Sharley McMullen, a 72-year-old former resident of Manhattan Beach, was a patient at Torrance Memorial Medical Center in May of 2014. She was there to receive treatment for a bleeding stomach ulcer, but developed a fever hours after leaving the operating room. Five weeks of intensive care, countless antibiotics, and morphine to dull the pain later, McMullen died from septic shock and respiratory failure caused by the ulcer – at least, that’s what was written down on her death certificate.
According to McMullen’s daughter Shawn Chen, her mother’s death certificate was missing a key piece of information.
“It should say she died of an infection she got in the hospital,” Chen said to the LA Times. “She was so hardy. She would have made it through if it wasn’t for this infection.”
McMullen’s medical chart backs up Chen’s claims. On it, a doctor wrote down CRKP, underlining it three times for emphasis. CRKP, or carbapenem-resistant Klebsiella pneumoniae for long, is one of the most lethal superbugs in the world – as many as half of the patients suffering from this bacterial infection die after they develop sepsis when the disease spreads to their bloodstream. Sepsis triggers an inflammatory response from the patient’s body, which can severely damage their organs and cause them to fail.
As terrifying as this disease may be, California, as well as another two dozen or so states, doesn’t require doctors to report when patients are affected or killed by it. In fact, they aren’t required to report when their patients are sickened by any type of hospital-acquired infection like CRKP.
When Chen attempted to report her mother’s infection to the Los Angeles County public health department, she told the LA Times that the department informed her that CRKP was not a reportable infection. According to county health officials, they stopped requiring health facilities to report carbapenem-resistant enterobacteriaceae (CRE) infections – the classification of infection CRKP falls under – back in 2012 because of “resource limitations.”
The United States Centers for Disease Control and Prevention (CDC) estimates that 75,000 patients die from CRE infections every year, but some experts argue that the actual number of deaths may be far higher. In fact, just this March the CDC estimated that up to 140% more Americans die every year from sepsis than are reported on death certificates, or up to 381,000 additional deaths each year. Another study suggested that approximately 140,000 patients die from healthcare-acquired sepsis each year. Sepsis only makes up a fraction of hospital-acquired infections.
Another patient, Nile Moss, went to Children’s Hospital of Orange County in 2006 to receive an MRA before unexpectedly dying at the age of 15 from methicillin-resistant Staphylococcus aureus (MRSA), one of the most common types of hospital-acquired infections days later. However, his death certificate didn’t reflect this information discovered during his infection. Instead, his death was attributed to adult respiratory distress syndrome, septic shock, and pneumonia.
“Doctors have the ability to write whatever they want,” Carole Moss, Nile’s mother told the LA Times. “Many people are angered by this. They cause the harm and then cover it up.”
Experts say that one of the main reasons doctors are so hesitant to include hospital-acquired infections in public records is the possibility of malpractice lawsuits. Whether or not doctors are worried about being held accountable, one study suggests that medical errors account for more than 250,000 deaths every year in the United States. Only heart disease – 611,105 lives claimed in 2013 – and cancer – 584,881 lives claimed in 2013 – account for more.
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