Mysterious deaths during rutine surgeries in Minnesota

[Madscientist]

Health Experts Puzzled by Minnesota Surgery Deaths
By Paul Simao

ATLANTA (Reuters) - Puzzled by a cluster of mysterious surgery-related deaths in Minnesota, U.S. health experts on Wednesday warned doctors across the nation to be on alert for unusual complications in patients who underwent knee or major joint operations.

The Centers for Disease Control and Prevention (news - web sites) issued the advisory after helping to conduct a preliminary investigation into the unexpected deaths of three men following routine knee operations in Minnesota hospitals.

The men, who ranged in age from 23 to 78, died last week within four days of undergoing elective knee surgery at St. Cloud Hospital in St. Cloud, Minnesota. and Douglas County Hospital in Alexandria, Minnesota. All were in good health before surgery.

``At this point we don't know if it is associated with any medication, surgical instrument or procedure,'' Dr. Dan Jernigan, a CDC epidemiologist, told reporters in a conference call. ``I don't think anything is really jumping out.''

Jernigan noted that a blood culture from one of the men had tested positive for clostridium sordellii, a non-airborne bacteria that can cause septic shock. The source of the infection has not been determined, the CDC said.

An estimated 215,000 Americans die each year from septic shock, which is characterized by abdominal pain and a sharp drop in blood pressure, organ shutdown and respiratory failure.

The CDC added that the symptoms seen in the Minnesota cases also could be consistent with cardiogenic shock, which occurs when the heart is unable to pump enough blood to meet the body's needs.

Cardiogenic shock is fatal in about 80 percent of cases.

Although the Minnesota Department of Health has recommended that all elective knee surgeries be suspended pending an investigation, the CDC said it was not advising that other states take this step.

``There are always risks going into surgery, but at this point there does not appear to be an elevated risk,'' Jernigan said. It has been estimated that two out of every 1,000 people who have knee surgery in the United States each year die from complications.

The CDC said it had not identified any additional cases outside Minnesota, though the agency is trying to collect information on patients who have had orthopedic surgery involving the knee or other large joint since Oct. 1, 2001.

The agency is interested in those patients who have experienced hypotension, abdominal pain or other symptoms of septic or cardiogenic shock and those who have been required intensive care or died within 7 days of surgery.