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York Hospital has identified two more patients with infections likely related to a device used during open-heart surgery — and two more suspected cases in which the patients died before the connection was discovered.

When the hospital first announced the probable connection last October, WellSpan — in coordination with the Centers for Disease Control and Prevention and the state Department of Health — had identified eight infected patients, four of whom had died.

Those numbers rose to 10 infected patients, six of whom had died, as of May, but two additional infected patients — both living — had been identified as of Sept. 15. One of the six living patients is no longer receiving treatment.

York Hospital is the first hospital in the country to publicly identify a connection between heater-cooler devices and Nontuberculous mycobacteria, or NTM, infections.

The device, used during open-heart surgeries, was a previously undiscovered risk because it does not come into direct contact with patients, but new research has found that it could transmit airborne bacteria through the device's exhaust vent into the environment and to the patient.

The CDC and U.S. Food and Drug Administration posted advisories last October related to the new-found threat, and five other health care facilities have since identified similar issues.

Those facilities include a hospital in Michigan that sent letters to patients last November but did not publicly disclose the issue and, most recently, Penn Presbyterian Hospital in Philadelphia, which alerted patients on Monday after identifying four patient infections, according to a letter posted on the Penn Medicine website.

In addition to the 12 confirmed cases, York Hospital has also identified two suspected cases. Those patients died before the infection link was discovered but  likely had NTM infections, according to a WellSpan FAQ posted on its website.

WellSpan spokesman Dan Carrigan said those patients were identified after the state Department of Health issues new guidance directing hospitals to review its lab records and a new case definition for what qualified as an NTM infection.

The identified patients met the new case definition, as their symptoms were consistent with those of an NTM infection, but there are no tests available to confirm such infections posthumously, Carrigan said.

WellSpan spokesman Brett Marcy said the organization did not notify families of already-deceased patients when they made the announcement in October because of that lack of available testing.

They did notify approximately 1,300 living patients, and that notification was integral to identifying the four additional patients with infections after the initial investigation, Marcy said.

"The key is to make sure they're alert to any signs of the infection," he said. "As a result of (notifying patients), we've been able to consistently monitor their health."

— Reach David Weissman at dweissman@yorkdispatch.com or on Twitter at @DispatchDavid.

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