[The mistakes by the Samsung Medical Center are now the focus of
much that has gone wrong to escalate South Korea’s MERS crisis, the worst
outbreak beyond Saudi Arabia, where the disease first appeared in 2012. As of
Tuesday, nearly half of all 162 confirmed MERS cases in South Korea have been
traced to Samsung, historically regarded as the nation’s best hospital.]
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Nearly half of all
confirmed MERS cases in South Korea have been traced to
the Samsung Medical
Center in Seoul, regarded as the nation’s best hospital.
Credit Jeon
Heon-Kyun/European Pressphoto Agency
|
SEOUL, South Korea — It is the jewel of South
Korea’s medical service: a 1,900-bed hospital of steel and glass
owned by the famous Samsung conglomerate. It also is where a 35-year-old man
whose symptoms were misdiagnosed as pneumonia languished for three days in an
overcrowded emergency room and hallway, where he coughed up sputum teeming with
the Middle East respiratory
syndrome virus and exposed dozens.
Doctors of the renowned hospital, the Samsung Medical Center in
Seoul, were the first to confirm the
disease, known as MERS, in another patient a week earlier but
failed to detect the connection between the two cases. Investigators now say
the misdiagnosed patient, awaiting a vacant bed in a general ward upstairs,
wheezed and expectorated in common areas with no oversight, turning into a MERS
“superspreader.”
The mistakes by the Samsung Medical Center are now the focus of
much that has gone wrong to escalate South Korea’s MERS crisis, the worst
outbreak beyond Saudi Arabia, where the disease first appeared in 2012. As of
Tuesday, nearly half of all 162 confirmed MERS cases in South Korea have been
traced to Samsung, historically regarded as the nation’s best hospital.
Several hundred of its patients are under quarantine in the
hospital or elsewhere, either because their infections have been confirmed or
they are under observation for symptoms. Nearly 300 of its 3,900 medical and
other staff members are under similar quarantine. Other hospitals have refused
to accept patients from Samsung for fear of infection. By Sunday, it stopped
taking new patients as it struggled to prevent the virus from further spreading
beyond its gleaming compound.
“We offer our deep apologies to all MERS patients and those
quarantined because of our employees,” said Song Jae-hoon, the president of the
medical center, bowing before television cameras.
Up until now, Samsung’s reputation for quality had gone
unchallenged. South Koreans looked no further than its list of patients: Lee Kun-hee,
the country’s richest man and the chairman of the Samsung conglomerate, has
been hospitalized there, holed up in a 20th-floor V.I.P. room, since his heart
attack last year.
Nobody was surprised when Samsung diagnosed the country’s first
case of MERS on May 20, attributing the discovery to its medical skills.
Calling Samsung a general hospital hardly explains its place in
South Korea’s system.
In South Korea, when a parent gets sick, it is widely considered
a filial duty for the children to mobilize all connections to secure a bed in
Samsung or at a few other mega-hospitals, including one run by another
family-controlled conglomerate, Hyundai, that they believe provide the best
care.
When that strategy fails, patients are often taken into the
hospitals’ emergency rooms, where they can wait for days for a bed in a general
ward to be available.
The Samsung hospital beds were usually filled, with 1,800
patients, with a long waiting list. Each day, 8,500 outpatients passed through.
But it was not just the fame of Samsung that attracted patients.
Medical service is so affordable under the country’s universal medical
insurance system that “there is no threshold at hospitals,” said Kwon Jun-wook,
a senior Heath Ministry official.
“Patients go to hospital as if they go shopping,” Mr. Kwon said,
referring to the widespread practice of hospital hopping to get a second
opinion or to get a referral to a mega-hospital, some of them with more than
2,000 beds.
Low medical fees also mean that hospitals must treat as many
patients as possible to stay profitable. The big hospitals get more crowded as
family members and private nurses they hired stay with patients, sleeping on
cots between hospital beds. It is also important to social etiquette for South
Koreans to visit hospitalized relatives, friends and colleagues, often with
gifts like fruit boxes. Church members cluster around a patient’s bed, praying
and singing.
The overall scene, as Koreans like to say, looks like a “flea
market.”
It is this overcrowded hospital condition that a World Health
Organizationmission said had made the otherwise modern South Korean
hospitals particularly vulnerable to MERS. All those in the country who have
the virus were infected in hospitals. Of them, 65 were relatives, friends or
family-hired caretakers who contracted the disease while they were visiting or
looking after hospitalized patients.
“The Samsung Medical Center is a national hospital in the sense
that there are no regional boundaries in medical service in the country and
everyone wants treatment there,” said Kim Woo-joo, head of the Korean Society
of Infectious Diseases. “The MERS outbreak was a stress test of our medical
system, revealing its problems.”
At Samsung, the system began unraveling when the 35-year-old
man, whom investigators called Patient No.14, arrived at its emergency room on
May 27, a week after Samsung had discovered the first case.
Patient No.14 had been infected by the first patient when both
were in the same hospital south of Seoul in mid-May. But neither he nor Samsung
doctors had any clue he was infected. Unlike the first case, he had no record
of having visited the Middle East.
Samsung doctors diagnosed his case as pneumonia. But with no
room in wards upstairs immediately available, he waited in the overcrowded
emergency room for three days and sometimes loitered outside, investigators
say.
It was not until May 29, when the Korean Centers for Disease
Control and Prevention told them about the man’s possible link to the first
case, that the emergency room doctors were alarmed, according to Samsung
officials. By then, the man had become the biggest “superspreader” in the
outbreak, infecting people in South Korea’s best hospital.
“It’s the nation that was penetrated,” Chung Doo-ryeon, a
Samsung doctor, responded during a parliamentary hearing last week, when
lawmakers criticized the hospital for failing to control the outbreak. But
blunders continued at Samsung.
After Patient No.14 tested positive on May 30, the hospital
listed 893 people who may have come in contact with him in the emergency room,
and placed them in quarantine or in self-isolation at home. But it failed to
trace many visitors who had been in the room.
About half of the 80 cases that were traced to the Samsung
hospital were found outside that list. Not bound by quarantine, they had gone
about their lives, riding subways and visiting saunas. Some visited other
hospitals when fever and other symptoms occurred. A
Samsung doctor continued to work until he developed symptoms last week. A
55-year-old employee at Samsung carried 76 patients, some in wheelchairs,
before he tested positive on Friday.
The breach in the quarantine at Samsung complicated the national
battle against the disease.
So far, a total of 162 MERS cases have been found in 13
hospitals, including 20 deaths. But before the disease was diagnosed, the
patients also passed through 70 other hospitals, raising fears that they may
have infected people there. In some train stations, the local authorities have
used heat-detecting cameras to stop potential MERS carriers from entering their
towns. More than 6,500 people are in quarantine or in self-isolation at home,
many of them after visiting the Samsung hospital.
“What pains us the most is our failure to contain Patient No.14
at the Samsung hospital,” said Kwon Deok-cheol, a senior official at the
government’s MERS response headquarters.
Mr. Kwon said that the government planned to overhaul the
country’s “hospital culture,” such as unrestrained visits. But critics also
blamed a “Samsung-style management” for the crisis.
The mass-circulation daily Chosun Ilbo said of Samsung Medical
Center in an editorial this week: “It’s fair to say that their tendency to put
profit and efficiency before public health prevented them from taking more
decisive pre-emptive steps to contain the virus.”
The Samsung conglomerate, the biggest among the enormous South
Korean corporate empires that have been compared to “tentacles of an octopus,”
moved into the hospital business when it opened the Samsung Medical Center in
1994. Opening a modern hospital was said to reflect the wish of Mr. Lee, the
conglomerate’s chairman, who used to travel to the United States for cancer treatment.
