Deadly infection could have been caused by poor maintenance: doctors
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Deadly infection could have been caused by poor maintenance: doctors

In April 2016, two leukemia patients on the same ward at Canberra Hospital contracted a rare and dangerous fungal infection called scedosporium.

Both died in hospital within days of each other.

Yolandi Vermaak says series of failures contributed to her husband's death at Canberra Hospital

Yolandi Vermaak says series of failures contributed to her husband's death at Canberra HospitalCredit:Dion Georgiopoulos

Yolandi Vermaak, the wife of 56-year-old Reynier who was one of the men to die on the ward, has spent the past two years fighting for the hospital to be accountable for his death.

Mrs Vermaak says the infection was the final failure that led to her husband's death after a series of events that started with a dangerous combination of drugs.

She only found out about the fungal infection during a conversation with doctors weeks after he died while discussing the reasons for his sudden death.

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With an already compromised immune system and failing liver there was little chance of recovering from the infection.

She said doctors told her it was being treated as a "mini outbreak" and they believed construction work, along with poor maintenance of HEPA filters, most likely led to the fungus creeping into the hospital.

The hospital has now acknowledged, in response to the The Canberra Times' questions, that two patients contracted the infection.

But they have continued to suggest the patients could have contracted it independently and outside the hospital.

Mrs Vermaak is angry and wants to make sure her husband's death was not in vain.

Reynier Vermaak

Reynier Vermaak

In response to formal complaints to ACT Health and the human rights commission, the hospital said while it was possible Mr Vermaak contracted the fungal infection at the hospital it could have been dormant in his system for months or he could have contracted it while at home or other parts of the hospital.

The hospital failed to mention another man on the same ward, in the same week, with the same condition, had also contracted the infection and died.

While Canberra Hospital has maintained its filters were up to date, it has declined repeated requests to provide its maintenance records.

"All these things that happened to Reynier tell a story in the sense that there was a knock on effect," Mrs Vermaak said.

"One piece fell over and then they all followed."

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By February 2016, Mr Vermaak was in remission after successful treatment of leukemia.

The family, originally from South Africa, was loving its new life in Australia and working towards an ultimate goal of gaining Australian citizenship.

His doctor advised him to take one more round of chemotherapy which he took in tablet form after a nurse delivered it to his home.

But within days of starting the medication he was back in hospital hospital suffering from drug induced liver failure.

Mrs Vernaak believes the combination of the chemotherapy drug mercaptopurine and his regular gout medication allipurinol,  led to the liver failure.

While Mrs Vernaak said she gave him the allipurinol while he was taking the chemotherapy drug, Canberra Hospital has not conceded he was taking both medications,  maintaining the cause of his drug induced failure could not be certain.

When Mr Vermaak's liver started failing doctors eventually ordered a biopsy to determine whether it was due to his leukemia or due to the drugs he was taking.

But this test was delayed for days because Canberra Hospital did not have the necessary equipment available to complete the test.

The test was made more difficult by the deteriorating state of his liver, and he sustained two puncture wounds in his liver during the procedure, causing him to bleed internally.

He deteriorated further after contracting infections, and died from sepsis on April 12, 2016.

By late March tests had shown Mr Vermaak had relapsed with leukemia present in his bone marrow, but Ms Vermaak believes he was never given the chance to beat it.

Doctors told Mrs Vermaak the scedosporium was a contributing factor in her husband's death, and is almost impossible to fight off once one’s immune system is compromised.

Multiple doctors were of the belief the infection - which is found in soil - came into the hospital due to construction work.

One doctor told her he discovered there were problems with the hospital's maintenance schedules which meant the HEPA filters may not have been working as effectively as they should to keep microbes out.

He said a number of clinicians believed the most likely way the two patients contracted it was through the construction work going on nearby to the cancer ward.

If there had been one more infection the whole ward would have been closed down, doctors said.

But in written responses to Mrs Vermaak, ACT Health has not acknowledged the possibility the construction caused the infection, nor acknowledged the fact another person on the ward contracted the disease at the same time.

It suggested Mr Vermaak could have contracted the fungus - which is found in the soil - while at home or in other parts of the hospital.

They also suggested it could have been in his system for months before manifesting itself as his condition deteriorated.

ACT Health said the filters were maintained but it has refused to provide The Canberra Times or Mrs Vermaak copies of the maintenance reports.

A spokeswoman for ACT Health said "time constraints" meant they were not able to provide the records which were first requested last week.

A number of scientific studies have linked construction work in hospitals and leukemia patients contracting the fungal infection.

"Outbreaks in neutropenic patients in hospitals have been described and have been associated with hospital construction," a 2008 study published in Clinical Microbiological Reviews said.

After the deaths, there were no changes at Canberra Hospital which took into consideration the possibility the infection came into the hospital due to construction.

ACT Health said the action it took after the infections was discovered included disinfection and cleaning and warning patients to avoid exposing themselves to soils.

ACT Health has denied the doctors' claims there was an "outbreak" and said the source of the infection in the two patients was never determined.

"The ward inspection included an extensive review of ward cleanliness and general maintenance, checking of the air conditioning systems and environmental testing," she said.

"ACT Health wishes to convey its utmost sympathies to Mrs Vermaak over the loss of her husband in 2016.

"It is not appropriate for ACT Health to comment on Mr Vermaak’s clinical treatment while he was in our care."

Mrs Vermaak said in his last days, her husband made her promise she would make someone accountable for the events that led to his death.

"This was not a normal death, this was an injustice," she said.

"I think if his story is told I could go on with my life, and I could rest."

Daniella White is a reporter for The Canberra Times with a special focus on health issues