SEATTLE — Editor's note: The above video aired in November 2019.

Newly released documents show that Washington Department of Health investigators questioned Seattle Children’s use of an operating room during a cardiac surgery on an infant in early October 2019. 

Just over one month later on Nov. 7, that baby tested positive for Aspergillus infection. 

“The investigators interviewed the leadership team to determine why they approved cardiac cases to return to the OR’s,” said a 10-page DOH report from a November inspection of the hospital.  

The KING 5 Investigators obtained the report through a public records request.

“(Operating Room) OR suite #11 had not undergone new construction to add a High-Efficiency Particulate Air (HEPA) filter,” the report said, noting that several other of the hospital’s operating rooms did have advanced filtration systems.

Aspergillus mold has killed six patients at Seattle Children's since 2001, an investigation found. In November, the hospital shut down all its main operating rooms for the second time in 2019 after air tests showed a re-occurrence of Aspergillus in the air handling and filtration systems that serve the operating rooms.

CEO Dr. Jeff Sperring admitted at that time that the hospital “failed” to link the Aspergillus-related deaths to the hospital’s filtration system and that the operating rooms would not re-open until late January when HEPA filters were installed in all of them.

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In response to the DOH’s questions about why OR #11 was used for a surgical cardiac case in October, the report said that in September of 2019 the "(chief medical officer) and chief surgeon made the decision to open the OR’s to cardiac cases after consultation with the infection prevention and the 'Heart Team.'" 

Specifically, the hospital said that OR #11 had “continued negative air sample results” when tested for Aspergillus and that the closure of the OR was creating “concerns of workflow issues with caseloads.”

The hospital was not cited for any violations during the Nov. 12, 2019 on-site inspection.

Washington Department of Health spokesperson Lisa Stromme said, “There was no legal requirement for having a HEPA filter in the operating room. In this case, it was not within the scope of the investigator’s role to make a judgment call about doing surgery in that location.”

Seattle Children’s did not immediately respond to a request for additional comment.

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