A fifth patient involved in a bacterial outbreak this fall at Allegheny General Hospital has died, but hospital officials say the death was unrelated to contaminated bronchoscopes that are the subject of an ongoing investigation.
Allegheny General Hospital announced last month that Pseudomonas bacteria spread by contaminated bronchoscopes apparently caused a fatal pneumonia in one patient. In addition, nine patients were found to be "colonized," meaning that the germ was present in their systems but hadn't caused an infection. Three of those patients died from causes unrelated to the contamination.
The Allegheny County coroner's office has added the most recent death to its review of the outbreak, but has not yet ruled on the cause of death, said Joseph T. Dominick, chief deputy coroner. The coroner performed an autopsy on the latest case but is awaiting test results. He has relied on medical records to review the other cases.
So far, the coroner has agreed with all of the hospital's findings, ruling that the first three deaths in colonized patients were, indeed, unrelated to Pseudomonas, Dominick said. The coroner won't be able to rule for another week on whether the hospital correctly linked the pneumonia patient's death to the outbreak.
Bronchoscopes are small, flexible tubes about the width of a pencil that are threaded through a patient's nose or mouth into the upper airways and lungs. The scopes let doctors look into the lungs, suction out material and remove biopsy specimens.
The hospital's investigation, which is being run in conjunction with the state and local health departments, has not ruled out any of the three factors that experts say could have enabled the contamination: a bronchoscope defect, a problem with machines used to clean them or mistakes by the machine operators.
But the federal Food and Drug Administration, which regulates the marketing of both bronchoscopes and the machines used to clean them, has joined the investigation and focused questioning on the cleaning machines.
Hospital officials originally thought a total of 12 patients had been exposed to Pseudomonas during the outbreak. But Dr. Richard Shannon, chairman of medicine at Allegheny General, said that total was reduced to 10 because a further review of medical records revealed that two of the patients were colonized by the bacteria before undergoing bronchoscopy.
Christopher Snowbeck can be reached at csnowbeck@post-gazette.com or 412-263-2625.
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