Investigation into 74 deaths at Limerick Hospital

University Hospital Limerick

THE DEATHS of 74 University Hospital Limerick patients who tested positive for the CPE ‘superbug’ are the subject of an independent external investigation with 29 of those cases being referred to the Limerick coroner.

A whistleblower, who raised concerns about CPE, sent a list of 29 cases to Limerick City coroner, John McNamara. The whistleblower, who is a HSE infections control expert, is claiming that lives could have been saved if warnings had been listened to.

The same list was given to Minister Simon Harris last year and the whistleblower claims she was driven out of her job because of her actions.

Once CPE infects the bloodstream, it can be very difficult to treat and can lead to death in up to half of all patients infected.

Hospital management is drawing a clear distinction between patients who tested positive for CPE as carriers and those who were actually infected.

In a statement, a spokesman for the UL Hospitals Group said they recently completed their own internal review and had commissioned an independent external review by a senior microbiologist from the UK.

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“The Group looks forward to sharing the findings of both reviews with the coroner and other interested parties,” the statement said.

UL Group is examining 74 cases where patients with a CPE detection subsequently died.

The distinction between those colonised with and carrying CPE and those infected with CPE is a crucial one”, the statement continued. 

“Infection relates to the presence of micro-organisms in the body causing adverse signs or symptoms. Healthy people usually do not get CPE infections. These usually occur in patients in hospitals, nursing homes, and other healthcare settings. Patients whose care requires devices like ventilators; urinary or intravenous catheters; and patients who are taking long courses of certain antibiotics are most at risk for CPE infections.

“The management of multi-drug resistant organisms through infection prevention and control (IP&C) procedures and proper antimicrobial stewardship is taken with the utmost seriousness by UL Hospitals Group. Antimicrobial resistance is one of the most serious challenges faced by health systems all over the world. UL Hospitals Group welcomes the establishment this week by the Minister for Health of the Public Health Emergency Team on CPE.” 

The statement said that the UL Hospitals Group accepts – and has acted on – the critical findings on hygiene referred in two HIQA reports.

“The Group also draws attention to HIQA’s positive assessment of the screening and other mitigation measures around CPE within the Group”.

Between January 1, 2009 and May 31  2017 there have been 193 confirmed new detections of CPE in the Mid West. Of these, 166 cases related to patients from UL Hospitals Group and 27 from the community.

The hospital group spokesman pointed out that the fact that CPE was detected in hospital does not mean that’s where the patient was infected or colonised.

“High numbers of detections are to be expected within UL Hospitals as the group has a comprehensive screening programme in place.”  

“The vast majority of the cases detected in the Mid West relate to CPE carriers, where the organism is living harmlessly in the gut.

“UL Hospitals Group says it is fully cooperating with Limerick City Coroner on this matter. The new emergency department at UHL is designed very much with infection prevention and control in mind and facilitates the management of relevant patients in en-suite isolation rooms,” the statement concluded.

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