Kidney dialysis center in Town and Country under investigation for injecting patients with cleanser

2012-12-06T00:05:00Z 2013-04-05T21:11:57Z Kidney dialysis center in Town and Country under investigation for injecting patients with cleanserBy Blythe Bernhard bbernhard@post-dispatch.com 314-340-8129 stltoday.com

TOWN AND COUNTRY • Federal health officials are investigating a kidney dialysis center in Town and Country after eight patients were injected with bleach or other cleanser on Monday.

At least seven of the patients were hospitalized and two have since been released, according to a spokesman for U.S. Renal Care, which operates the facility and another in Ferguson. All of the patients are expected to recover.

“We can confirm that a cleaning solution, commonly used in dialysis, was inadvertently added into our water supply due to a one-time human error,” spokesman Tom Weinberg said in a statement.

The facility, situated on the campus of the Cedars of Town and Country nursing home, is closed while Medicare inspectors conduct an investigation. Residents of the nursing home who need dialysis will be taken to nearby centers.

Six of the patients sickened on Monday are residents of the nursing home, which operates independently.

“It’s disconcerting to say the least that it happened, and hopefully whatever steps are necessary to insure that it won’t happen again are taken,” said Mark Rubin, a St. Louis attorney for the nursing home.

U.S. Renal Care, based in Texas, operates about 100 dialysis centers in 13 states. The company bought the two St. Louis area facilities in September from Premier Dialysis Centers.

The local facilities had the worst patient death rates of any dialysis centers in the St. Louis area based on the most recent data available.

The Town and Country center from 2007 to 2010 had a patient death rate that was 88 percent higher than would be expected based on the patients’ ages and conditions. The Ferguson facility’s death rate was 91 percent higher than expected in the same time frame, according to a nationwide investigation by the nonprofit journalism organization ProPublica.

Tom Weinberg, the spokesman for U.S. Renal Care, said the facilities came under new management after those numbers were released.

About 400,000 Americans with kidney failure receive dialysis treatments. The machines serve as substitutes for the kidneys by filtering toxins out of the blood in four-hour sessions three times a week. The patients’ blood is taken through a catheter into a machine as purified water gets pumped through the machine’s filter to carry out the toxins. Any bacteria or toxins in the water can be introduced to the bloodstream.

Dialysis centers add chlorine bleach to tap water to disinfect it and to clean the machinery. The tubes are typically flushed out for 30 minutes to an hour to insure the chlorine levels are satisfactory.

Technicians are required to regularly test the water for impurities. If the system isn’t adequately flushed out, or the filters are ineffective, then bleach or bacteria can enter the patient’s blood.

Side effects from cleansers in the blood can include anemia, low oxygen, headache, fatigue and shortness of breath. In most serious cases, patients can experience seizures or comas and die.

“The dialysis unit should be very meticulous about checking water before using it,” said Dr. Bahar Bastani, a nephrologist at St. Louis University Hospital.

Patient advocates said they hadn’t heard of another situation in which several patients were sickened by cleanser in a dialysis center.

“Dialysis is scary to begin with. You have blood circulating out of your body,” said Lori Hartwell, founder of the Renal Support Network. “If there is one lesson here, patients and family members and staff need to constantly make sure that safety is the highest factor.”

Blythe Bernhard covers health and medicine for the Post-Dispatch. Follow her on twitter @blythebernhard

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