At 96 years old, Edward J. Miller was defying his age — living alone, cooking his meals, and never missing a Fanwood Veterans Day parade or other veterans’ event. As recently as September, he was steering a boat across a lake in New Hampshire on vacation with his children.
But a bout of low blood pressure sent him to Overlook Medical Center in Summit for 13 days in mid-October. Miller tested positive for the coronavirus the day he was discharged, according to his daughter, Denise Sherwood, who believes he caught the virus at the hospital. He died at home five days later.
Also in October, Mary Ellen Petti, 72, of Green Brook Township was admitted to the seventh floor of Overlook Medical Center so she could get intravenous antibiotics for an infection. Two days later, Petti said, staff told her she had been exposed to COVID-19. Her roommate had been coughing for two days, but she said they told her that wasn’t the problem. She said she tested negative at first but a few days later, another test came back positive.
After five days of remdesivir and other treatments, Petti said she was discharged, but she was back at another hospital a week later with pneumonia and blood clots in her lungs. She said she spent another 10 days in the hospital, 10 days at a rehab center and 10 days staying with her sister before Petti could safely go home alone.
The state Department of Health said it works with local health officials to investigate acute care hospital outbreaks, defined as “two or more epidemiologically-linked patients occurring seven days or more after admission for a non-COVID condition, which would be an indication of in-hospital transmission.”
Since the start of the pandemic, they’ve investigated 28 outbreaks in acute care hospitals, affecting 475 people, both staff and patients, according to Dawn Thomas, a spokeswoman for the Department of Health.
“With increased COVID-19 community transmission as well as an increase in the number of hospitalized COVID-19 positive patients, there is greater risk that staff working at a hospital, similar to other members of the public, may be exposed to COVID-19…” Thomas said in a statement Dec. 30. “While the source of transmission may not be known in all scenarios, staff to patient transmission is a potential factor in some outbreaks.”
Hospitals around New Jersey and the country are encouraging people not to delay elective procedures, promoting their infection control procedures. And while it’s important for people not to delay necessary treatments, health officials also acknowledge that when there is a lot of community spread, the risk of catching the virus in a hospital setting is never zero.
“To see exposures in any health-care facility is just not uncommon. That’s just what happens when we’re in a pandemic,” said Megan Avallone, head of the Westfield Health Department that has jurisdiction in Summit.
The New Jersey Hospital Association declined requests for comment for this story, but it has been promoting the safety of the state’s hospitals in its “Get Care Now NJ” public awareness campaign, touting best infection control practices including cohorting of infected patients in separate units, staff and visitor screening, and constant cleaning and mask-wearing.
“Our hospitals are taking extraordinary COVID-19 safety precautions to be the centers of safety and care that our communities rely on,” NJHA President and CEO Cathy Bennett said in a press release about a report showing people have been avoiding hospitals in the state since the pandemic.
Sherwood said her father was at Overlook for 13 days without a roommate and had tested negative earlier in his stay. His only visitors tested negative and visitation had been stopped several days before he tested positive, she said. Because of those factors, the family feels confident that he caught COVID-19 from hospital staff despite precautions, and they’re considering a lawsuit.
“Mistakes happen. It’s how you handle them that matters,” she said.
Complaint leads to hospital inspection
Losing her father to COVID-19 was hard enough, Sherwood said. But what incensed her to the point that she filed a formal complaint with the state Department of Health — sparking an inspection that found some screening deficiencies, according to state records — was that she said hospital staff repeatedly told her in the days before her father was discharged that there were no COVID-19 cases on the unit.
She asked numerous times, she said, because she learned her father was being tested for the virus and she was told visitors and nonessential personnel were no longer allowed on the unit. “If they called us to tell us, we could have made the decision to get him out of there,” she said.
In a Jan. 11 letter to Sherwood that she provided to NJ Advance Media, Patricia Sohler, the hospital’s director of patient safety and risk management, acknowledged that “a limited number of COVID cases were identified over a brief period of time” during Miller’s stay in October. She also noted that the decision to restrict visitation on Miller’s unit was “based on COVID rates in the community and the hospital.”
Asked about Sherwood’s complaint, a spokesman for Overlook Medical Center said there were a “limited number of COVID cases unexpectedly identified on a specific unit” but did not specify the unit.
“As this occurred at the same time as a rapid rise in community spread, we immediately followed all appropriate guidelines and industry best-practices, and took steps to not only isolate the unit, test staff and patients, but also restrict visitation,” said Robert Seman, a spokesman for Atlantic Health, which runs the facility. He declined to comment on Petti’s claims of being infected at the hospital.
“It is nearly impossible to know how, where or from whom an individual specifically contracted the COVID-19 virus,” he said in a statement. “The increased spread in our communities since the start of fall, as well as the unique nature of the virus, which involves an incubation period during which a person can unknowingly be infected yet contagious, has been particularly challenging for health care systems across the state.”
The Department of Health’s Health Facility, Survey and Field Operations investigated Sherwood’s complaint after her father became ill. The inspector concluded after an inspection and interviews Oct. 22 that Overlook “failed to ensure all visitors and healthcare personnel entering the facility are provided a screening to identify and isolate Coronavirus Disease 2019 (COVID-19) in accordance with CDC guidelines and facility policy,” according to a copy of the statement of deficiencies obtained through a public records request.
Seman noted the findings did not find any deficiencies on the unit where the cases were identified in October.
The inspector wrote in her report that on Oct. 22 she walked past a security guard at Overlook’s entrance and into a lobby where another staffer said, “Your temperature is good, how can I help you?” In total, three staffers she encountered entering the facility failed to screen her for symptoms or ask about any possible exposures, she wrote in the report.
Staff later told her that visitors were supposed to be screened by the security guard at the door and via a thermal scanner in lobby, she wrote. She also noted that staff did not document that visitors were confirmed to have no symptoms, as the CDC recommends.
In response to the findings, Overlook noted in its plan of correction that it has revised screening guidelines and questions to align with NJHA recommendations, retrained staff in the new procedures and added redundancy and electronic documentation to confirm everyone is screened on entry.
The findings did not mention any specific staff screening issues, but Seman said Overlook has also implemented an “electronic attestation” process for staff that makes it easier to verify that screening takes place regularly.
While Sherwood was complaining that staff refused to admit there were COVID-19 cases on her father’s unit until after he had died, legislators and union leaders have been pushing for hospitals to be more transparent about cases among staff.
Since April, the state has required long-term care facilities to report cases among residents and staff, and made that information publicly available on the state’s COVID-19 dashboard. But during most of the pandemic, hospitals were not required to do the same.
After a nurses union and others pushed for transparency, hospitals began voluntarily reporting staff COVID-19 cases to the NJHA in the end of December. Thomas, with the Department of Health, said a dashboard with that data is “being finalized and will be available soon.”
Legislators didn’t wait for the NJHA, and passed a bill Dec. 17 requiring hospitals to make biweekly reports to the state. Gov. Phil Murphy signed it Feb. 4.
Sherwood said the information about staff cases is something that wasn’t available to her family when her father was admitted — but it should have been.
“Maybe when these numbers become public, the residents of New Jersey can finally make informed choices as to where they prefer to be treated during this pandemic,” she said.
Petti, who said she is also considering a lawsuit, said she went to Overlook for treatment because she trusted that it was safe.
“I went in relatively healthy, certainly not on death’s doorstep,” said Petti, who believes she caught the virus at the hospital. “I trusted them and they basically almost killed me, when it comes right down to it.”
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