Geisinger has accepted full responsibility for the bacterial infections that led to the deaths and injuries of infants in its Danville medical center neonatal intensive care unit last year, something unheard of in cases against health systems, said the attorney representing the families involved.
“They acknowledge full legal responsibility not simply for these infections occurring, but (that) these infections were the factual and legal cause of two deaths and one serious brain injury,” said attorney Matt Casey, of Ross Feller Casey LLP, of Philadelphia, who has been practicing law for 21 years.
The admission is part of Geisinger's settlement it reached with two families whose infants died. A second child in one family suffered a permanent severe brain injury.
“In addition to monetary compensation, this litigation and settlement have resulted in express apologies from Geisinger to my clients and contributed to Geisinger taking steps to prevent anything like this from happening again,” Casey said in a statement.
“Geisinger recognizes Mr. Casey’s advocacy on behalf of these families and we apologize to each of the families involved,” said Dr. Jaewon Ryu, Geisinger president and chief executive officer. “The loss of a child is tragic, and this settlement can never replace these young children. However, we believe we have taken the steps necessary to prevent future infections and spare other families from this loss.”
Eight infants in all were sickened and three died from pseudomonas bacteria infections linked to breast milk.
“Nothing can change what happened, and these families remain heartbroken,” Casey said. “They lost children and in one case, they have to provide care for a child who suffered a brain injury.”
He added, though, “I’m pleased we were able to resolve the case, both for monetary compensation but also for the closure it hopefully will provide for these families.”
Casey filed a wrongful death lawsuit on behalf of Zuleyka Rodriguez and Luis David Cepeda, the Hazle Township, Luzerne County parents of Abel David Cepeda, who died at the age of 6 days. Casey said he also intended to file a lawsuit on behalf of another Northeastern Pennsylvania couple whose twins were born at Geisinger during the outbreak, but the lawsuit was not necessary.
The death of one of the twins and severe brain injury of the other were part of the settlement negotiation.
The attorney said he was not at liberty to identify the other family or to reveal either settlement amount.
“In the context of medical malpractice litigation, this resolution was quicker than most,” Casey said. “Most cases settle, if they do settle, just prior to a trial date.”
The case had been scheduled to go to trial in March of 2021.
"Geisinger has changed the process by which it prepares donor breast milk, and it has accepted full responsibility for what happened to my clients’ children," Casey said. "I recognize Geisinger’s willingness to cooperate in achieving a resolution of these cases and its efforts to be transparent during the litigation.”
By Dec. 6, Geisinger corrected several deficiencies discovered by the state Department of Health (DOH) in October, and the neonatal intensive care unit (NICU) resumed normal operations.
Geisinger has not had any additional cases or outbreaks in the NICU since then, Geisinger spokesman Matthew Van Stone said Wednesday.
DOH representatives visited the medical center on Oct. 18 and cited Geisinger for not having a written policy that reflected changes implemented on Sept. 30 for cleaning equipment used to measure donor breast milk, Van Stone said.
"We immediately corrected the citation and drafted a new policy the same day," the spokesman said. "Since September 30, there have been no new cases of infants becoming ill from pseudomonas in the neonatal intensive care unit."
DOH determined during its initial investigation that the hospital’s systemic failure to prevent infection in its most vulnerable patients constituted “immediate jeopardy” — a legal finding that means Geisinger placed its patients at risk of serious injury or death.
Geisinger routinely failed to sanitize the equipment it used to prepare donor breast milk, which led to the infections and deaths, according to the report.
A total of eight premature infants at Geisinger tested positive for the bacteria between July 1 and Sept. 29, according to the health department’s report. A subsequent investigation found pseudomonas in a cylinder used to prepare donor breast milk, on a brush used to clean the cylinder, and in breast milk that had been given to an infant who died Sept. 30, the report said.
Geisinger announced the deaths at an Oct. 7 news conference. The cause of the contamination was announced about a month later.
Neither Geisinger nor the DOH would say if the department fined Geisinger.
Pseudomonas bacteria, which are waterborne, are common and often harmless but can pose a health risk in fragile patients. The hospital saw no new cases of infants becoming ill since the change. Geisinger said it now uses a process using single-use, sterile equipment.
The hospital also diverted mothers delivering at less than 32 weeks and babies born prematurely at less than 32 weeks during the investigation.
After conducting follow-up inspections and finding the hospital to be in compliance, DOH cleared Geisinger to resume normal operations in the neonatal intensive unit on Dec. 6.