Ambulatory Surgical Center Infections: Awful Headlines in NJ

Here is a sampling of the recent television news and news paper headlines in New Jersey.

New law suits, some of them class actions. Reports of Hepatitis B infections. Lawyers and patients standing in front of TV cameras.

It’s been five weeks since the first stories broke about the HealthPlus ambulatory surgery center (ASC) in Saddle Brook, New Jersey. The headlines are still running.

New Jersey, which has more ASCs than either of its bigger neighboring states, New York and Pennsylvania, is reeling from this continuing news onslaught. How are physicians and patients and regulators processing the news? Will it affect other ASCs, not just HealthPlus?

The HealthPlus story broke in late December, when New Jersey reporters learned that the state Department of Health had issued a shut-down order after inspecting a HealthPlus location on September 7.

The facility was forced to send letters (just before Christmas!) to 3,778 former patients, saying they might have been infected with HIV, Hepatitis B, and/or Hepatitis C due to a wide range of bad infection control procedures in operating rooms and in the sterilization of surgical equipment and supplies.

So far, very few patients have claimed infections, but hundreds are seeing lawyers.

The negative headlines and social media publicity continue

Now, as of January 30, 2019, googling “healthplus surgery center in saddle brook” showed these headlines for the first five hits:

“HealthPlus Saddle Brooke NJ – See If You Have A Legal Case”

“Patients at surgery center wait to learn if they have HIV, hepatitis”

“Saddle Brook surgery center patients question handling of HIV tests”

“Lawsuit filed against NJ surgery center that exposed patients to HIV”

“N.J. Surgery Center Sued After 3,778 People Possibly Infected With …”

And the last two headlines are about different lawsuits. The horrifying mainstream news media headlines and news stories are the least of the consequences—but they’re certainly bad for anyone thinking about the business end of an ambulatory surgery center in North Jersey.

It gets worse if one digs in and reads these news stories. Here’s an example, a sub-headline and three paragraphs from a December 29, 2018 news story about the September 7 state inspection:

“‘Rust-like stains’ and a bloody sheet”

“Among the most alarming findings in the state’s report: Operating rooms at the facility were not properly cleaned and disinfected between procedures, upping the chances of exposure to dangerous diseases. According to the report, surgical tools were sometimes discovered with “brown rust-like stains” just before use.

“In one instance, a state inspector observed a stretcher in a hallway with a blood-stained sheet that wasn’t properly disinfected even after the inspector pointed out the problem to staffers.

Most troubling, a HealthPlus employee told a state inspector that ‘due to the high volume of procedures, surgical trays were not always allowed to dry in sterilizers before being used.’”

That gruesome story is at this URL.

Social media, too, are crucifying HealthPlus. Search “HealthPlus surgery center” on Facebook or Twitter, and literally all you’ll see is post after post and tweet after tweet about the infection issue and lawsuits, as recently as January 17.

Even worse than the news headlines, if one can digest the bureaucratic fine print, is the 34-page New Jersey Department of Health report arising from the September 7 inspection, titled, “Statement of Deficiencies – Citation Summary Sheet.” It’s posted at the state website for anyone to read and will probably be there for years. It cites literally dozens of problems with infection control, such as:

• During the September 7 visit (when staff knew they were being watched), state inspectors saw “At 10:40 AM, Staff #19 was observed preparing two (2) parenteral medications in OR #3. a. Staff #19 failed to perform hand hygiene prior to handling the medication.”
• During both operations and sterilization, they saw personnel working with facial hair not fully covered by masks.
• They saw surgical instruments with rust on them and debris in hinges.

Oxycodone, fentanyl, Versed, hydromorphone missing

The state inspection report also says that “Staff #18″ had a habit of “wasting” (that is declaring to be wasted) supplies of fentanyl on multiple occasions, and that oxycodone, Versed, Midazolam, and hydromorphone also disappeared from inventories without proper documentation. HealthPlus acknowledged that opioids had disappeared, and said it fired some people to deal with the problem.

Corrective action doesn’t stop the horrible publicity

Management at the surgery center quickly implemented a detailed set of corrective actions, and the state let the surgery center reopen on September 27. However, this is being written at the end of January, and the destructive publicity shows no sign of abating. Former patients were making the news early this month, saying they’d tested positive for Hepatitis B infections after procedures at HealthPlus.

On January 17, one of the attorneys who filed patient lawsuits against HealthPlus, Michael Maggiano, held a televised press conference to keep the story in the news.

In that conference, Maggiano cleverly added two new themes to the story: victimization of minorities and a New York City angle. He said at that conference that about half of the 200+ former patients who contacted his law firm are Spanish-speaking and about half are residents of New York City. Both themes widen the press coverage.

The owner of HealthPlus, Long Island, New York, real estate mogul Yan Moshe, also owns Hudson Regional Hospital in Secaucus, New Jersey, and an ambulatory surgery center in Hackensack, New Jersey, Bergen County. One implication of co-ownership for hospitals which acquire ASCs is that the assets of a bigger entity like a hospital might be at risk for liabilities of a smaller one, such as an owned ASC.

The bottom line: in this era of superbugs, headlines about infections are among the hottest news stories the mainstream media publish.