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Area knee surgeries canceled due to strange illnesses

Duluth operating rooms are a bit quieter this week than they would normally be. The Minnesota Department of Health (MDH) has asked all hospitals in the state to refrain from doing any elective knee operations for a one-week period, while state he...

Duluth operating rooms are a bit quieter this week than they would normally be. The Minnesota Department of Health (MDH) has asked all hospitals in the state to refrain from doing any elective knee operations for a one-week period, while state health officials investigate three deaths that occurred recently.
All of the deaths involved patients who had recently had knee surgery. The patients included a 23-year-old man and a 78-year-old man, both of whom died on Nov. 11, and a 60-year-old man who died on Nov. 16.
The first two patients had surgery on Nov. 7 and Nov. 9 at a hospital in St. Cloud. The third patient had surgery on Nov. 13 at a hospital in Alexandria.
All of the patients had previously been healthy.
Orthopaedic Associates of Duluth, a group of orthopaedic surgeons who work mainly at St. Luke's Hospital and the Lakewalk Center, have canceled 16 knee surgeries that had been scheduled this week. The orthopaedic group at SMDC has canceled 14 surgeries. Both groups say that because of the holiday their number of scheduled surgeries is lower than usual.
"People don't choose to have elective surgery near a holiday," said Beth Johnson spokeswoman for SMDC. "We are rescheduling for as early as next week. Because it's a slow time of year, we're finding it relatively easy to squeeze them in."
As an extra precaution, SMDC is also canceling its elective knee surgeries at St. Mary's Hospital in Superior, even though the Department of Health is only asking hospitals in Minnesota to comply with its request. Two such surgeries had been scheduled there for this week.
"We've taken that as an extra precaution for safety reasons until the health department determines the cause of the deaths," Johnson said. "When this happens and you don't know the cause, you have to take the necessary precautions."
Officials at the Minnesota Department of Health are now reporting, on the basis of preliminary lab results, that one of the three patients may have been infected with bacteria from the clostridium family. The clostridium bacteria were found in clinical specimens taken from the 23-year-old patient who first became ill. Clostridium bacteria produce a potent toxin, and a clostridium infection can be life-threatening.
The one-week moratorium on elective knee surgery is precautionary in nature, MDH officials say. While the moratorium is in effect, MDH investigators will continue their efforts to determine what the three cases might have in common -- and what might have caused the deaths.
Larry Sundberg, with the St. Louis County Health Department, says the state will work quickly to determine if there were any links between the three deaths.
"They know this is a big burden (to ask hospitals to hold off on elective knee surgeries) so they're going to be working fast and furious to determine a cause," Sundberg said. "If it's a medical device or product, then you're looking at a nationwide issue. I'm sure they're hoping to have an answer by the week's end."
While all of the patients who died had some form of knee surgery, they didn't all have the same type of procedure. There are important differences, as well as similarities, between the three cases, officials noted. All three patients became ill up to several days after having surgery, and deteriorated rapidly after their first symptoms appeared. In all three cases, symptoms of the illness strongly suggested some type of infection.
Clinical specimens from all three patients, as well as drugs used in treating the two St. Cloud patients, are being analyzed by MDH and the U.S. Centers for Disease Control and Prevention. More lab results are expected next week, and officials hope they will provide additional clues about what may have caused the deaths.
MDH has also asked health care providers throughout the state to report any deaths or illnesses that appear to be similar to the three currently being investigated.

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