The Joint Commission on Accreditation of Healthcare Organizations is investigating 421-bed Exempla Saint Joseph Hospital, Denver, where six patients may have been exposed inadvertently to a deadly brain disease.
The Oakbrook Terrace, Ill.-based Joint Commission is drafting a letter asking the hospital to provide a written response to concerns about the potential exposure, JCAHO spokeswoman Charlene Hill said. Joint Commission officials have not decided whether a site visit will be made, she added.
Hill is not certain how the JCAHO became aware of the situation, but said that the tip could have come from patients, hospital staff or media reports.
Exempla Saint Joseph learned of the Joint Commission's interest from a reporter, and later received the agency's letter requesting information, hospital spokeswoman Pat Barker said.
Providers have slammed the Joint Commission in recent years for what they see as headline grabbing by the agency after media reports publicize incidents. For instance, last fall, the commission conducted an announced survey of Tulane University Hospital and Clinic in New Orleans after the Wall Street Journal reported that eight patients there may have been exposed through surgical instruments to the same disease suspected in the Exempla situation, Creutzfeldt-Jakob disease (Dec. 11, 2000). Tulane maintained its status of accredited with recommendations for improvement after the survey.
Exempla Saint Joseph said in March that there is a remote chance six of its patients were exposed to CJD during surgeries late last year. The instruments had been used on a patient on Nov. 20, 2000, but that patient's CJD was not diagnosed until Dec. 11, 2000, after the other six patients had had surgeries using the instruments, Barker said. The patients were later notified, she said.
CJD is passed on by proteins that aren't always removed from surgical instruments during normal sterilization processes, so Exempla Saint Joseph can't claim definitively that the patients were not exposed, Barker said. The hospital believes the chances of exposure are remote, she added, but it did institute a new procedure for handling instruments used in brain surgeries: The instruments will be quarantined after a surgery until a biopsy shows that the patient does not have CJD.
Exempla fully accredited
Exempla Saint Joseph was last surveyed by the Joint Commission on Feb. 12, 2000, Hill said. Three areas were cited for improvement, and the hospital was compliant by April 19, 2000, and is fully accredited, she said. Surveyors made an unannounced visit last December in response to an unrelated complaint, but they could not substantiate the complaint, she added.
The original patient diagnosed with CJD has died, Barker said. Another Exempla Saint Joseph patient, who was not one of the six patients who may have been exposed to CJD at the hospital, also died recently of the disease, but that patient had been diagnosed previously with the disease, she said.