An investigation into the design of a flagship hospital in Scotland has been launched after the death of a child who had caught an infection from pigeon droppings while being treated there.
A post-mortem confirmed that the infection was a “contributory factor” in the death of the child. However, a second patient who caught the infection was found to have died of unrelated causes.
“I am confident that the board has taken all the additional infection control steps they should to ensure and maintain patient safety”
Scottish health secretary Jeane Freeman revealed details of the incident in Scotland’s parliament on Tuesday.
Ms Freeman explained that the bacteria, called Cryptococcus, was first identified at Glasgow’s Queen Elizabeth University Hospital in one patient in November. This patient was discharged for palliative care and later died of unrelated problems.
Though for the second patient who was a child, it was proven that Cryptococcus was a contributing factor to their death in December, Ms Freeman said.
According to the NHS Greater Glasgow and Clyde, which runs the hospital, the bacteria from pigeon droppings, while harmless to healthy humans, can pose a risk to the health of very sick people with extremely low immunity.
In the wake of the deaths, Ms Freeman has asked the Healthcare Environment Inspectorate to review the incident fully and recommend any further steps that should be taken.
Additional infection control measures have already been undertaken by NHS test, including the provision of prophylactic antifungal medication to the relevant group of vulnerable patients, the provision of additional high-efficiency particulate air – HEPA – filter machines to ensure clean air, and air monitoring.
“We are pleased that an external expert advisor is to work with us on a review of the fabric of the hospital”
In investigating the source of the infection, the pigeon excrement was found in a plant room on the 12th floor, at the top of the building.
Ms Freeman described a small break in the wall where the pigeons had entered as “invisible to the naked eye”. She added that it was only found by means of smoke detection, because it was so small.
Staff are continuing to work to find out how bacteria from the pigeon droppings were able to enter a closed ventilation system, she noted.
In a statement issued yesterday, Ms Freeman said she had visited the hospital and met with the medical director, senior nurse, senior board members and a family.
She said: “I am confident that the board has taken all the additional infection control steps they should to ensure and maintain patient safety.
“However, to provide further independent assurance I have asked Healthcare Environment Inspectorate to fully review this incident and to make any further recommendations they consider appropriate,” she added.
The health secretary also stated that she had asked for a review, with external expert advice, to look at the “design, commissioning, construction, handover and maintenance of the building”.
“This will allow me to ensure that the fabric of the hospital is fit for purpose, and whether there are any wider lessons to be learned. I intend to publish the remit of this review by the end of this week and the reviews recommendations will be published,” she added.
NHS Greater Glasgow and Clyde said in a statement on the review: “We have reassured Ms Freeman that patient safety is our top priority.
Source: Andrew Cowan/Scottish Parliament
“We are pleased that an external expert advisor is to work with us on a review of the fabric of the hospital to look at issues relating to the design, commissioning, and maintenance programme,” it added.
In a separate infection issue, Ms Freeman also mentioned two additional fungal infections at the hospital, which had been brought to her attention.
She explained that neither of these were connected to the Cryptococcus infection caused by pigeon droppings and said that only one of these patients required treatment for the infection.
“Additional control measures have been put in place and the source of the infection is currently being investigated,” said Ms Freeman.
The NHS Greater Glasgow and Clyde statement also responded to the two additional infections. It explained that its infection control team held a meeting to manage “separate fungal infection totally unconnected to Cryptococcus”.
“This involves two patients who have tested positive with another fungal organism, one of whom is being treated for infection. The other does not require treatment,” it said, while noting the likely source, a water leak, has been identified and repaired.