DECH closes operating rooms Insects, nurse shortage cause shutdown until end of August

MACHIAS – Too many bugs and not enough nurses have closed the operating rooms at Down East Community Hospital, and they will remain closed through the end of August, except for life-threatening emergencies, the hospital’s chief executive said Tuesday.

The operating rooms have been closed for all but two days since July 16.

Philo Hall, the hospital’s chief executive officer, said he sent a memorandum to medical staff Tuesday informing them that the operating rooms would be staffed only for emergency surgeries or emergency cesarean sections. Other hospital patients who need surgery will be stabilized and taken to other facilities, he said.

Hall said the extended shutdown is the result of a shortage of operating room nurses and a surge in the population of springtails – the tiny insects that caused the hospital’s decision to close the three-room surgical suite on July 16.

Springtails are minute, wingless insects commonly found outdoors but enter buildings through doorways, screens or other tiny openings.

The bugs had closed the operating rooms for two weeks last year. Hall said the hospital believed it had solved the problem last summer when the insects disappeared after a commercial applicator put pesticides in between the interior and exterior walls of the surgical suite.

The closing has ramifications for the 36-bed hospital, which serves 20,000 people, from Milbridge to Lubec. A total of 13 people – nurses, housekeepers, schedulers and technicians who worked in the operating rooms – are either not working as a result of the shutdown or have been reassigned to other duties within the hospital.

Hall said the hospital’s gross revenues were down by approximately $300,000 in July, and a significant portion of that amount was the result of lost income from surgeries.

Dr. Aziz Massaad, chief of surgery, said Tuesday that operating rooms do for small hospitals what oxygen does for a body. He said the hospital’s operating rooms are used by three general surgeons, an orthopedist, a gynecologist, cardiologist, pulmonologist, two part-time ophthalmologists and three part-time urologists.

Massaad said he performs 80 to 100 procedures a month and the operating room does 240 cases a month.

“You can imagine the impact on our staff,” he said. “You have to answer to all these patients and see all these people suffering.”

Massaad said that the operating rooms had reopened on Aug. 12 for the first time since the springtails were detected on July 16. It was reopened after a new physician, Dr. Imad Durra, a specialist in infectious diseases, called the Centers for Disease Control and Prevention and learned that springtails had no known connection to human disease, he said.

Staff at the federal agency had said that, given the type of insect, it was unrealistic to think the count would ever get down to zero and that a count of below 20 in an 8,000- to 9,000-square-foot surgical suite was acceptable.

“They basically gave us the authority to operate, but said the decision had to be local,” he said.

After medical staff, administrators and board members made the decision to reopen last week, surgeons were operating by Thursday, when they were informed that the hospital had lost nursing staff and had to shut down again, Massaad said.

Massaad said one of the nurses was fired, another was on sick leave, and three temporary nurses who were working under contract decided to leave.

The closure was immediate and temporarily included surgery for life-threatening emergencies last weekend, he said.

Hall said the insect population had gone up and some people weren’t comfortable continuing to work in the operating room. Ecolab, a pest elimination company, expects to reduce springtail populations to zero by the end of August and the staffing shortage should also be addressed by then, Hall said.