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has been spearheading, the problem has not run its course, given that we at Angels Orthopedic had another case late today. It’s a patient by the name of David Jeffries.”
    â€œOh, no!” Angela lamented. “I hadn’t heard. I’m crushed. We’d been spared for more than a week.”
    â€œLike all the previous cases, we’re trying to keep it quiet,” Herman said. “As I said, it unfolded late this afternoon.”
    For a few moments, silence reigned.
    All eyes switched to Cynthia. The expressions ranged from anger to dismay to inquisitiveness: How could this happen after all that Cynthia had just told them was being done, with considerable funds that they did not have?
    â€œIt hasn’t been confirmed it was methicillin-resistant staph,” Cynthia snapped defensively. She’d been called by the hospital’s infection-control committee chair and briefed on the case just prior to coming to the current meeting.
    â€œIf you mean it hasn’t been cultured, you’re right,” Herman said. “But it was positive by our VITEK system, and my lab supervisor says she’s never had a false positive: false negatives yes, but not false positives.”
    â€œGood Lord,” Angela said, trying to keep her composure. “Was the patient operated on today?”
    â€œThis morning,” Herman said. “Anterior cruciate ligament repair.”
    â€œHow is he doing, or shouldn’t I ask?”
    â€œHe died while being transferred to the University Hospital. For obvious reasons, once it was clear he had septic shock, he would have been far better treated over there.”
    â€œGood Lord,” Angela repeated. She was devastated. “I hope you realize that was a bad decision. Sending two patients in as many days to a regular, full-service hospital raises the risk the media might get ahold of the story. I can just see the headlines: Specialty Hospital Outsources Critical Patient. That would be a PR nightmare for us and do what we are trying desperately to avoid: negatively affect the IPO.”
    Herman shrugged. “It wasn’t my decision. It was a medical decision. It was out of my hands.”
    â€œHow has the Jeffries family taken it?” Angela asked.
    â€œAbout the way you would expect,” Herman responded.
    â€œHave you spoken with them personally?”
    â€œI have.”
    â€œWhat is your sense; are they going to sue?” Angela asked. At this point, damage control had to be a priority.
    â€œIt’s too early to tell, but I did what I was supposed to do. I took responsibility on behalf of the hospital, apologized profusely, and told all the things we have been doing and will do to avoid a similar tragedy.”
    â€œOkay, that’s all you can do,” Angela said, more to reassure herself than Herman. She made a quick note. “I’ll inform our general counsel. The sooner they get on it, the better.”
    Bob spoke up: “If there had to be another postoperative infection, as tragic for everyone as it is, it’s best the patient passed quickly. The cost to us is considerably less, which could be critical under the circumstances.”
    Angela turned to Cynthia. “Find out if the procedure was in one of the operating rooms that had just been cleaned. In any case, see that it is again taken care of, but don’t shut the whole OR. And find out when all the involved personnel had been cultured and if any of them had been a carrier.”
    Cynthia nodded.
    â€œIsn’t there some way we can get our physician owners to up the census?” Bob asked. “It would be enormously helpful. We have to have revenue. I don’t mind billing Medicare in advance if it is only for a couple of weeks.”
    The three hospital presidents looked at one another to see who would speak. It was Herman who spoke up: “I don’t think there’s any way to increase census, especially with this new MRSA