C-Diff and MRSA figures reveal new shock superbug deaths

By Barry McCaffrey & Caroline McIlwain

MRSA and C-Diff superbugs have officially been confirmed for the first time as being linked to more than 1,100 deaths in Northern Ireland during the last 10 years, The Detail can reveal.

The shocking new figures come weeks after Health Minister Michael McGimpsey was forced to publicly apologise for the deaths of 31 people who died as a result of C difficile following an outbreak of the superbug at hospitals in the Northern Health Trust area during 2007/2008.

In March 2009 Mr McGimpsey ordered a public inquiry into the circumstances surrounding the outbreak of the disease in five local hospitals in the Northern Trust.

It was Northern Ireland’s worst ever outbreak of the superbug.

The inquiry, which lasted two years and cost £2m, concluded that C- Diff had been the underlying cause in the death of 15 patients and a contributory cause in 16 other deaths.

The report was highly critical of a number of trust practices.

Mr McGimpsey acknowledged the criticisms and said lessons would be learned in other health trusts right across Northern Ireland.

“I want to apologise to all those affected by this outbreak and offer my sincere sympathies to those families who lost loved ones,’’ he told the Assembly.

``There is no doubt that this 027 strain of C. difficile was extremely virulent and caused a great deal of pain and distress to all those affected.

“The inquiry report includes a number of positive comments, showing that high quality care was provided in many instances and in many wards.

“However, it is clear that in some areas things happened which fell short of the standard of care that people have a right to expect.”

The Detail can now reveal new figures which link the C-Diff and MRSA superbugs to 1,163 deaths in Northern Ireland between 2001 and 2010.

The official government statistics were compiled by the Northern Ireland Statistics & Research Agency (NISRA).

Between 2001 and 2010 the MRSA superbug appeared on the death certificates of 463 people.

In 141 cases MRSA was attributed as the underlying cause of death.

During the same 10 year period C-Diff was included on 700 death certificates.

It was recorded as the underlying cause of death in 283 cases.

In total the superbugs were directly blamed for the deaths of 420 people.

However a spokeswoman for the Coroners Service confirmed that many of the deaths had not been investigated by an inquest as they did not involve sudden death.

``C Diff and MRSA are deaths that the coroner does not have to investigate so the vast majority of the cases will have been dealt with by death certification and not reported to the Coroners Service,’’ she said.

However, the spokeswoman did confirm that the Coroners Service had officially recorded C-Diff as being responsible for 64 deaths and MRSA being responsible for 74 deaths between January 2006 and December 2010.

Former Assembly Health Committee chairman Jim Wells described the superbug death figures as ``startling’’.

``We have been given various statistics in the past, but this is the first time that we have seen a complete overview of the numbers of people who have died from the two superbugs during the last 10 years,’’ he said.

``It’s the first time we have been given the complete figures in a true sense.

``Sadly, a lot of these people were over the age of 65 and in many cases their dignity was taken away by the horrible circumstances in which they were forced to die.

``There is no doubt there have been huge efforts made in recent years to try and reduce the number of C-Diff and MRSA deaths.

``But, I have no doubt people will be shocked by these figures.’’

In October 2010 Yvonne Cameron gave evidence to the public inquiry into C-Diff deaths.

In June 2007 Ms Cameron’s 86 year-old mother Eva had been admitted to Antrim Area Hospital having suffered a minor stroke (TIA).

Within a week of being admitted to hospital she had been placed in an isolation room.

Her family say they were told she had a bug in her bowel.

She was later moved to another hospital where she was again kept on an isolation ward.

Yvonne Cameron was only then informed by a member of the hospital staff that her mother had the C-Diff bug.

She was eventually returned to Antrim Area Hospital but died on 18 July.

``Before this whole thing I had never even heard of C-Diff,’’ said Ms Cameron.

``Part of the problem which the inquiry highlighted was the lack of communication and that the public was being kept in the dark.

``Another area of concern that it highlighted was the fact that the number of people who died as a result of C-Diff was not being properly collated.

``I don’t know whether this was because of bad administration or poor record keeping.

``I feel that the limited terms of reference which the inquiry was allowed to investigate actually made it worse for other people whose loved ones died from C-Diff, but whose deaths were not investigated by the inquiry, because the deaths did not occur in the specific hospitals and the specific timeframe which it was allowed to investigate.

``The families of these people must feel that no one cares about the death of their loved ones.

``On one hand I was satisfied with the public inquiry because we got justice for mum, but on the other hand the terms of reference of the inquiry meant it was not allowed to apportion blame.

``No one was held accountable.’’

Expressing concern over the new figures showing the real extent of the superbug deaths, Ms Cameron said:

``The real figure could and probably is a lot more, but we will never know because it’s not always recorded on the death certificate.

``I believe better communication between the health trusts and the public must be paramount.

``One of the main recommendations from the public inquiry was that proper measures should be put in place to make statistics available to the public.

``People should be given the proper information, not to frighten, them but to show that the majority of people who go into hospital do come out again with a positive outcome.’’

When contacted by the Detail a spokeswoman for the Department of Health was unable to provide figures for the number of people who had died from C-Diff or MRSA in recent years.

She said it would be inappropriate to comment on the latest superbug death figures because of the forthcoming Assembly election.

Public Relations expert Professor Ann Gregory gave evidence to the C-Diff public inquiry in which she said the media had a legitimate interest in holding the Health Service open to public scrutiny.

Speaking to the Detail following the latest publication of the C-Diff and MRSA related death figures, Prof Gregory said:

``It is important that public agencies are open and transparent but it should also be acknowledged that it is often difficult to collate these types of figures and that the failure to do so sometimes may not be in anyway malign, but may be simply because of logistical difficulties.

``On issues like hospital acquired infections it is sometimes difficult to gather together all the information as quickly as the public would like and to give a fully informed picture.

``There is sometimes a trade off between accuracy and speed, particularly when information from several sources has to be put together.

``C-Diff may be one of multiple causes that contributes to a death and it often affects people who have serious conditions.

``So it is very important for both the hospital to not only give the facts in as timely accurate way as possible, but to provide the right amount of context so that people understand the issue including the real size of the problem, what the infection is, the type of patients who are at risk, and how its being tackled.

``The media too need to provide the facts and this wider context, so as not to cause undue panic and distress, while holding the hospital to proper account. Both hospitals and the media need to act in the public interest.

``Part of that is also explaining what the public can do to get further information and how they can help in containing the problem.’’