Mike the Mad Biologist

I told you this would happen. I used to give a lot of talks about antibiotic resistance, and when I did so, I would often use a cartoon as a humorous way to portray the severity of the resistance problem:

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Sadly, this is no longer a laugh line:

Former Cleveland Browns receiver Joe Jurevicius sued the team and the Cleveland Clinic on Friday, saying the team misrepresented the cleanliness of its training facility and blaming doctors with negligence over a staph infection in his right knee that kept him from playing last year….

Jurevicius has said he contracted staph following arthroscopic surgery at the Cleveland Clinic in January 2008. As a result, the lawsuit said, “Jurevicius may never be able to play professional football again.”

…The legal filing in Cuyahoga County Common Pleas Court included an affidavit by Dr. Bonnie Bock, an infectious diseases specialist from Newport Beach, Calif., who said her examination of the case showed that the player’s staph infection was due to circumstances outlined in the suit.

“Sterile techniques were not at all times used at the Browns training facility,” she said. “Therapy devices commonly used by multiple Browns players were not properly maintained, disinfected or cleaned, if at all at the Browns training facility.”

I’m sad that it’s come to this, but I’m not surprised–I predicted this over two years ago:

At some point, people are going to become really pissed off and start suing over antibiotic misuse. And they’ll win. If hospital administrators, doctors, and nurses don’t deal with this voluntarily, the courts will force them to do so. There’s one thing I’m certain of: judges will be awful at practicing medicine and developing public health strategies.

It shouldn’t take lawsuits to fix this problem, but too many facilities will only respond when the financial cost of rigorous infection control is less than not engaging in infection control. I just hope that we don’t get court-mandated infection control programs. There are so many subtle things involved in good infection control (and setting uniform benchmarks won’t work well–in some patient populations, resistance is the norm).

Hopefully this will be a wakeup call to hospitals.

Comments

#1 Scrabcake
June 28, 2009

You know, there used to be a time, and I know about this solely from fiction, that when shit happened, people adapted and in the case of this guy changed careers, or just sat around and moped about it.
What ever happened to “shit happens: deal”? It seems to have transmogrified into “shit shouldn’t happen but when it does there’s always someone to blame and that person is never me!”
#2 maryn
June 28, 2009

In the area of jail-prison MRSA there have been suits for a while — not many successful because they have mostly been class actions and judges have refused to certify. But it is not surprising that a pro athlete’s suit would get more news attention than a prisoner’s…
#3 Mandamus
June 28, 2009

Well, they could start by outlawing anti-bacterial soaps. Those are the worst.. they only kill 99% of germs, the 1% that are left are the strongest ones.. Who the hell thought that this was a good idea?

Use plain ordinary soap, which breaks up the oily bonds that bacteria use to cling to things, and wash them away. Much more effective, and won’t cause anti-biotic resistance to develop. Of course, thanks to anti-bacterial soaps, it may already be too late for that.
#4 jay
June 28, 2009

Where does this go. Do you sue if the doctor does NOT play it ‘safe’ and prescribe antibiotics freely for your case, and sue doctors for too freely prescribing to others.

[Just a couple weeks ago my wife had a suspected lyme desease infected bite and the doctor prescribed treatment without waiting for lab test results]

So who will be the volunteer to NOT take antibiotics??
#5 jay
June 28, 2009

Where does this go. Do you sue if the doctor does NOT play it ‘safe’ and prescribe antibiotics freely for your case, and sue doctors for too freely prescribing to others.

[Just a couple weeks ago my wife had a suspected lyme desease infected bite and the doctor prescribed treatment without waiting for lab test results]

So who will be the volunteer to NOT take antibiotics??
#6 megan
June 28, 2009

Having been an old school workout gymrat for years, the idea that this guy played hot sweaty nasty icky clothing and sports training articles and equipment passed between players football, only wiped off by an already dirty towel or rag seems really disingenuous about being abhorred or shocked about the unclean status of his rehab facility to the point of expecting it to be a medical lab or operating room.
#7 Mike Olson
June 28, 2009

I think the concluding statement says alot. The fact is bad things happen. Frequently without any real reason or cause. People also make honest mistakes, which shouldn’t force them into bankruptcy or cause them to cease acting for the public good. However, although lawsuits are apparently, frequently frivolous, there are times when they are very necessary simply due to the fact that they hold folks accountable when existing criminal laws don’t. No one should be sued if I blindly step in front of a train. On the other hand, if I step in front of a train while being led by the guide dog you trained…
#8 Kelly
June 28, 2009

wait — the suit is over cleanliness, not over antibiotic use. While the problem stems from out of control and improper antibiotic use, the suit is more specific. My family went thru hell when my Dad’s bilateral knee replacements were infected with an antibiotic resistant bug. We nearly lost him, he nearly lost his legs — he is extremely fortunate as far as how things came out. Mind you, this is even more serious with artificial joints b/c there is no blood source to carry an immune response. This stuff is not just a matter of “go find another job”.

That being said, it’s a systemic problem. You can’t point the finger at a particular person. It’s a matter of the culture, priorities in the facility, are there reminders and fail safes to prevent. I’ve seen hospitals that now have a hand washing station at every or every two rooms.

Patients and pharmaceutical companies need to bear some of the responsibility. Pharmaceutical companies have gotten everyone used to taking antibiotics anytime you feel sick. Patients have gotten it into their heads that if they go to the dr, they should get medicine! My gp’s office has signs in every exam room to the effect that ‘antibiotics do not help viruses and flu. We won’t prescribe antibiotics unless you have a bacterial infection.’ I imagine they actually risk losing patients doing the right thing, which doesn’t say much for the patients
#9 Hypocee
June 29, 2009

Exactly – where the heck is the antibiotic abuse in this story? Unsterile operating environment -> staph infection.
#10 Mike Olson
June 29, 2009

I concur with Kelly’s dismay at a Doctor losing patients doing the right thing. This is the same kind of problem you get into when prescribing placebos. Of course it all falls back to living in a country with a really poor national understanding of science. There are legitimate miracles which can be performed by modern medicine. But that doesn’t mean you can alter fundamental science. I think more widespread use of bacteriophages would slow this down.
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June 30, 2009

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#12 Chris
July 2, 2009

All in all, it seems like a bad idea for health systems to make marketing-heavy connections with sports teams. IF the suit is true, this happened at the Browns’ facility. Sports teams and players are so erratic, and now Cleveland Clinic may get tarred (unfairly, maybe?) in the process.
#13 Barry
July 2, 2009

“You know, there used to be a time, and I know about this solely from fiction, that when shit happened, people adapted and in the case of this guy changed careers, or just sat around and moped about it.
What ever happened to “shit happens: deal”? It seems to have transmogrified into “shit shouldn’t happen but when it does there’s always someone to blame and that person is never me!” ”

Posted by: Scrabcake

There used to also be a time when such an infection would be considered Will of God(s). So?
#14 yalcın
August 3, 2009

thanks very