Forsyth Medical Center says 18 patients exposed to deadly disease

FORSYTH COUNTY, N.C. – Novant Health Forsyth Medical Center announced Monday they are reaching out to 18 neurosurgery patients exposed to Creutzfeldt-Jakob disease, a degenerative neurological disorder that is incurable and invariably fatal.

“Today we are reaching out to 18 neurosurgery patients who were exposed to Creutzfeldt-Jakob disease over the last three weeks at Forsyth Medical Center,” said Jeff Lindsay, President of Forsyth Medical Center.

According to the National Institute of Neurological Disorders and Stroke, Creutzfeldt-Jakob disease (CJD) is a rare, degenerative, invariably fatal brain disorder.

CJD affects about one person in every one million people per year worldwide.

“While the CDC categorizes such risks as “very low,” any risk of transmission is simply unacceptable,” said Lindsay. “On behalf of the entire team, I apologize to the patients and their families for this anxiety. We are committed to providing support to patients and their families.”

CJD has been closely associated with mad cow disease (Bovine spongiform encephalopathy), however Dr. Jim Lederer said this particular strain is not associated with mad cow disease.

“The patient had sporadic CJD. This is important to note, because it is often incorrectly associated with mad cow disease. It is not,” said Dr. Jim Lederer.

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Dr. Jim Lederer of Forsyth Medical Center (WGHP)

“On January 18, an operation was performed on a patient with symptoms that could have been attributed to CJD. There were reasons to suspect this patient may have CJD. As such, extra precautions to clean equipment should have been taken but it was not,” said Dr. Jim Lederer.

Forsyth Medical said the exposure occurred through surgical instruments that were not properly sterilized.

The surgical instruments used during the surgery were sterilized using standard hospital procedures, however they were not subjected to the enhanced sterilization procedures necessary on instruments used in confirmed or suspected cases of CJD.

“I have a two year old to live for and mommy might not be here,” said Amanda Morin, who entered Forsyth Medical Center last month for back surgery. She says a hospital staff member contacted her Monday saying she is one of 18 patients who may have been exposed to the disease. “[Novant staff member] say that it’s not the hospitals fault but they are taking full responsibility.”

patient

Amanda Morin was contacted Monday by hospital officials, saying she is one of 18 patients who may have been exposed to the disease.

Morin says the unknown is what will keep her awake at night for decades to come. Doctors say it is rare that the exposed patients will develop the disease, but if the disease surfaces in patients it likely won’t happen for 20 to 30 years.

“I am angry; very, very angry something so little could cost me my life. I want grandkids; I want to be there for them.”

Novant Health says they will keep tabs on the health of the 18 patients watching for any signs of the disease for the rest of their lives.

According to the CDC, prions, the infectious agent of CJD, may not be inactivated by means of routine surgical instrument sterilization procedures.

The World Health Organization and the US Centers for Disease Control and Prevention recommend that instruments used in confirmed or suspected CJD cases be immediately destroyed after use; short of destruction, it is recommended that heat and chemical decontamination be used in combination to process instruments that come in contact with high-infectivity tissues.

According to the CDC, no cases of iatrogenic transmission of CJD have been reported since 1976, when current sterilization procedures were adopted.

“We believe the chances of transmission to another person is very, very low,” said Dr. Jim Lederer.

The operation at Forsyth Medical was performed on a patient that was “suspected and later confirmed” to have sporadic CJD.

In a news conference, Forsyth Medical officials said the disease has no cure and may not show up in exposed patients for decades.

CJD usually appears later in life and runs a rapid course. Typically, onset of symptoms occurs about age 60, and about 90 percent of individuals die within 1 year.

In the early stages of disease, people may have failing memory, behavioral changes, lack of coordination and visual disturbances. As the illness progresses, mental deterioration becomes pronounced and involuntary movements, blindness, weakness of extremities, and coma may occur.

The Department of Health and Human Services issued a statement on Monday.

“DHHS officials are aware of the incident at Novant Health Forsyth Medical Center and have been in contact with the facility.  Our primary concern is the health, safety and welfare of patients, and we will continue to closely monitor the situation” said Kevin Howell, DHHS spokesperson.

49 comments

    • Deidre

      My dad had the same thing happen there in November of 1997. It got into his heart and nearly killed him. This must be bad.

  • FaithC

    “Forsyth Medical said exposure occurred through surgical instruments.”

    I wonder what exactly that means? They did not say how this is spread.

    • Chris

      Prions are the abnormal protein in spongiform encephalopathies (such as mad cow) and they are not eliminated in standard sterilization procedures. Luckily it usually takes a long time for someone’s brain to be significantly deteriorated by this.

    • Fran

      It means the surgical instruments ( tools )were not properly sanitized or cleaned and the disease could have been spread to others through using those instruments ( tools ).

    • Lee

      The same way any disease is spread, Dirty infected things coming into contact with open wounds or a break in the skin.

  • Wally the Engineer

    I’m guessing that they can’t guarantee that intense high heat will kill the prions that cause this disease. SCARY stuff! Any of those surgical instruments need to be melted down and buried.in Cement.

  • Chris

    Unfortunately for Novant, it wasn’t known until recently that standard sterilization procedures do not clear prions.

  • Janet

    We had a patient who had this. She had some vague symptoms starting in April. They thought it was an inner ear problem. She declined quickly and died in October. Only 6 months later. This disease can sit dormant in your body for DECADES before you start having symptoms. It is like being a walking grenade!!! Very scary stuff!!!

    • indyrose

      There were two cases some time ago that patient donated corneas and was later found to be sporadic CJD. The transplanted corneas caused the two recipients to rather quickly come down with CJD since it was almost like injecting it directly into the brain. Some cadaver dura grafts have caused the same problem. I am thinking that the first surgery patients after the infected ones have the highest risk, due to “viral load” so to speak then risk tapers off. Seen many patients with the disease over the years, crappy way to do medicine when it was easy to clean the stupid instruments.

  • Laurie

    How emotional heartbreaking and terrifying for these patients and their families waiting and living with the fear of if they were exposed or when will they show signs of having CJD???
    Wow unbelievable!!!

  • rob

    my mother in law had this!!! very very serious… declines in months and and death will occur with inside one year!!!! the fast thing I’ve ever seen!!!!! one day walking three days later in a wheelchair a week after that bedridden in the later stages… one day feeding there self three days later can’t get the spoon to there mouth!!!! can be contracted though brain matter and spinal fuilds…. they done an autopsy at Duke and sent the body back sealed and suggested cremation only!!! some states require cremation as a state law!!!! it is human form of mad cow disease!! can incubate in your body 50 years..without symptoms !! comes out between 60-65 she died ess than 30 day after her 65th birthday!

  • The One

    Isn’t there safeguards in place to stop something like this? I can only think of Incompetence, ignorance, and stupidity. Makes one think of affirmative action programs set in place years ago that are now catching up with us.

    • JOE BLOW

      THANK U. THE ONE
      Did the drs get exposed too so they can suffer for ther mistakes.Pay up FMC so people can at least b compensated for there exposier.sorry doesnt fix problem!!Thoughts and prayers w paitents and familys.

      • YouDon'tReallyKnowWhatYou'reTalkingAbout

        Actually, the person at greatest risk (besides the unfortunately fellow who had CJD) was the neurosurgeon and assistants in the operating room performing the procedure. I’m glad you are a compassionate human being who wishes misfortune onto others. It restores my faith in humanity. God forbid you actually had some medical knowledge about the transmission of CJD and the extremely low low low low likelihood of transmission in this case. You do more dangerous things everyday and don’t think twice.

    • The Twisted Truth

      Your post is very ironic, given that your grammar is incorrect. How you are making any connection between affirmative action and this is quite a leap. You show about as much decency as the gentleman below who wishes that the doctors working on the patient be harmed so they can “suffer for their mistakes.”

  • Allison

    What if the hospital had never said a word about the “possible” contamination?? They could have said nothing! They are at least trying to do right by the 18 patients that have a very low chance of contracting the disease.

    • Renee Hines

      I agree with Allison. At least the hospital took the initiative to call a press conference. They did so with the knowledge that they were going to make themselves look bad and possibly set off several law-suits! Not an easy thing to do….taken ownership for their (potientially deadly and devastating) mistake. At least give them credit for being honest and upfront about it.

    • Tammy

      They did know, and did nothing.they tested him for this on the 18th, and my Daughter surgery was on the 29. she is only 27, and told her and us not to worry about the bill for her surgery. Amanda is my daughter, people dont know all the facts here.

  • janie

    I had a heart cath there in 2005 and developed a staff infection. I was very sick for 3 months. I blame it on laziness of the staff. If they were doing their jobs the way they are supposed to these problems wouldn’t be happening.

  • Tina Hicks

    My mom was flown there by helicopter on January 21st 2014 because she had a stroke and they operated on her brain the 22nd. She was recovering well and all of a sudden she quit responding at all. So I know they are saying the 18th and it takes a while to progress but if the instruments were infected and you operate on the brain how long does it take?

    • Jeff

      To Tina Hicks,

      I am very sorry to hear about your mother.

      My mother in law died of CJD (in fact I may know Rob that replied earlier). CJD takes months to deteriorate the brain. It is not a disease that would kill a person in a day or two. Thus, even if they used the non-sterilized equipment on your mother, CJD would not have been the cause of your mother’s sudden down turn.

  • CJ

    How much money did they think they were saving, by not sterlizing the equiptment properly? Well, NOW it will cost them millions. How terrible for those patients.

    • The Twisted Truth

      This report is not accurate. The instruments were not sterilized to the level needed TO KILL THE CJD. This is not standard at any hospital. The process to kill CJD is much more involved. It was not known at the time that the patient had CJD. The instruments were sterilized just like any other hospital would have sterilized them. It just so happens that the results came back (weeks later) as CJD.

  • maarten vasbinder

    Incubation time of CJD is between 20 and more than hundred years. Yes, it can jump to later generations. The only way to get rid of prions is burning them. The chance that these probably (not surely) infected people get the disease, is extremely small. They rather worry about being hit by a meteorite than by CJD.

    • Ishra

      You would think different if you had a love one die of CJD. My father did not have much in life, but he did have wonderful memories..And CJD took that away from him in six weeks. I pray for everyone who has or has a loved one with this horrible diease.

  • Renee Hines

    Very sadly, one of the patients that was exposed is my daughters best friend from childhood. She has a beautiful two year old daughter and wants desperately to be here not only to watch her grow up, but also her grandchildren. She will spend the next 30+ years with the cloud of the dark disease hanging over her head!!! So unfair to her, her child (as she gets old enough to understand), her parents, her future grandbabies and ALL the people that love this beautiful young lady!!! I just ask that we all stop pointing fingers and start praying for the 18 patients and their families.

  • Fooey

    Enhanced sterilization should be used EVERY TIME!!! You never know what someone may be incubating in their body until later when symptoms appear, and a test comes back positive. Its better to be safe than sorry…..all of these incurable diseases and superpower bacteria cannot be taken lightly.

  • Calvin Morgan

    Novant has taken over several doctor’s offices and hospitals in North Carolina. If you think that Novant charges/charged high prices now wait till we the patients or should I say victims get hit with the passed down cost of another one of their mistakes when WE start paying for these infected patients!! It will trickle down to us not the stock holders! I almost lost our 2 year old son because of the incompetence of two of their facilities doctor’s and then they had the nerve to send bills! The Government forces us to get insurance to assure Novant gets paid, but does nothing when this type of horrific thing happens to one of us!!! Thank you Obama for your care or lack there of!!! Novant is a company which buys medical businesses for profit and then passes their mistakes cost on to the people they are treating or should I say mistreating! Ask yourself this.! What have they passed on to me when I was treated at one of their facilities and they didn’t get caught!!!!!!!!!!!! Novant like our Obama care will simply pass the buck on to the people!!! I guess we will be forced to bend over and take it like always since we have to pay for other more important things like a one million dollar first lady birthday party or extravagant vacations for the Obama’s. This money should have been used for more important things like our countries deficits or someone to oversee these type companies. If you think this don’t play a part in what has happened then you need to sue your brain for non-support! Health care reform starts with the providers of health care not the cost or lack of insurance that American’s are now unconstitutionally forced to pay. I will pray for the individuals and their families to which this atrocity has occurred and suggest we as a Christian Nation all do the same, as it could have been one of us in their position at this time.

  • Common Sense

    Search Google for Novant Health Forsyth Medical Center and read the reviews. How is this place still operating?!?!!!!

  • Pavlo

    So if a person had this diagnosis before they come in for surgery we use DISPOSIBLE instruments. The trick is that no one knew before this person had a surgery that they have CJD so surgical instruments were cleaned and sterilized as usual but usual sterilization is not enough to kill prions. That’s they way they got transmitted. What if someone has CJD and has no symptoms yet? No one knows so no precautions taken and it can still get transmited.

  • Claudine Hayes

    I feel sorry for these patients and their family. My mother had the same thing happen to her when she had to have her Aorta Heart valve replaced. She did very well from the surgery until the third day she was home and had to be rushed back to the hospital. They found she had the worst deadly blood infection called Sepsis” The family was called to the hospital because the doctors didn’t expect her to live through the night and was slipping into a coma. But my mom was a fighter and she did survive but she never did fully recover. It caused her mind to be bad, she had incontinence, was very weak and lost so much weight because it killed her appetite. She also lost all her hair. She died only a few years after having this infection. This is getting to be a huge problem now with hospitals especially. We sat at my moms bedside and watched a technician come into her room to take blood from her and didn’t have any gloves on. And when we got mad and told her to put on gloves she got mad at us. I couldn’t believe the horrible care that patients now get in the hospitals. There’s also a lot of doctors, surgeons to blame for this as well.It’s way past time that something is done to stop this. Time for new laws and it’s time to see they get enforced. Makes anyone afraid to go into any hospital or have surgery and this is ridiculous.

  • Rhonda

    Shame on you Novant. How dare you say , with a suspected case, that it is not the hospitals fault. Yes, i know it wasn’t confirmed until later. You get charged $42 a minute for your time in the operating room. Your also charged for each pan of insturment that is opened durning your surgery, regradless they are used. Your charged for the cleaning of those instruments. Down to the marking pen that is used on patients prior to there surgeries. It is crazy. They charge way to much, yes surgical instruments are expensive but you charge enough to destroy those insturments used. Not your fault. Who’s fault is it the patient with the suspected case or the patients who needed surgies. Good grief. Get off your high horse. The only reason you came forward to admit guilt is the news were starting to ask questions call for your response. If a patient, that was told of this chance, hadn’t went to the press, then nothing would of been said. I’m praying for all these patients and this hospital, they need to change.

  • indyrose

    Guidelines for sterilization of CJD contaminated instruments folks: in our laboratory we do use 2 Normal Sodium Hydroxide and a higher autoclave temperature since we work with KNOWN contamination at a higher level. But this is for surgical instruments, very simple. Sodium hydroxide in laymen’s terms is lye.
    See:

    http://www.cdc.gov/ncidod/dvrd/cjd/qa_cjd_infection_control.htm#reprocessunsurepatient

    What are the most stringent chemical and autoclave sterilization methods outlined in Annex III of the WHO infection control guidelines for transmissible spongiform encephalopathies? (CJD)

    The three most stringent sterilization methods for heat-resistant instruments described in Annex III of the WHO guidelines are listed below; the methods are listed in order of more to less severe treatments. Sodium hypochlorite may be corrosive to some instruments, such as gold-plated instruments. Before instruments are immersed in sodium hypochlorite, the instrument manufacturer should be consulted about the instrument’s tolerance of exposure to sodium hypochlorite. Instruments should be decontaminated by a combination of the chemical and recommended autoclaving methods before subjecting them to cleaning in a washer cycle and routine sterilization.

    Immerse in a pan containing 1N sodium hydroxide (NaOH) and heat in a gravity displacement autoclave at 121°C for 30 min; clean; rinse in water; and subject to routine sterilization.
    [CDC NOTE: The pan containing sodium hydroxide should be covered, and care should be taken to avoid sodium hydroxide spills in the autoclave. To avoid autoclave exposure to gaseous sodium hydroxide condensing on the lid of the container, the use of containers with a rim and lid designed for condensation to collect and drip back into the pan is recommended. Persons who use this procedure should be cautious in handling hot sodium hydroxide solution (post-autoclave) and in avoiding potential exposure to gaseous sodium hydroxide, exercise caution during all sterilization steps, and allow the autoclave, instruments, and solutions to cool down before removal. An experiment conducted by Food and Drug Administration (FDA) investigators indicated that the use of appropriate containment pans and lids prevents escape of sodium hydroxide vapors that may cause damage to the autoclave (Brown and Merritt. Am J Infect Control 2003;31:257-260). PDF version Adobe Acrobat Reader icon (86 KB)]
    Immerse in 1N NaOH or sodium hypochlorite (20,000 ppm available chlorine) for 1 hour; transfer instruments to water; heat in a gravity displacement autoclave at 121°C for 1 hour; clean; and subject to routine sterilization.
    [CDC NOTE: Sodium hypochlorite may be corrosive to some instruments.]
    Immerse in 1N NaOH or sodium hypochlorite (20,000 ppm available chlorine) for 1 hour; remove and rinse in water, and then transfer to open pan and heat in a gravity displacement (121°C) or porous load (134°C) autoclave for 1 hour; clean; and subject to routine sterilization.
    [CDC NOTE: Sodium hypochlorite may be corrosive to some instruments.]

    FDA investigators evaluated the effects to surgical instruments of the steps involved in the sterilization protocols listed above; some of the protocols they assessed subjected the instruments to harsher conditions than those prescribed above. Their findings indicate that much of the damage from autoclaving in sodium hydroxide was cosmetic and would not affect the performance or cleaning of the instruments. Soaking in sodium hydroxide had the least damaging effect on instruments, but immersion in sodium hypochlorite bleach caused severe damage to some instruments. The article summarizing the findings of this experiment by Brown et al. of the FDA was published in the Journal of Biomedical Materials Research (electronic version published October 2004) PDF version Adobe Acrobat Reader icon (191 KB/5 pages).

  • ReneeAnnette

    Sadly, CJD is caused from a prion, a misshaped protein, that can replicate itself. It is not a bacteria or virus, and does not die under normal heat sterilization in an autoclave. I knew someone in Winston Salem area, a nurse, that died from this disease about 5 years ago, presumed to be from a needle stick while caring for a patient. Lets hope that the instruments were cleaned well enough to remove all traces of the prions, and no one else is infected. I cannot imagine knowing that you may be infected, and not know when, if ever the disease will occur. Hopefully, a test can be devised that would detect the presence of the prion that causes the disease. May God bless you all, and the caregivers, who also might have been exposed.

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