Originally created 01/13/05

MCG scare halts VA surgeries



Elective surgeries will resume today at the Augusta Department of Veterans Affairs Medical Centers after a potential contamination scare at affiliated Medical College of Georgia Hospital and Clinics also forced the VA to close its operating rooms.

MCG Hospital learned Monday night that some equipment in the operating room of a brain biopsy last week was not subjected to more powerful sterilization techniques designed to combat Creutzfeldt-Jakob disease, a rare but always fatal brain illness. Even though the equipment was not used on the biopsy patient, and even though the patient was not suspected of having the disease, MCG shut down surgery while it subjected all of its equipment to the greater sterilization, officials said.

When the Augusta VA learned of the situation Tuesday afternoon, it also suspended surgeries because it sometimes shares equipment with MCG, said Jerry L. Brown, the acting chief of surgery. Emergency surgeries were diverted to Dwight D. Eisenhower Army Medical Center while the VA began its investigation, which found no cause for concern, Dr. Brown said.

"We've confirmed that no potentially contaminated instruments were used on any of our VA patients," Dr. Brown said. Emergency surgery was available Wednesday and the nonemergency schedule will resume today, he said.

No one could remember ever having to do something like this before, hospital epidemiologist Brian Catto said.

"Certainly we haven't had a problem with CJD before," Dr. Catto said. "Periodically it's a concern, but we have our protocol in place for handling patients where that's a concern. This is the first time as far as I'm aware of that we've had this kind of problem in our relationship with MCG."

It was new ground for MCG Hospital as well, and part of the delay in notifying the VA was caused by having to consult with the Centers for Disease Control and Prevention on what was the right course, said Ralph Caruana, the senior vice president and chief medical officer the health system.

MCG also had to search inventory lists before realizing that some of the equipment might be at the VA, he said.

"I have talked to the people at the VA, and I told them I regretted that they heard about it by some back pathway before they were formally notified," Dr. Caruana said.

Retrieving all of the equipment quickly also was an eye-opener, Dr. Caruana said.

"We had them at a dozen places under our own roof," he said, from clinic drawers to the crash carts in the patient care areas.

All of the precautions are looking less essential as the patient continues to improve and might be discharged Wednesday or today, Dr. Caruana said.

The more likely diagnosis now is acute demyelinating leukoencephalopathy, in which, for unknown reasons, the body's immune system attacks the protective sheath around the nerve cells and causes a brain inflammation. The condition is responding to steroids.

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.