Report - Fly larvae grew in comatose patients

KANSAS CITY, Mo. -- Maggots infested the noses of two comatose patients at a Veteran's Administration hospital, and mice were so common that nurses cared for some of them as pets, according to a medical journal report.

The story in today's Archives of Internal Medicine said mice once dashed over the feet of employees in the hospital director's suite during the 1998 infestation.

Hospital officials said the mice were contained within a small part of the hospital and were quickly eradicated, along with the flies. The hospital investigated the incident, but hospital officials refused to release the report Friday, citing a Veteran's Administration regulation.

"We learned from that incident and took action to make sure it doesn't happen again," said Pat Landon, the hospital's director of facilities.

It all started with a housecleaning oversight, according to the article.

Dr. Stephen Klotz, then the hospital's chief of infectious disease, said the mice moved in after the cafeteria and food storage area were dropped from a cleaning list. Some areas hadn't been cleaned in at least a year, according to the article.

"Every canteen employee was aware of the magnitude of the mouse problem but had not reported it," the article said.

By July 1998, a pest control contractor put out bait and glue boards to kill the mice.

Inspectors later found dead mice in food storage rooms, mouse nests behind boxes on food shelves, and mouse droppings on the floor of a cafeteria work room. They even found live mice trapped in a large wastebasket.

Flew into ICU

But cleaners missed some of the dead mice. That brought the flies.

Big, lumbering green blowflies like to lay their eggs in dead mice, which the hospital had in abundance by that time. Electronic fly-control devices were installed. And pest-control workers began using live traps for the mice, to take away the flies' reason for entering the hospital.

Some of the flies flew into the hospital's intensive-care unit, where they were trapped by automatic doors and kept away from mouse carcasses. The maggots were found in the nostrils of one patient on July 22, 1998. They were removed immediately, and were not believed to have harmed the patient, Klotz said. The patient died two days later from other causes, Klotz said.

Maggots were found in the nose of a second patient on Sept. 30, 1998.

Klotz said he believes neither patient's family knows about the maggots.

"The maggots are actually harmless," he said. "They're ghastly, but they're harmless."

In response to the article, hospital officials defended the hospital's cleanliness. Barbara Shatto, the hospital's quality manager, said the hospital got a score of 99 out of 100 when it was inspected by the Joint Commission on Accreditation of Hospital Organizations in October.