Mysterious Knee Surgery Deaths?

mcl4 · Nov 24, 2001

Originally posted by nurs4kids
Thank you, PRN.

I worked ortho for a year, think I may have done blood cultures a few times. Also, did I not say they don't ROUTINELY order BC's??? In no way did I intend to imply the ortho docs did something wrong. It's be pretty stupid to order bc's on every ortho case that runs a temp, since the temps ARE normally pulmonary.

Ancef is what's normally used here too, X3 doses. I WAS not saying the docs were wrong. I figure it's manufacturer packaging or something.

I'll have my head back now, thank you Bonnie!

I agree it is not appropriate to order bc on every ortho case with a temp. I reread your statement and I understand what you are stating. Thanks you for clarifying your post with more details. Ancef is order every eight hours for the first and second post op days by the orthopedics whose patients I care for postoperatively.

I agree with the last two post in stating that blood cultures are not ordered routinely, however I've seen them done for prolong high temps. Sometimes it is the medical doctor who is following the orthopedic patients progress that orders them.

mcl4 · Nov 24, 2001

Originally posted by nurs4kids
Ancef is what's normally used here too, X3 doses. I WAS not saying the docs were wrong. I figure it's manufacturer packaging or something.
Unfortunately, it appears they have not found the reason why these three men died from knee surgery within a short period of time.
While the news article stated the physicians were not upset about canceling surgery next week, some stated on the news that they felt that the health department alarmed patients unnecessarily. Who knows, but starting Monday, knee procedures will resume and I imagine it will be a busy week catching up with the canceled surgeries from the previous week.
I talked to a couple of surg techs from a chem class and they stated they had gotten off early with the light surgery schedules last week.

mcl4 · Nov 24, 2001

Originally posted by nurs4kids
Ancef is what's normally used here too, X3 doses. I WAS not saying the docs were wrong. I figure it's manufacturer packaging or something.
Unfortunately, it appears they have not found the reason why these three men died from knee surgery within a short period of time.
Here is a recent article:
Knee surgeries to resume; inquiry continues
Jill Burcum
Star Tribune
Published Nov 24 2001
As Minnesota doctors prepare to resume knee operations Monday, state health officials say the investigation of three knee surgery patients' deaths is far from over.
The Minnesota Department of Health requested a weeklong halt on elective knee surgery on Nov. 18 after three Minnesota men died mysteriously within days of having their knees operated on.
While doctors and health officials said Friday they're confident that knee patients in the state face no additional infection risk, state epidemiologist Dr. Harry Hull said the investigation will continue for some time at the state and federal level.
"We're looking at a long-term investigation," Hull said.
Disease detectives from the state and the U.S. Centers for Disease Control and Prevention (CDC) have focused on a rare but deadly bacterium called Clostridium sordellii that was found in Brian Lykins, 23, of St. Cloud.
Lykins and Wayne Hulterstrum, 78, died Nov. 11 after having knee surgery at St. Cloud Hospital. The third victim, Ronald Bettin, 60, died at Douglas County Hospital in Alexandria three days after his surgery.
So far, the bacterium strain has been found only in Lykins, and disease detectives have yet to link it to the other two men, Hull said. And the facts so far do not suggest that there's a higher risk of infection from knee surgery in the state.
Dozens of calls about knee-surgery complications poured into the Health Department after reports of the deaths. But Hull said that health officials have not found any that appear to be linked to the three cases. Nor have there been any links to knee infections outside of the state.
These were "reassuring things" when deciding to lift the moratorium, Hull said. The lack of additional cases could mean that the three cases happened through "elements of chance," he said.
But the investigation will take time, Hull said. The CDC is still testing environmental samples taken from both the St. Cloud and Douglas County hospitals to check for possible contamination in those medical centers.
In addition, Hull said, state health departments elsewhere are just beginning to investigate other knee-surgery-related infections that could be linked to the three Minnesota deaths.
It's possible other cases could turn up, though it will be arduous to sift through older medical evidence to link other cases to the Minnesota deaths, Hull said.
Twin Cities orthopedic surgeons said Friday that they expect the usual number of patients when knee surgery is resumed Monday. So far, surgeons said, few have canceled. "I'm getting the feeling that patients are pretty comfortable," said Dr. Edward Szalapski, an orthopedic surgeon who operates at Fairview Southdale in Edina.
Surgeons are encouraging nervous patients to call and talk about their concerns. Those who do will find confident doctors.
"We believe that the events in ... northern Minnesota were isolated and unique to that particular hospital system," said Dr. Owen O'Neill, an orthopedic surgeon who operates at Fairview hospitals in the Twin Cities. "We feel that it's completely safe to proceed with any type of elective orthopedic surgery."
Surgeons also said they don't plan to do anything differently in the operating room to control infection.
"Our plan is to proceed with surgery using all the precautions we usually use to prevent infections," said Dr. Gregg Strathy, orthopedic surgeon and chief of surgical specialties at Park Nicollet Health Services. "Our infection rates in general are exceedingly low."
-- Jill Burcum is at [email protected] .
Return to top
© Copyright 2001 Star Tribune. All rights reserved.
Related content
Email this story
Print this story
Search
News Classifieds Advertising Web
More search options

thisnurse · Nov 24, 2001

what instrument(s) are used in ortho that arent used in other surgeries?

WriteStuff · Nov 24, 2001

:rolleyes:

Question: what instruments are used in "ortho" surgery that aren't in others?

ANSWER: buzz saw, chain saw, chop saw, band saw, hammer drill, bench grinder, high-impact re-bar hammer, air hammer, arc welder, tig welder, nail gun, sawzal..........and when they're done using all that, they use a buffer.

*********************

Sorry, listmates.......couldn't resist that one!!

thisnurse · Nov 24, 2001

what size buffer?

WriteStuff · Nov 25, 2001

Hi thisnurse:

ROFLMAO.......in Minnesota! You get the last laugh..

I'm glad your sense of humor is intact........FYI - "buffers" are a "one-size-fits-all" item, to the delight of the CEO and his Wolf Pack in the Ivory Tower!

realnursealso/LPN, LPN · Nov 25, 2001

Don't know if any of you remember the post from me called sad for my friend. My firend's husband died within hours of being discharged from the hospital after having knee replacement surgery. He was healthy and strong and an autopsy was done but no real cause of death was pinpointed. He had surgery on Tuesday and was discharged on Thursday at 10am or so....by 430pm that same day he was dead. My friend got a copy of his chart from the hospital. Significant findings from reading were alot of postop pain not relieved by some new ball thing they implanted in his knee...also pt's were not at theraputic levels, even thought he was on heparin post-op and was to take coumadin at home. I am going to tell my friend about this. I had heard it on the tv, but got much more info from these posts. Keep me informed, ok? will let you all know what my friend finds out.

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · Nov 25, 2001

I just wanted to point out that there are like 5-6 different type of Clostridum and everyone has just assumed that it is cdiff but it could be another form of the clostridium.

willie2001 · Nov 25, 2001

I doubt if the culprit is C. difficile. As pointed out by moonshadeau, there are numerous types of Clostridium that can cause anything from tetorifice(C.tetani), botulism. gas gangrene, and the list goes on. One thing all the types have in common is that they are all very lethal.

thisnurse · Nov 25, 2001

response to write...

i must admit i was put out by your first post for about 30 seconds then i just laffed. life is too short to take all this so seriously.

in regards to the cdiff...i thought only one of the fatalities tested positive for that.

willie2001 · Nov 25, 2001

I have read that the bug responsible for these deaths is Clostridium sordellii which can be associated with gas gangrene.