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UPMC Presbyterian moves cardiothoracic patients to escape mold threat

Ben Schmitt
| Monday, Sept. 14, 2015, 11:03 p.m.
The main entrance of UPMC Presbyterian in Oakland.
Trib Total Media
The main entrance of UPMC Presbyterian in Oakland.

Officials continued searching Monday for the cause of a mold outbreak that forced UPMC Presbyterian to close its cardiothoracic intensive care unit and relocate 18 patients.

State health officials are investigating the mold infestation, although no other parts of the hospital — the largest in Western Pennsylvania — are believed to contain mold, officials said.

A critical care doctor noticed a possible mold infection in an external wound of a male transplant patient on Sept. 3, which precipitated the closure, said Holly Lorenz, chief nursing officer for UPMC. That patient and two others were subsequently moved once doctors confirmed the presence of mold in the wound.

Investigators opened a wall in a room of the unit and found mold. On Sept. 8, hospital staff moved the remaining 15 patients when workers discovered mold in other parts of the 20-bed unit.

“It is a rare and unfortunate event, and I'm really blessed to have the level of expertise here at UPMC Presbyterian to help us solve the problem,” Lorenz told the Tribune-Review. “We've closed down the unit entirely for obvious patient safety reasons.”

Lorenz declined to elaborate on the patient's condition or type of transplant he had. So far, he is the only patient known to be affected by the mold.

“That patient had been acutely ill for most of his hospitalization,” she said. “We're still exploring what is going on in this patient.”

The cardiothoracic ICU typically handles patients with heart and lung disease and are admitted for open-heart bypass procedures or transplants.

Mold infections can be very serious, even fatal, in sick people, said Dr. Amesh Adalja, a Pittsburgh-based infectious disease expert who serves as a spokesman for the Infectious Diseases Society of America.

“There is a high degree of fatality with mold infections because the people who get these are already chronically ill or have severely compromised immune systems,” he said. “In general, mold outbreaks in a hospital setting are rare because the patient population that gets infected is a very small population — immunocompromised people.”

An open wound is a perfect point of entry for mold, he said.

“The mold needs a way in,” Adalja said, adding doctors use various anti-fungal intravenous treatments to combat infection, depending on the type of mold.

Lorenz said she was unsure specifically what type of mold had been found, adding it is not a threat to healthy staff members and hospital visitors, who regularly encounter mold in the environment.

“I think we have a level of confidence that this has been contained to this unit,” she said. “As we learn more about this, we may end up looking in other areas to have a stronger level of confidence. For now, we're pretty sure there's no mold anywhere else.”

UPMC notified the state Department of Health along with the Allegheny County Health Department, which is standard operating procedure, Lorenz said. State officials confirmed an investigation is under way.

A team from UPMC's infection prevention division is working with an outside mold removal company to ensure that the ICU is clean and safe for reopening at an undetermined date.

“We're looking at everything we need to do to upgrade the unit,” she said. “It definitely has our attention.”

Joe Katzfey, a mold removal specialist and co-owner of Preferred Restoration in Pine, said depending on the damage, a cleanup could take weeks, if not longer.

“Handling the mold remediation is half the equation,” said Katzfey, who is not involved in the cleanup. “Once you remove the mold and get a clean bill of health, you still have to put everything back together.”

Lorenz said the cleanup gives the hospital an opportunity for upgrades and she's unsure how long the unit will be closed.

Adalja said the hospital's reassurance that most people are generally safe from mold sickness is accurate.

“Mold is something that is everywhere in the environment, in buildings, refrigerators and basements,” he said. “For the vast majority of humans, mold poses no threat. It sounds like the hospital has been quick to deal with this problem.”

Ben Schmitt is a staff writer for Trib Total Media. He can be reached at 412-320-7991 or bschmitt@tribweb.com.

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