UPMC changes story on mold infection of patient at Presbyterian

Mold discovered in a UPMC Presbyterian transplant patient's lung tissue raises the question of whether he — and possibly other patients — inhaled spores in the cardiothoracic intensive care unit, experts said Tuesday.

“The outbreak could be more widespread and have infected more patients than the hospital is admitting,” said hospital safety expert Larry Muscarella, a Philadelphia-based biomedical engineer who specializes in infection control.

UPMC spokeswoman Wendy Zellner said there's no evidence mold adversely affected other patients, adding it would not threaten healthy staff members and visitors at Presby, the largest hospital in the region.

This month, investigators opened a wall in a room of the unit and found mold and later discovered more in other parts of the 20-bed unit before closing it indefinitely.

UPMC's chief nursing officer, Holly Lorenz, based on questions from the Tribune-Review, initially said Monday a critical care doctor determined that a male transplant patient had mold in an external wound. However, on Tuesday, Zellner said doctors detected mold in the patient's lung tissue, not a wound, precipitating the ICU's closure and relocation of patients Sept. 8. She declined additional comment.

UPMC on Monday said it immediately informed the state Department of Health and Allegheny County Health Department about the mold situation.

Asked Tuesday whether the public should have been informed, Pennsylvania Health Department spokeswoman Amy Worden referred to an emailed statement.

“The PADOH is actively investigating the report. In the event the PADOH determined that a health threat existed, steps would be taken to protect the public,” the statement said.

Melissa Wade, a spokeswoman for the county Health Department, said the department did not need to be notified about the outbreak and UPMC provided the information as a courtesy.

The hospital giant has not revealed what type of mold was found or what caused it to thrive in the ICU.

Most likely, humidity, water leakage or construction produced the moldy environment, Muscarella said.

“Construction, as in banging on walls and knocking down foundations, in the hospital could cause mold to be aerated,” he said. “If there was water leakage behind the walls and water spots did not start appearing, you can't fault the hospital for that.”

Dr. John Perfect, a professor of medicine and chief of infectious diseases at Duke University School of Medicine, said transplant patients could be particularly susceptible to mold infection because of a compromised immune system.

“Patients with heart and lung problems who are opened up for a period time could have a colony or couple of spores drop down into the chest and create a local infection,” he said.

Perfect did not rule out the possibility that the infected patient inhaled mold at home and a different type was found behind the ICU walls by coincidence.

“The important thing is to shut it down and look closely at the ICU environment,” he said.

The type of fungus in question should be easily identifiable, said Dan Howard, owner of Envirospect of Western Pennsylvania in Freeport. He handles commercial and residential mold inspections and assessments.

“When I test mold, I send it to a laboratory and have results within 48 hours,” he said. “I would assume UPMC and the state know what type of mold this is by now.”

Muscarella found the lack of transparency from the state Health Department and UPMC to be disturbing.

“Once this had been identified and confirmed, there is the question of whether the public should be told so they can make a choice where to go for a medical procedure,” he said. “We should not be depending on tips in order to connect the dots and learn about outbreaks.”

Ben Schmitt is a staff writer for Trib Total Media. He can be reached at 412-320-7991 or bschmitt@tribweb.com.