Medical Malpractice (Adverse Events) & Virus Spreading At Scarboro General Hospital in Toronto

SCARBORO GENERAL HOSPITAL: Scarborough General Hospital in Toronto (Scarboro), Ontario, Canada, is becoming known for it's medical incompetence, malpractice & virus spreading environment (poor infectious disease control) by contributing to patients premature deaths & unnecessary suffering. I just returned from my mother-in-law's (Mona MacKenzie) funeral (February 2001). In August of 2000 she had back surgery done at Scarborough General Hospital by Dr. Michael Chapman & was recovering nicely in hospital for the first 12 days, at which point she informed the staff that she was starting to take a turn for the worse. They did a culture of her wound on Wednesday & the results came back 2 days later (they probably could have rushed the results back much sooner). It turned out to be a "staph" (staphylococcus) infection which seems rampant in Toronto hospitals, but they still did NOTHING for 2 more days (total 4 days of doing nothing), possibly because it was almost the weekend (mid Friday afternoon) & they couldn't reach her surgeon Dr. Chapman & the staff didn't bother to get the resident doctor on call to approve treatment. There definitely appears to me to be an attitude of the part of the hospital staff that they would rather make a patient wait (& possibly die), rather than make a medical decision themselves, or ask another doctor to do it. Seems that doctors are feared or treated as God's in this hospital by the nursing staff, much to the detriment of the patients. I do not understand this patriarchal stronghold in the medical system because most nurses are well trained & capable of making good decisions if empowered to do so, but the doctors clearly aren't empowering the nurses to make important decisions & the nurses clearly aren't willing (read scared) to do an "end run" around the doctors when the doctors fail to do their job or respond in a timely manner. On the 4th day after my mother-in-law informed the hospital that there was a problem, they finally put her on antibiotics (after I strongly insisted they do something), but by this time it was a full blow raging infection & she was so sick that she had to stay an addition 6 weeks in the hospital before being released to recuperate at home. The next 4 months at home were extremely painful & miserable for her. Because of the severe staph infection, she wasn't even able to walk for about 4 months after the operation & all her muscles were atrophied (shrunk in size) from the forced inactivity (this affects the heart muscle too). In mid February 2001 she got a strain of the flu (even though she had been given a flu shot) & about 6 days later, she was so weakened from her previous condition, weakened heart muscle & the current flu that she had a heart attack & passed away. I am convinced that had Scarboro General Hospital taken pre-emptive action by putting her on broad spectrum antibiotics as soon as it was evident that there was a problem, or had they rushed the culture test & got her on infection specific antibiotics within a day, rather than 4 days later, she would have been completely recovered from her back surgery by mid winter & would not have died from the weakened condition & having the flu. My mother-in-law was only 78, in excellent shape before the surgery & had many good years left to enjoy (her mother lived to be 96). At the funeral I was told of a least two other people who also recently died as a result of complications resulting from similar incompetence over a staph infection at Scarborough General Hospital.

As a point of interest, I personally witnessed the hospital staff sharing a portable toilet between another patient & my mother-in-law, without first wiping it clean with a disinfectant. It should come as no surprise, that under these third world conditions, patients get unnecessary infections. I've been to several developing nations & seen their appalling lack of appropriate sanitation standards & I saw the same lack of sanitation standards at this Toronto hospital (Scarboro General Hospital). I once assumed that part of the problem might be immigrants from developing nations working in our hospitals without being fully trained or with lifelong bad habits of sanitation, but many health care workers have made me aware that we have plenty of our own home-grown (born in Canada) incompetent medical professionals. Don't believe the Federal or Provincial governments when they try to convince the public that we are not facing a health care crisis in our hospitals in Ontario. The level of care in many hospitals in Ontario has slipped to an appallingly low level & unless you have a loved one there every day advocating for the patients best interests, you can count on getting substandard medical treatment. The medical staff of course try to pin the blame on insufficient government funding & some of that may be true given our governments record in recent years of severely cutting medical funds. The real problems here were an unclean hospital environment that allowed the spread of the staph infection & that Dr. Chapman wasn't returning his pages/phone messages which would have alerted him to the problem & the nursing staff refusing to go over his head to make a decision themselves, or call in another doctor to provide timely treatment. This medical incompetence at Scarborough General Hospital not only cost the health care system a lot of extra money because of a 6 week longer stay in the hospital & home nursing care for months afterward, but it cost my mother-in-law her life & my family an awful lot of unnecessary grieving & anxiety (in fact it contributed to tearing apart my family permanently). First published March 3/2001, last updated March 2/2008

April 24/2003 follow up. Today the World Health Organization (WHO) took the unprecedented position of slapping a travel alert on Toronto, recommending that nobody travel to Toronto because of the outbreak of Severe Acute Respiratory Syndrome (SARS) viral infection in some Toronto hospitals (including Grace Scarboro General Hospital) & a few non hospital areas of Toronto. Canadian politicians are furious because of the ramifications this will have on tourism & the Canadian economy, but they should have been more diligent & done more than the bare adequate amount of infectious disease control to keep SARS from spreading & being exported to other countries from Canada. In my opinion, the WHO appropriately recognizes that hospitals & other officials in Toronto simply haven't done an adequate job. I'm not surprised, because as my article above explains, spreading of viruses & bacteria is very common in Toronto hospitals because of inadequate sterilization & containment. As a Canadian, my congratulations go to the World Health Organization for taking the stern position that they have. Maybe now that the WHO has drawn attention to the problem in Toronto Hospitals, others will start to see what I saw over two years ago when my mother-in-law died because of the same lack of appropriate cleanliness, containment of bacteria & viruses for infectious disease control in a Toronto hospital.

May 25/2004 follow up. Today in the Canadian Medical Association Journal was a study from the University of Toronto & other universities regarding "adverse events" of all types, caused by Canadian hospitals. The definition of an "adverse event" is an unintended injury or complication that results in disability at the time of discharge, death or prolonged hospital stay and that is caused by health care management rather than by the patient's underlying disease process (in other words, medical malpractice or medical incompetence). Highlights from this study indicate that 7.5% of admissions to acute care Canadian hospitals result in adverse events & you have a 1.6% chance of dying from an adverse event when admitted to an acute care hospital. The researchers said that 36.9% of adverse events were potentially preventable & possibly as much as 51% (conservatively at 36.9%, that's 70,000 preventable adverse events across Canada each year & 20.8% of those resulted in death, or an average estimate of 14,560 unnecessary deaths each year from all types of Canadian hospital induced adverse events) (Centers for Disease Control had previously estimated 50% of adverse event deaths from infection were preventable). The CMAJ study estimated the unnecessary deaths each year in Canadian hospitals to be between 9,250 - 23,750. Clearly an estimate of 14,560 deaths is a conservative realistic figure & the unnecessary death toll each year might be higher. This just blows me away to find out how many unnecessary deaths there are in Canadian hospitals each year. The events of 911 pale in significance to this. Of particular interest was that 57.1% of adverse events were caused by failure to carry out necessary diagnosis or treatment & 42.9% were caused from errors of commission (incompetence). In other words, NEGLIGENCE caused the bulk of the deaths, just like what happened in my mother-in-law's case where they failed to do anything in a timely manner. Also of interest was the fact that the results were not out of line with those found in several other developed countries & nearly identical to those of the United Kingdom, which tends to validate the Canadian study.

Nov. 29/2007 follow up. The Canadian Institute For Health Information has designed a "hospital standardized mortality ratio" (HSMR) which says that Scarborough General Hospital has the worst mortality rate of all hospitals in Toronto & 3rd worst in all of Canada.

Feb. 29/2008 follow up. Today the CTV W-FIVE did an hour follow up documentary on Scarborough General Hospital about another doctor who has damaged many patients and been sanctioned. The full video is viewable online and called RIGHT TO KNOW because it suggests that the public has a right to know the competence level of the surgeons that operate on them.

One other note. Studies show that Canada spends more money per person on health care than any other industrialize nation, yet we rank 15th in the quality of our health care. That tells me the situation isn't going to be solved by more money, it's about more efficient use of money & getting those incompetent health care professionals out of the business, so the cost of treating medical malpractice goes down.

LINKS

http://www.cnn.com/2007/HEALTH/conditions/10/16/mrsa.cdc.ap/index.html CNN article: “CDC: Drug-resistant staph deaths may surpass AIDS toll”
http://www.consumersunion.org/campaigns/stophospitalinfections/newsroom.html News articles on hospital infections.
http://www.consumersunion.org/campaigns/stophospitalinfections/learn.html other people's stories. 
http://cu.convio.net/site/PageServer?pagename=SHI_shareyourstorypage Share your story of your hospital acquired infection.
http://www.cbc.ca/fifth/donoharm.html CBC "The Fifth Estate" documentary February 16/2005 on Adverse Events.
http://www.hc-sc.gc.ca/english/care/cpsi_2.html Health Canada's Canadian Patient Safety Institute (CPSI).
http://www.iom.edu/Object.File/Master/4/117/0.pdf  A U.S. report on building a safer health care system.
http://www.patientsafetyinstitute.ca/index.html Patient Safety Institute.
http://www.apic.org//AM/Template.cfm?Section=Home Association for Professionals in Infection Control and Epidemiology
http://www.cnn.com/2009/HEALTH/07/09/hospital.acquired.infections/index.html CNN article about hospitals preventing hospital-acquired infections.

http://www.cnn.com/2012/08/01/opinion/gupta-medical-mistakes/index.html?hpt=hp_c2 Aug 1/2012 CCN article about doing no harm.

By Doug Hembruff.