Waterborne Pathogens in Healthcare
A dental group discovered the limitations of filtration systems the hard way. By the time CDC officials and a local health officer pinpointed the source of the issue, dozens of adolescent dental patients treated by the dental group were infected with Mycobacterium abscessus, a type of bacteria that can colonize healthcare facility water supplies. In all cases, hospitalization and surgery were required to combat the infection.
After irrigation water used at the practice was identified as the cause, the dental group filed suit against the filtration company that supplied the system used at the practice’s several offices. FACS environmental scientists were hired by the attorney representing that company to investigate and report their findings.
Key Results
FACS environmental consultants and FACS litigation support personnel examined documents related to the case and provided two expert reports to the attorney representing the filtration company. These reports were primary components of a motion for summary judgment.
After considering the evidence presented, the court issued a decision in favor of the filtration company. The dental group suffered catastrophic damage to its reputation and financial integrity. All offices were eventually closed and sold.
About the Client
FACS water quality experts and the FACS litigation team were enlisted to advise in the case by the attorney representing the water filtration company that supplied the filtration equipment to the dental group.
The Problem
FACS waterborne pathogen experts sought to answer two primary questions related to this case: How did the bacteria enter the irrigation water, and how were the children exposed?
Water filtration systems can help to remove waterborne pathogens from supplied water and therefore prevent their downstream growth and spread. When outbreaks of waterborne pathogen-related illness occur, the focal point for causation is often placed on filtration systems, if they are in place.
Healthcare facilities often mistakenly rely heavily on water filtration systems as the sole control measure for providing safe water for patients, when in fact most filtration systems do not supply water that is completely pathogen-free. They need to be properly maintained in order to work effectively.
The responsibility for cleaning and inspecting the system quite often belongs to the business leasing or purchasing it, not to the supplier or manufacturer (depending on the particular agreement struck between the supplier and end user).
The work required the careful review of documents collected: medical records, water sampling data, office procedural regimens, and an examination of scientific publications on both the particular strain of bacteria causing the problem and best practices for controlling its spread.
The FACS Solution
The attorney for the dental group enlisted a PhD research scientist with no field experience in water filtration devices, outbreak investigation, or environmental health to provide their expert testimony. FACS experts focus on helping companies protect their facilities from waterborne pathogens and other environmental quality issues and have extensive field and outbreak investigation experience.
Assisted by FACS litigation support staff, the team prepared two reports that clearly indicated the problem was not due to the water filtration system used by the dental group. Instead, it was the staff’s failure to properly manage satellite reservoirs that attach to the dental chairs and supply filtered water to irrigation tools. Dental staff did not properly empty, rinse, and clean these satellite containers. They allowed the water to remain stagnant and attached to the dental chairs for long periods of time, facilitating the growth of Mycobacterium.
Potable water is not sterile and most commercial water filters do not produce sterile-grade water. While they can be effective in removing bacteria from the water supply, small numbers of bacteria can still pass through the filter. When small numbers of bacteria are left in stagnant water, they can grow and proliferate to unsafe levels. This is why it is still important to properly manage water reservoirs by preventing stagnation and performing regular cleaning and disinfection, even when filtered water is used to fill them.
The attorney for the filtration company asked the court to issue summary judgment on the dental group’s claim that the water filtration system caused the bacterial growth. The court decided in favor of the filtration company, and the case against them was dismissed.
Don’t take unnecessary chances with the future of your company or the health of the people you employ and serve. For further information about FACS’ litigation support services and the control of waterborne pathogens in healthcare settings, spas, corporate offices, or any facility where water features or water-containing equipment is used, call FACS at (866) 643-0237.