TWO fungal outbreaks were linked to defects at Glasgow’s £842m hospital years before a 10-year-old contracted a disease from bird droppings.
The Herald on Sunday has obtained hundreds of documents which detail problems at the Queen Elizabeth University Hospital and associated buildings, including details of two outbreaks linked to defects at the facility.
In 2016 a child on the cancer ward at the Royal Hospital for Children (RHC) was infected with Apergillus - a mould commonly found on bread, and the following year two more children on the same ward were infected with the fungus.
It was suspected to have come from mould in a ceiling void, which developed following a leak.
Another fungus, Exophiala, was detected in 2017 coming from a mouldy dishwasher which hadn’t been installed, maintained or cleaned properly and was used to wash cups and jugs.
As previously reported, three microbiologists had to blow the whistle over a catalogue of safety concerns at the site, including issues about patient safety and infection control in 2017, following concerns also raised in 2015.
The Herald on Sunday has can reveal details of the 27 issues raised in their official whistleblowing complaint, including the fungal infections, an increase in other infections in children and adults with lowered immune systems, confusion over where to put patients with lowered immune systems, a lack of isolation rooms and concerns that infection rates were not being monitored.
Their report states: “[An employee] commented that there was an outbreak of Aspergillus in the unit and that there is still a risk to patients.
“There were two cases in March and April, associated with a leak in the ceiling space. This was investigated and the tiles were removed and replaced, with no further cases of Aspergillus.”
“Dishwashers had not been cleaned, installed or operated according to manufacturing instructions. Water jugs and cups had been washed in these dishwashers.
“This was brought to light with the investigation into patients with Exophiala. [An employee] had already discussed the outbreak with experts and given the striking epidemiology of increasing numbers, it is a reasonable hypothesis to assume a link to the dishwashers as a possible source.
“It is unknown if there are further gaps in the cleaning schedules.”
NHSGGC said Exophiala had been detected in sampling tests and as a precaution some dishwashers from both the RHC and main QEUH building were removed, but added that no patients were treated for the infection.
They said all patients recovered from the Aspergillus infections.
The health board said its medical director set out a plan to deal with the problems raised in the whistleblowing complaint and last night confirmed 20 of the issues had now been addressed, one wasn’t possible, and 6 others are expected to be resolved this year.
However the microbiologists were forced to take their complaint to stage two of the whistleblowing process after becoming unsatisfied with how their concerns were handled.
On the fungal outbreaks, NHSGGC said all incidents were reported to Health Protection Scotland and added: "In 2016 one patient was successfully treated for an Aspergillus infection in the Royal Hospital for Children.
"Investigations included air sampling and review of the environment for any dampness. One hypothesis was that this could have been caused by a tear on a vent duct and this was repaired. No other patients were infected.
"In 2017, two further probable cases of Aspergillus were investigated in RHC. This investigation also included a review of the case from 2016.
"No source was confirmed as some of the patients were in and out of the hospital during the period in question and construction work (which is a risk factor) was ongoing at the time.
"Actions taken included the replacement of damaged ceiling tiles.
"In 2017 Exophiala was identified in an environmental sample taken from a dishwasher. As a precaution dishwashers were removed from some areas in both the adult and children’s hospital. No patients were affected.
"We fully comply with the national infection control guidance on the management and reporting of outbreaks.
“This sets out when a public statement should be made on an incident."
On the concerns raised in 2015 and 2017, a spokeswoman said: "In 2015, there were a number of opinions offered about issues highlighted by microbiologists in relation to the Institute and arrangements for managing isolation patients in the new hospitals. At the time there wasn’t clinical consensus about the issues raised but they were all actively looked at.
"In 2017 a process was put in place to agree an action plan in response to ongoing issues raised by the microbiologists.
"This was reported through an open and transparent process to the Board.
"A later Stage 2 whistleblowing investigation in 2018 found that the concerns raised, whilst legitimate, had already been dealt with."
The Scottish Government confirmed they had been informed of an Aspergillus infection from 2016, but not about the other two in 2017, or about the incident with the dishwashers.
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