New tests show that opiates found in the systems of three newborns at Anne Arundel Medical Center did not come from tainted medical supplies, leaving open the possibility that the drugs were given to the babies directly.
Preliminary results of laboratory tests released yesterday showed that medical vials, tubes, solutions and medications taken from the Annapolis hospital's critical-care nursery were not tainted with narcotics, said medical center spokeswoman Carolyn Shenk.
Medical center administrators yesterday did not draw any conclusions about the cause of the Jan. 31 episode.
"We still have not ruled anything out," Ms. Shenk said. "But nothing has become obvious in terms of what it could be."
Nevertheless, as the likelihood of environmental contamination diminishes, hospital staff are left with the possibility that someone gave the drugs to the infants by accident or on purpose. Earlier tests have indicated there was no failure in the nursery's equipment and that the drugs were not transferred to the newborns from their mothers.
The three babies, none of whom had been prescribed opiates, suffered respiratory difficulties and had to be placed on ventilators within 14 hours of each other last week. Tests on the babies' urine showed an unidentified opiate in the systems of all three.
More sophisticated tests on those urine samples, expected this week, should determine the type of opiate. That information, in turn, could yield clues on the origin of the drugs.
An opiate, such as opium, morphine, codeine or heroin, is a central nervous system depressant that impairs breathing.
The three babies are not expected to suffer long-term medical problems, hospital officials say. One newborn was discharged from the hospital this week.
Meanwhile, the hospital will turn over its internal investigation today to Warren Sanger, a lawyer who has handled medical malpractice cases in the past.
Mr. Sanger defended Good Samaritan Hospital in West Islip, N.Y., against a suit filed by the family of a man who died after a nurse gave him a fatal injection of a drug that causes paralysis.
The nurse, Richard Angelo, was sentenced in 1990 to 61 1/3 years to life for killing four hospital patients and assaulting another with the paralyzing drugs in the fall of 1987.
Mr. Sanger did not return phone calls yesterday.
The outcome of the civil negligence suit against the hospital and Angelo was not known yesterday.
Anne Arundel Medical Center officials said they are not bringing in Mr. Sanger for his legal expertise, but for his skill as a medical investigator.
Frank Weathersbee, Anne Arundel County state's attorney, said one of his investigators will meet with hospital officials and Mr. Sanger this week. Although his office can start investigating the incident, Mr. Weathersbee said he is waiting for the hospital to receive the final test results. He said he has confidence in the hospital's internal investigation.
"It is certainly in their best interest to determine what happened so that it never happens again," he said.
The Annapolis hospital's critical-care nursery celebrated its one-year anniversary last month and is considered one of the jewels in the medical center's crown.
The nursery does not handle critically ill newborns or babies requiring surgery. It provides care for premature infants and those who suffer from jaundice, dehydration, blood infections and other ailments. In some cases, babies born by Caesarean section are placed in the critical-care ward immediately after birth.
The babies who suffered the mysterious respiratory difficulties last week were three of six in the unit at the time.
Before the incident, none of the babies required help breathing from a ventilator, although they were placed on the machines briefly after suffering respiratory troubles.