Negative-Pressure Rooms Found To Increase TB Risk

August 9, 2000

NEW YORK, NY—Clinicians at St. Joseph's Medical Center announced Tuesday that the "negative-pressure" isolation rooms which are currently utilized there in the care of patients with active tuberculosis are "extremely" ineffective in preventing spread of the disease to healthcare workers.

St. Joseph's Medical Center,
New York, NY

Based on the hypothesis that rooms with "positive pressure," that is, rooms where air flows towards the outside environment due to a positive pressure gradient, may be associated with the outward spread of tuberculous droplets, most modern hospitals are equipped with "negative-pressure" respiratory isolation rooms, where airflow is reversed into the room, preventing airborne spread.

In what was at the time seen as a stunning and humiliating planning error, the "negative-pressure" rooms at St. Joseph's were, in 1986, erroneously designed by a team of misguided hospital administrators and engineers as areas of decreased "psychosocial" pressure, where patients with tuberculosis could "relax their mycobacteria away."

Each room was generously equipped with a Zen rock fountain, Patchouli incense lit 'round-the-clock, six to eight "Amazing Affirmation" posters, an interactive I-Ching oracle, and several copies of "The Tao Of Pooh."

Yanni

The soothing melodies of Yanni were prescribed for extensive extrapulmonary disease; patients intolerant of Yanni (up to 40% of all patients) were given second-line Enya / George Winston combination therapy.

For patients with multi-drug resistant (MDR) tuberculosis, treatment also included wrist magnets, thrice-weekly foot massages, daily sessions with the Nature & Harmony chimemaster, and meditation in front of a 17" jade Buddha acquired by St. Joseph's from Sri Lanka in 1989.

Though the unorthodox treatment methods were widely derided as inappropriate and possibly hazardous for patients with such a serious and potentially fatal illness, records kept by Public Health officials from 1990 through 1999 showed an above-average response to the unorthodox treatment, with patients staying in negative-pressure rooms found to have a 60% chance of being "satisfied" or "extremely satisfied" with their care.

Improvement in actual signs or symptoms of tuberculosis, however, was not noted in any of the 256 patients followed, and further care in a "real hospital" was eventually necessary for the entire cohort.

Moreover, a recent epidemiologic study of TB spread in New York City completed suggests that St. Joseph's Medical Center was at the center of the great majority (>76%, p<.005) of new tuberculosis cases presenting to all major metropolitan hospitals during the same period.

At Tuesday's press conference, St. Joseph's spokesman Dr. Germaine Belfore admitted the negative-pressure rooms were "a huge mistake right from the get-go," and added that "we're [extremely] sorry for any damage the Yanni may have done."

Plans are underway to convert the hospital into a Zen Garden.

Remember: Quality Without The Q Is Just Uality!