Hospital water system filled ‘too early’ before receiving patients, inquiry told

A hospital water system was filled “too early”, increasing the opportunity for contamination, a microbiologist has told the Scottish Hospitals Inquiry.

The inquiry heard that the water system at the Queen Elizabeth Hospital (QEUH) in Glasgow was filled more than 12 months before it opened to patients.

Dr Tom Makin said he accepted that the water system has to be filled during the construction process to test that it is working properly but that this should be done “as late as possible” and that he was “surprised” it was done so early.

The inquiry is currently investigating the construction of the QEUH campus in Glasgow, which includes the Royal Hospital for Children.

As soon as you put water into a system it gives the opportunity for biofilm to develop

It was launched in the wake of deaths linked to infections there, including that of 10-year-old Milly Main.

Dr Makin, a microbiologist, runs the Makin and Makin Consultancy which provides water quality advice to companies and healthcare facilities and previously worked for the NHS between 1968 and 2010.

He was contacted by NHS staff in Glasgow in April 2018 and asked to provide advice after contamination was found in the hospital water supply.

Dr Makin first visited the hospital on May 10 2018 and said that given the size of the hospital and the fact it was a new build he was not surprised there were issues.

The witness told the inquiry of a report by a Dr Susanne Lee which said that the water system was filled during construction and remained so for more than 12 months before the hospital began receiving patients.

He said: “Now, that’s an unusually long time to have a water system filled before it goes into operational use. I was quite surprised.

“As soon as you put water into a system it gives the opportunity for biofilm to develop. You should really only fill a water system as late as you can prior to it being used.

“I accept the people who constructed it have to put water in at some point to test whether it’s leaking and that it’s functioning properly so there is a period of time to allow them to do that.

“But if you do it too early, and I would consider a year prior to patients moving in too early, then that leaves it open, the opportunity, for contamination to occur.

“And not just for contamination to occur, we’re not just talking about micro organisms entering the water system and floating around, we’re talking about organisms getting into the water system and establishing biofilm and biofilm once it gets established is particularly difficult to remove.”

Dr Makin said that, in his view, a biocide should be put into the system as soon as it is filled with water to reduce the risk of problems

This could help prevent the accumulation of biofilm – a community of micro-organisms – the inquiry heard.

Graham Maciver, junior counsel to the inquiry, asked whether he gained an understanding of what the underlying causes of the issues at the QEUH actually were.

Dr Makin replied: “As far as I’m concerned, obviously, there was the issue of the size of the system, it was so big, so much more easily contaminated when you’ve got a big system like that.”

He said it was a “very complex problem which involved a lot of issues” and that “some of them were outside the control of people who were then occupying the building to a certain extent because they may have inherited some of the problems”.

He also told the inquiry that he did not know whether the water system was flushed or a biocide introduced during the construction process.

A spokesperson for Multiplex, the construction company which designed and built the hospital, said: “Dr Makin’s evidence in the public inquiry will be responded to in the fullness of time. It would not be appropriate for Multiplex to comment further at this stage. ”

The inquiry, taking place before Lord Brodie in Edinburgh , continues.