Clarification (posted June 4, 2016): This story has been updated to clarify and correct the following: There was only one anteroom built in the ICU, not two. The anteroom that Mr. Meyers and his client saw in the ICU was not a permanent structure, but, rather, a device designed to contain construction dust for construction being done in the corridor between the two negative pressure rooms.
A transplant patient at UPMC Montefiore has contracted a mold infection of the same type – and possibly under similar circumstances - that infected four UPMC transplant patients in 2014 and 2015 and led to an ongoing federal investigation, according to the man’s attorney.
Dan Krieg, a 55-year-old former truck company scheduler from St. Marys, Elk County, had a kidney transplant in July at Montefiore and was readmitted in late March after contracting pneumonia outside the hospital, his Pittsburgh attorney, Jerry Meyers, said today.
Mr. Krieg was recovering in the hospital in April when he contracted another infection that hospital records provided by Mr. Krieg’s family show was caused by mucormycosis mold, the same type that infected the prior patients at UPMC Presbyterian. UPMC said it is still testing to confirm the latest diagnosis.
Mr. Krieg was at first placed in a “negative pressure” room – normally reserved for patients with an infectious disease - because there were no neutral pressure rooms available for him.
The federal Centers for Disease Control and Prevention said in its preliminary report last year that three of the four prior patients died after contracting a mucormycosis mold infection that they may have contracted because they stayed in a negative pressure room at UPMC Presbyterian.
UPMC was not the only transplant hospital in the region with mold infections in recent years. Allegheny General Hospital reported last year that it had two mold infections of transplant patients in 2014, and one of them died, though the AGH cases were unrelated to the UPMC cases. AGH also had a heart transplant patient contract a mold infarction last fall and the patient is doing well, a spokesman said.
In the UPMC case, the CDC determined that because negative pressure rooms are designed to prevent infectious patients’ germs from getting out of the room, the room at Presbyterian potentially pulled mold spores into the room, infecting those three patients.
The CDC advised UPMC to no longer house transplant patients – who are significantly immuno-compromised and vulnerable to mold infections – and UPMC said then that it immediately complied.
Mr. Krieg’s case “reveals a health care operator who believes it’s above the law,” Mr. Meyers said. “Why would you put an immuno-compromised patient in a negative pressure room” after the CDC said not to?
UPMC said Mr. Krieg was only kept in a negative pressure room in the transplant intensive care unit at Montefiore for 30 hours, and the room’s negative pressure was not in use while he was in it, “though it has that capability,” UPMC said, in part, in an emailed statement.
Mr. Meyers said the family remembers being in the negative pressure room, where the door was regularly left open, for up to four days, before he began to improve and was moved to another area of the hospital.
When the new mold infection took hold and he had to return to the intensive care unit, he was not placed in the negative pressure room, Mr. Meyers said.
When the family returned to the hospital Friday, a metal anteroom door had been built on the outside of the corridor linking the two negative pressure rooms.
“If the [negative pressure] rooms operate the way they say” and the negative pressure can be turned off, Mr. Meyer said, “then why did they suddenly in 24 hours build this monster anteroom?”
UPMC said in its statement that the construction of the anterooms was part of “routine maintenance in a corridor of the transplant ICU, following all proper infection prevention precautions. The work is not related to any mold issues on the unit.”
UPMC said the anteroom was built to contain construction dust on the ICU while construction was ongoing in the corridor that links the two negative pressure rooms.
UPMC said it has been in touch with the county and state departments of health and is consulting with them about Mr. Krieg’s case.
Mr. Krieg is in critical condition and is scheduled to have the mold-infected, lower left lobe of his left lung removed in surgery Monday.
UPMC said: “Our physicians and nurses are working diligently and compassionately to care for Mr. Krieg and his family.”
Sean D. Hamill: shamill@post-gazette.com or 412-263-2579 or Twitter: @SeanDHamill
First Published: June 4, 2016, 1:25 a.m.
Updated: June 4, 2016, 9:16 p.m.