Anesthesia and Intensive Care doctor from the Burn Hospital: "We saved them from a fire bomb and they died in a germ bomb!"

"I don’t want any longer to silently watch the masquerade that is being sold to the people. The wounded died from the hospital-acquired infections.", says a doctor from the Burn Hospital. The hospital confirms into detail the testimonies.

UPDATE: This afternoon, the Health Department has undergone an investigation at the Intensive Care Unit of the Burn Hospital and has collected samples.

UPDATE: In the difficult circumstances of a press conference, the doctors from the Burn Hospital were honest. As it was the outburst of Vlad Mixich. 

UPDATE: A call first thing in the morning from doctor Stănculea, the chief of the intensive care unit and the official representative of the Burn Hospital: ”Thank you very much! We hope at least this time things will be understood as they truly are. These are things we have told repeatedly but they were never heard. Maybe for our hospital things will take a turn for the better”. 

by Mirela Neag and Cătălin Tolontan

First came the message.

"Good afternoon! I am a doctor at the Burn Hospital and I witness powerlessly the masquerade that is being sold to the people on all the channels and through all the media. If you are interested in finding out the truth, give me a sign, only if you are genuinely interested, as my ability to trust is almost exhausted".

Our response was not encouraging, yet it was sincere. We feel pretty exhausted ourselves. 

It is the burnout, it is focusing on the circumstances of the catastrophe, it is the inability to grasp everything in this field of investigation; we were not feeling capable as journalists to collect the details also for what happened after the fire. We waited for a while, taking on other projects.

And, day by day, messages from more and more people started to come one after another.

Overwhelmed by secrets, the doctors, the relatives and the friends of the ones wounded at Colectiv and the people from the healthcare system broke out. Everyone aiming to let the public grasp a clearer image of what happened.

Then there was the meeting.

The doctor works at the Burn Hospital, having gathered over 17 years of professional experience in operating on patients with severe burns. 

This interview is recorded but we agreed not to reveal the name of the doctor just yet.

In fact, it is no longer needed.

Because, after being asked about it, the board of the hospital confirmed every detail of the doctor’s testimony!

We start with the one who decided to speak up.

 

1. "The young people died in a biological bomb, because of the hospital-acquired infections."

- Which is the most important fact you want to communicate to the public related to what happened with the wounded people from Colectiv?
- That many of the wounded died before their time. Here, at the Burn Hospital, the majority died because of infections with different germs, among which the most aggressive is the pyocyanin. I talk with certitude about the Burn Hospital, but I know from colleagues from other hospitals that the situation is similar.

- Isn’t this the way the people with severe burns die?
“Not in the civilized world, no. I don’t want now to refer to studies from the US, neither to go into figures, but they enjoy a much higher rate of recovery.”

”Here, the ones who escaped from the fire died because of the bacteria infesting the hospitals and none of the heads of the health system has the audacity to admit it” A DOCTOR FROM THE BURN HOSPITAL

- But the pyocyanin bacterium had existed before Colectiv.
- Of course it existed. That’s exactly the problem! At the Burn Hospital people have been massively killed by the septicemia caused by bacteria infections. Why haven’t they announced their families from the first days, to give them the option to reroute them abroad?!

- Could they have been transported?
- Some of them, yes. The bacteria infections appear, from our experience, around the fifth day. There was time. After being intubated, the patients could have been transported.

- So, they got the infection.
- Yes, and from that moment on the chance to remain alive is really, really small. People die because these hospital acquired germs are very aggressive and resilient. And the bacteria become immune as they overuse antibiotics in hospitals. But this is another story. Let’s rewind, the pyocyanin is resilient to any antibiotic, except for Colistin. The problem is that if you overuse Colistin, that may lead to kidney failure.

- Where do patients get in contact with germs?
- Anywhere! We are not, as far as both intensive care and other units are concerned, an adequate burn hospital. Although we are the only specialized doctors around the country. The rest of the hospitals have a few cases a year, the Military Hospital a few tens and here we have hundreds of severe burns patients each year.

 

- What would the normal conditions imply?
- Each patient should be isolated. The same for the access circuits. The air supply must be supervised. Here, all the patients are washed in a single bathtub. The tub is disinfected, it’s true, but ask the hospital management if this is enough! The hospital germs are extremely resilient.

- If the Burn Hospital does not provide appropriate conditions for the burn patients, who will?
- Not a single unit around the country. There is only the "Floreasca" modern burn unit, which you also wrote about and which was inaugurated and yet lies unused. Total mystery. The French also asked professor Lascăr about it.

- And what did he answer?
- That the staff was not trained.

”"I knew about the germs hazard. In the Burn Hospital there were people, I am talking before Colectiv because people are people, all of them, who died with only 10-15% burn wounds! And that because of the infections"” DOCTOR FROM THE BURN HOSPITAL

- We had the impression of a massive mobilization of the health system on the Colectiv night and afterwards.
- I know the situation was perceived that way. And efforts were made. But there are also many examples who reveal our limitations. Or sometimes the recklessness. Do you know, for instance, that at the Burn Hospital the testing lab was not open that night?!

2. "They ran detailed tests for the patients only in the morning."

- That information regarding the tests is hard to believe.
- But it’s true! People from the lab were not brought in. Only the tests from the anesthesia and intensive care unit were done and those are just a few, obviously.

- And the tests were that important that night?
- Think about a normal set of tests. We had no information about the white blood cells, for instance.

- What is your explanation?
- I don’t have any. The lab was not open and on top of that not all the doctors were brought in. There were situations when the operation started an hour late because there were not enough specialized doctors as they were undergoing other procedures.

”The French doctors who were in Romania those very days for the Burn Unit Program of the World Bank said about our hospital as little as this: «Totalement vetust»” DOCTOR FROM THE BURN HOSPITAL

3. "There is no national medical protocol for the treatment of the severe burns patients."

- A few days after Colectiv, Rareș Bogdan officially announced that a hospital manager from Transilvania told him that there is no protocol in Romania for the severe burns patients. Despite the pressures also done by other people, I saw Sorin Ioniță still asking about it, the subject was not clarified. Is it true that we lack such protocol?
- Yes, it’s true, we do not have a protocol!”

- Hold on a second. Does this mean that every hospital treats such a case as it sees fit?
- Yes, it means that patients are treated differently from one hospital to another. And that’s exactly how things unfolded after Colectiv! There were hospitals where the operations were done after a few days, although from our experience with thousands of cases, the operation is essential because the burnt areas are the most infection sensitive. I do not point the finger; I just relate the facts.

- And if there were a protocol, would it have been disseminated to everybody?
- Yes, sure, it would have been mandatory.

- You mean that for a heart attack we have a protocol, and one patient is treated in the same way both in Suceava and in Bucharest, but we lack such protocol for the severe burns patients?
- I know it is hard to believe, but it’s the truth. We don’t have such protocol! Some of the colleagues from other hospitals called, others didn’t. What example should I provide for the people to understand? Some of us used bronchoscopies to see if the respiratory tubes had been affected, others didn’t.

- Let’s go back to the infections, please.
- The wounded did not die only from pyocyanin. They died also from Acinetobacter, an extremely aggressive germ as well. We had cases where the tests of patients indicated the presence of four, five, bacteria! They didn’t stand a chance even if they got abroad, as they got there over infected.

”Despite the exceptional situation, we ran tests only on Mondays and Thursdays, as that was the regular schedule, although we should track the evolution of the bacteria according to the applied treatment” DOCTOR FROM THE BURN HOSPITAL

The official position of the Burn Hospital - Adrian Stănculea, head of the Anesthesia and Intensive Care Unit:

"It is possible that each one of them died of infections, but these are things that nobody wants to hear!"

We were expecting the management of the Burn Hospital to hide from the harsh accusations of their own medical staff. But this wasn’t the case. They confirm. We even sense relief in what they say. ”We do not keep secrets, we’ve been willing to say these things for a long time”.

1. "Yes, the ones who died more than one week after the accident were killed by bacteria"

- Is it possible for one part of the deaths recorded in your hospital in the Colectiv case to be caused by hospital acquired infections?
- Yes. It’s possible. Even for the patients transferred at the units abroad we had the CBC results after they left. Some of them were positive. We had a case that started with a good evolution, the patient was cut from adrenaline and after two or three days his condition deteriorated and he got into a septic shock, so he had an infection. He died.

- From what you know, the situation at other hospitals was the same?
- We received three patients from other hospitals. Two from Pantelimon and one from Sf. Ioan. It is possible that these patients were already contaminated when they arrived at our hospital.

”The infections acquired in Romania affected also the ones who were rerouted. A patient transferred to England died. And, the day he died, we found his positive blood panel left at home”  ADRIAN STĂNCULEA, HEAD OF THE INTENSIVE CARE UNIT, THE BURN HOSPITAL

- When did you have the first results of hospital acquired infection?
- Ten days after. No, a week after. We had cases where the bacteria cultures became positive in our lab after the cases were rerouted abroad. But you should know that the collection of the sample itself may carry the blame. It can cause contamination… I would like you to understand that a large burns patient develops the syndrome of systemic inflammatory reaction and if you add to that the nosocomial infection, that person goes into sepsis and dies.

- Which is generally the quota of the hospital acquired infections at the Burn Hospital?
- Are we talking about the Anesthesia and Intensive Care Unit?

- Yes.
- According to the official data, around 10%. The treating doctor is the one who should call the nosocomial infection. It is in his/her power to connect the evolution of the illness with the positive CBC. Three years ago, from my position as head of the unit, I took full responsibility of the nosocomial infections. When everybody had to declare such cases, not even a single doctor made any record. Maybe also because there is a lot of paperwork to do. Two months ago, I called 6 nosocomial infections out of 30 cases within the intensive care unit.

- Should we understand that the contamination with hospital acquired germs is much higher than the values on paper?!
- The contamination is much higher, but it is not recorded. Upon death, only the septic shock is declared.

- Why? Out of fear?
- Let me explain. The patient may be contaminated in the hospital, but not also affected. The test that shows the patient is infected, that the white blood cells started to work, is the tissue culture, which cannot be done in our lab. On this matter we cooperate with the Bals Hospital. There is a difference between colonization and infection. If the patient dies within the first 5 days, I cannot declare nosocomial infection as the infection lacks the time to unfold and evolve into sepsis. The severe burns patients are associated with a high risk of infection. So yes, there are a lot of infections. But there are also cases transferred with sterile wound secretion.

- Yes but here we refer to the contamination with the kind of germs that exist only in the hospital as they have acquired resilience to antibiotics. As the selected germs of pyocyanin, Acinetobacter or klebsiella... Is the Anesthesia and Intensive Care Unit from the Burn hospital contaminated with such germs?
- Yes. The situation is the same everywhere.

”All the hospitals are contaminated. Who does not admit that, has lost it!” ADRIAN STĂNCULEA, HEAD OF THE ANESTHESIA AND INTENSIVE CARE UNIT

- Let me repeat the question. Is it possible for the patients who were injured at Colectiv and who died one week after, to have died because of hospital acquired infections?
- Yes. It is possible for all of them to have died because of nosocomial infections. I tell it as it is, so that maybe a new building is constructed for this hospital. When prime minister Cioloş came to visit he asked us what we needed and we replied «A new building!».

- What do the hospitals from abroad, where the patients from Colectiv were transferred, have to offer?
- They also have nosocomial infections. But the patients are more protected. They are treated in individual wards. There they are ventilated, operated, cleaned, treated. From there they get out either fully recovered or dead.

- At the Anesthesia and Intensive Care Unit of the Burn Hospital are the patients bathed in the same tub?
- Yes. We have just one tub for the Anesthesia and Intensive Care Unit but at least we are the only hospital in the country where they get a bath!!!

 

2. "The lab was not open but for the severe burns patients the blood tests are not a priority."

- Was the hospital lab functional on the night of the tragedy?
- I don’t remember.... It’s possible it was not operational. Yes, it did not operate. The test samples were collected in the morning.

- You did not need urgent tests for so many cases that arrived during the night!?
- No, because for the severe burns patients the blood tests are not a priority. Basic blood tests like CBC, coagulation and ions are done within the Anesthesia and Intensive Care Unit.

- Is it true that the antibiograms were done only on Mondays and Thursdays although they would indicate germs?
- Yes, it is even a practice set by me, it is written on the wall, as we had an excess of tests. They would change antibiotics even twice a day. But if an emergency case comes in on Friday, of course we run tests.

3. "There is no national protocol, I told the ones from the Municipal Hospital to stop undergoing tracheostomies!"

- Is there a therapy protocol for the severe burns patients?
- There is no national protocol at the moment. There is something on this matter in Timişoara, but nothing besides that. The colleagues from the other hospitals called us to ask how they should proceed ... The ones from the Municipal told us that they want to do like the ones at Floreasca, meaning to undergo tracheostomies. I told them to stop as they were doing nothing more but increasing their chances of contamination! They should be intubated before developing acidosis. It is understandable we know more than the others as all the burn patients across the country are brought to us. Nobody wants to deal with burn patients.

Mixich: "The bacteria bomb, the first priority”

The doctors from several hospitals know exactly the cause of death for the injured at Colectiv. It is not by chance that Vlad Mixich, one of the journalists with the most reliable sources within the medical system, put this issue of the hospitals in Romania on top of the list of the current Government.

The second part of the dialogue with the doctor from the Burn Hospital in the tomorrow newspaper:

"In order to create the sense that death is inevitable and that no one is to blame, they said all the patients had burns of pulmonary tubes. That’s not true! It was also said that such burns were unprecedented. That’s not true! We have treated thousands of burn patients and the injured from Colectiv were exactly the same. They were declared different so that people wouldn’t ask themselves why they could not be saved"