Expert: 'I would put money' on linens causing UPMC mold outbreak

A hospital environmental expert who detected mold on linens supplied to UPMC from a DuBois laundry facility told the Tribune-Review on Friday that he believes laundry was the source of fungal infections that killed transplant patients at the health giant's hospitals.

“I would put money on it,” Andrew Streifel said. “The odds are that it is.”

Streifel, a hospital environment specialist with the University of Minnesota's department of environmental health and safety, was hired in 2016 by UPMC to investigate its laundry supplier, Paris Healthcare Linen Services. On May 2, he and a colleague issued a report indicating they found heavy amounts of rhizopus mold at the laundry facility and on its roof.

“I don't know why this launderer ever passed an accreditation after what we found,” Streifel said. “I'm referring to the amount of dust accumulated on inside surfaces and the roof. It looked like a snowstorm up there.”

As part of the investigation, Streifel inspected a linen cart delivered by Paris to UPMC Montefiore on Feb. 2.

Samples showed “heavy fungal growth” of rhizopus on the “wet sheets collected from the UPMC laundry carts.”

He explained Friday that he sampled a sheet taken from the middle of a pile of linens on the cart to ensure he was testing one of the cleanest sheets. He said the laundry carts were wet and linens inside were damp.

“The test was very conclusive for fungus,” he said. “It was also conclusive that something was wrong with that laundry.”

Still, the state Department of Health doesn't appear to be influenced by the findings.

“The facts of this investigation don't support the conclusion that infections resulted from exposure to linens,” spokeswoman April Hutcheson said in an emailed statement. “At this time, there is no evidence of an ongoing outbreak. We continue to provide consultative support to UPMC and will investigate as warranted.”

Presented with the Health Department's stance, Streifel said, “That is a very strong political statement. I think it's in UPMC's court now.”

Paris CEO Dave Stern also issued a statement Friday, saying, “We continue to cooperate with all regulatory agencies involved in the oversight of linen processing. We are reviewing recently filed court documents and cannot comment further due to ongoing legal proceedings.”

Five people have died in connection with the mold crisis that was first reported by the Tribune-Review in September 2015. UPMC contends the most recent death was not mold-related. Two lawsuits have settled for $1.35 million apiece.

It remains unclear why Streifel's report never surfaced after the Centers for Disease Control and Prevention declared the exact mold source was unknown. The CDC issued two separate reports in connection with the UPMC mold crisis. The first, issued Dec. 22, 2015, found “no single source” of fungal infections. The report pointed to ventilation at Presby as a possible source.

On May 13, just 11 days after the Paris report was issued, the CDC published a paper in the Morbidity and Mortality Weekly Report recommending that the ventilation system not be used for patients with weakened immune systems. The so-called “negative pressure” system, which pulls outside air into a room, in some cases “could result in net harm and therefore should be avoided.”

Streifel said he was concerned with the CDC's reports connected to the UPMC mold incidents because it didn't mention linens as a possible source. He said he believes UPMC took his report seriously and made necessary modifications.

“This is my business. I've inspected well over 100 fungal clusters around the world,” Streifel said. “We presented our findings to UPMC. They paid us and thanked us.”

UPMC declined comment Friday. In a previous statement, Chief Quality Officer Tami Minnier said, “UPMC still went above and beyond state and federal recommendations in order to implement changes to protect our patients.”

The CDC also weighed in Friday.

“CDC, state, local and hospital officials completed their investigation and issued reports last year,” spokesman Tom Skinner said. “The agencies stand by these. If state and local officials deem more work is needed and ask CDC for assistance, then CDC will assist.”

Streifel's report was unveiled Thursday as part of two lawsuits against UPMC on behalf of transplant patients Che DuVall, 70, and Daniel Krieg, 56, who died at UPMC Presbyterian and Montefiore, respectively. Their attorneys, Brendan Lupetin and Jerry Meyers of the Pittsburgh law firm Meyers Evans Lupetin & Unatin, added Paris as a defendant in the lawsuits Thursday.

“I think Mr. Streifel's comments to you are telling as to what is really going on here,” Lupetin said.

Krieg's nephew, Jesse, who represents his uncle's estate and is a plaintiff, said he wants accountability.

“I don't think UPMC or Paris understands the caliber of these events that have affected so many people,” he said. “I said it before: I want them to be accountable for what they have done, and I intend to make sure that happens.”

Laurie Amick, the mother of heart transplant patient Shelby Slagle, 27, who contracted a fungal infection and died June 26, 2015, at Presby, said she is seeking the truth. Amick, who lives outside of Columbus, Ohio, and Slagle's husband settled a lawsuit against UPMC in August for $1.35 million.

“If UPMC and the CDC and other parties would all work together instead of pointing fingers, they all might just save a life,” she said. “Somebody has to be an advocate for our families. If that's Jesse Krieg, I stand behind him 100 percent.”

On its website, Paris says it is accredited by an organization known as the Healthcare Laundry Accreditation Council, or HLAC.

“The HLAC accreditation process has given Paris a competitive edge with our clients knowing that we are following the strict process protocol established by a consortium of leading health care associations, but more importantly, it has made us a better company,” Stern wrote in a testimonial posted on the HLAC website.

HLAC executives did not return phone calls Friday.

A similar group, the Textile Rental Services Association (TRSA), said it would not have accredited Paris, based on some of Streifel's findings.

Launderers do not have to be accredited, but such a process can boost reputation, TRSA President and CEO Joseph Ricci said.

“It's a good third-party recognition of your efforts to follow industry standards,” he said.

UPMC rival Allegheny Health Network said it contracts with Paris for one of its facilities, Jefferson Hospital in Jefferson Hills.

“In light of the recent news, Jefferson has enhanced its quality assurance protocols relative to those services, and we have been in contact with Paris to assure that its quality protocols also meet our standards,” AHN spokesman Dan Laurent said. “We have had no mold-related infections in patients at Jefferson.”

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or bschmitt@tribweb.com.