Five patients at Cedars-Sinai Medical Center contracted staph infections after a surgeon implanted replacement heart valves in them while he had bacteria on his hands.
The surgeon wore gloves during the surgeries, which took place in June, but the gloves developed microscopic tears, NBC reports.
After five patients became infected with identical strands of the staphylococcus epidermidis bacteria, epidemiologists conducted an investigation that led them to the surgeon as the source, the Medical Daily reports.
The surgeon is still on the hospital's medical staff but is no longer performing surgeries. Four of the patients needed second valve replacement operations -- which the hospital paid for -- and are still recovering, KTLA reports.
The outbreak raises the issue that there is no national standard on whether surgeons are allowed to work if they have skin inflammations, the Los Angeles Times reports. There is also no national standard on types of gloves used, whether to wear double gloves or how many times surgeons should change those gloves during a procedure.
Some 99,000 Americans die yearly from hospital-acquired infections, according to data from the Center for Disease Control in 2010. In response, states, including California, have begun to require hospitals to report certain infections to state departments of public health.
A report card last month by Leapfrog Group, a nonprofit focused on health care, gave a C-grade to Cedars Sinai Medical Group. The prestigious Ronald Reagan UCLA Medical Center received an F.
The Leapfrog report -- which has been disputed by hospitals and experts -- used 26 different measures of quality, including death from treatable post-surgery complications, foreign objects retained after surgery, and wounds split open after surgery, according to the nonprofit.