prior to his death and it was successfully treated with a course of antibiotics.

But his daughter disagrees.

"It was all complications from that infection, because otherwise, his hip would have healed properly," Meyer said.

"Do not say this is not associated or related or downplay what this infection did, not only to me, but to those other two (families) who lost family members. For them to downplay something like this, it just makes me sick."

If Robertson's case is found to be linked with the outbreak in the community hospital's ER, it would be the only critical-incident investigation related to Serratia marcescens. Officials previously said patient-safety and medical experts reviewed the outbreak and determined there were no critical incidents.

Meyer said her father received intravenous fluids at the Seven Oaks ER prior to surgery to repair his hip. Several days after surgery, she said, doctors ran tests to determine what was causing the redness in his hip area and determined a Serratia marcescens blood infection was the culprit.

Meyer said her father was in tremendous pain and developed a blood clot and collapsed lung from lying in bed. She said he stopped eating due to the pain and eventually underwent a hip replacement after doctors said repeated attempts to "flush out" the infection didn't help.

Meyer said the infection was "stuck" to the hip-repair device and the infection stopped the blood flow to the head of his femur.

Her father went into shock before the surgery was complete and was put on life-support. She said he suffered bladder complications from the surgery and could not speak or communicate due to a tracheal tube that was inserted less than three months before he died.

Meyer said she wants health officials to acknowledge families and patients suffered due to the blood infection. Graham said officials apologized to the family on Thursday.

"I don't want a lawsuit, I don't want money, I just want my dad back," Meyer said, tearing up. "I want them to acknowledge it, to say, 'we made an error.' "

jen.skerritt@freepress.mb.ca

What is Serratia marcescens?

Bacteria that can cause fatal blood infections, but can be treated with antibiotics.

What happened last year?

In December 2009, Winnipeg Regional Health Authority officials publicly asked anyone who had recently received intravenous medication at the Seven Oaks emergency room and was suffering flu-like symptoms to see a doctor. They said staff detected an outbreak of Serratia marcescens at the end of summer. The outbreak began in January 2009, and 20 patients were infected before officials detected the increasing number of cases. An outbreak report said the suspected source was "environmental" and health officials tested pre-filled syringes containing heparin or saline and water for potential contamination.

What is happening now?

WRHA officials are investigating to see whether Dixon Robertson is the 48th case. WRHA officials reviewed his chart after they were contacted by the Free Press.

Republished from the Winnipeg Free Press print edition August 6, 2010 A3