In safer hands

CAROLYN Cross was one of the first to wake up following the crash.

Still in the airplane, she was enveloped by an eerie silence. Her nostrils were filled with smoke and the strong smell of fuel, and her eyes took in the flickering flames around her.

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"It was a really amazing moment for me because I had complete understanding of what happened," says the 50-year-old West Vancouver mother of three.

Cross smiled to herself after realizing she was still clutching her cellphone, having desperately texted goodbye messages to her children and husband minutes before the plane went down.

"I started yelling at everyone to wake up," she says. "I wasn't sure how I was going to get out of the plane, but I knew I had to. I was so surprised that I was alive. . . . I literally had closed my eyes and was ready to meet the maker. . . . And then I realized with huge panic setting in that, 'I can't move and the plane's on fire.' That's when the worst of the panic came in because I just did not want to be burned alive."

Realizing she was blocking her fellow passengers' escape, Cross tried to move, though she had no feeling in her legs. She blacked out for a few moments, then awoke to find herself having inched slightly closer to the exit at the back of the craft.

Cross was spent and a feeling of hopelessness began to set in. It was at that moment that, "This hand, this very big fellow starts grabbing me and lifting me out," she says. "That was immediately followed by the sensation that other, less strong, hands were lifting me and carrying me out and . . . immediately the 'hands of God' went through my mind."

Getting her to safety, her rescuer Simon Pearce and other Good Samaritans who were first on the scene of the fiery crash, continued to re-enter the wreckage to save the lives of the crash survivors.

"While I was on the ground I could feel the heat and I turned to look at the plane," says Cross. "I heard people saying, 'It's going to explode, get away!'. . . . And I saw them going back in and I just wanted to cry and I couldn't believe that they would do that."

Cross was one of nine people on a small Beechcraft Northern Thunderbird Air flight from Vancouver to Kelowna on Oct. 27, 2011 that went down shortly after takeoff following the pilot's realization that there was an oil leak. He attempted to make a safe return to YVR, though was unable to do so and the plane crashed on Richmond's Russ Baker Way, 900 metres from the airport's runway.

All the passengers survived, though the pilot, North Vancouver resident Luc Fortin, 44, and his first-officer passed away due to injuries sustained in the fire.

Cross's odds of survival were "impossible," the result of a number of "miracles," she says, like the pilots' ability to land the plane in such a way as to minimize impact; as well as the selflessness of the passersby who were undeterred by the intense flames and carried her and the other victims to safety.

Fifteen months later, Cross shares her memories of that day and how she "survived the unsurvivable," in an effort to draw a comparison between another ongoing challenge she's facing in her life, a 13-year journey to get the world to take notice of a technology she wants to get into the hands of hospital medical staff to better serve patients.

Cross is the chairman (her word) and CEO of Ondine Biomedical, a Vancouver-based company dedicated to the development of non-antibiotic anti-infective therapies for a broad spectrum of bacterial, viral and fungal infections.

Thanks to the support of Vancouver Coastal Health, Cross and her 25-member team's hard work is finally starting to pay off as the company's platform technology called photodisinfection has been in use at Vancouver General Hospital for the last year.

Ondine's MRSAid Photodisinfection System uses non-thermal light energy to kill potentially harmful bacteria in patients' nasal passages before they head into the operating room. VGH launched a year-long treatment trial combining the use of the non-drug therapy with antiseptic wipes, marking a world-wide first. The innovative pilot project, funded by the hospital and the University of British Columbia Hospital Foundation, yielded close to $2 million in cost savings. More importantly to patients, it allowed for more surgeries over the course of the year, meaning less wait times; and prevented a significant number of patients undergoing surgical procedures from having complications.

"I have a great technology that needed to get pulled out of the abyss and into a hospital system," says Cross. "Just like those kind arms (that pulled me from the plane) I had kind people that were willing to take a chance . . . and champion something at high risk to themselves. And they did and it was really amazing. I really do feel that the technology was saved just at the right time, just like I was saved at the right time of my plane."

. . .

Cross, who was born in Montreal and grew up in Waterloo, has a background in the investment world, having previously worked in Toronto as a portfolio manager.

"I really appreciated how hard it was and how long the time horizons for anything in the biotech life sciences world was," she says.

In the mid-1990s, Cross's husband received a job offer in the Vancouver area and they moved to the Lower Mainland. Looking to switch gears in terms of her career, she was introduced to Ondine's photodisinfection technology and was blown away by its potential. The process was invented by professor Michael Wilson at Eastman Dental Institute at University College London in the United Kingdom. Ondine had licensed it from the institute, however didn't have the funds to get the company off the ground.

Cross came on board with Ondine in 1999 and her initial focus was a dental application, though a personal experience prompted her to change gears.

In 2005, Cross' youngest child, Julia, then two-and-a-half, contracted an infection that puzzled doctors as to its root. She was very sick and antibiotics weren't working. Doctors eventually realized Julia, now 10, was fighting resistant forms of bacteria, colloquially referred to as superbugs.

"When you're looking at your daughter hooked up and possibly dying and they don't know what it is, you're starting to make deals with God," she says. "It was: 'Please God, take my life instead of hers;' or "Please God, if you let her live, I am going to take this technology and move it into the superbug space faster than I was planning to."

Julia made a full recovery and Cross has since worked to reorient her company to focus more on hospital-acquired infections and, in particular, surgical site infections.

Movement to get Ondine's technology into widespread use has been slow and the irony of the situation is not lost on Cross.

"That's what I do, I beat resistance," she says. "My slogan is I'm dealing with the world of resistance, but most of it is indifference, siloed budgets, 'Not my job,' 'Oh that's too bad,' or 'Good for you, but I can't help you.' It's often like the little chicken who's saying: 'Who will help me plant?'

"It's been really frustrating because even though there's a lot of lip service to infection there hasn't been a lot of support and certainly not enough investment dollars."

. . .

Cross started working with health authority on the pilot project two and a half years ago. Dr. Elizabeth Bryce, regional medical director, infection control at VCH, is credited with bringing Ondine's MRSAid into use at VGH, viewing the process as a means of helping prevent surgical site infections, which most often come from patients' own bacteria, she says. During an operative procedure, patients can get organisms coming from their nose as they breathe out, as well as from their skin, going to the operative site. Therefore, the skin and nose are targeted prior to surgery, traditionally with an antiseptic body wash and an antibiotic up the nose, administered for five to seven days leading up to the operation.

"The problem that's happened is people forget to do this when they're at home," says Bryce, meaning they don't have 100 per cent compliance with that preventative therapy.

"And in addition, what happens is you get antibiotic resistance developing from the product that people place in their nose," she adds.

Ondine's nasal decolonization system sees a photosensitizer formula applied to a patient's nasal openings, followed by a painless four-minute illumination step, killing the "bad bugs" and "leaving healthy tissue alone," a form of "targeted killing," says Cross. Overall, the procedure lasts about 10 minutes.

"Then you're into an operation completely cleared of the bugs that could self-infect when your immune system is down," says Cross.

Bryce viewed the process as having the potential to help prevent surgical site infections because it's immediate - "one zap to the nostrils so to speak" - and would result in 100 per cent compliance. "We thought that fits in very nicely with our needs to have a decolonization program that's safe and effective and doesn't promote antibiotic resistance," she says.

VGH's year-long pilot recently wrapped, seeing the combined use of MRSAid and chlorhexidine body wipes on more than 5,000 patients prior to surgeries, including cardiac, neurosurgical, orthopedic, spine, thoracic, vascular and breast.

"Those are our highest risk surgeries if they do get a complication. The consequences can be quite severe, so that's the group that we targeted," says Bryce.

The trial saved VGH an estimated $1.9 million in the first year. It also reduced the numbers of surgical site infections at the hospital by 39 per cent, allowing for approximately 140 additional surgeries to be performed, having prevented the need for readmission and prolonged hospital stays for many patients.

VGH's costs associated with implementing MRSAid and the antiseptic wipe pilot program, including staffing, materials and lab costs was approximately $500,000 for one year, which was "easily recouped by the money they saved," says Bryce. They ran a "Cadillac program," as they hired staff specifically for the project, as well as a nurse educator in anticipation of other hospitals looking for future training.

"I think for hospitals like Lions Gate for example, you could integrate all of this into the normal operating room flow and you probably wouldn't have to hire the additional people. It's all the scale of things. For us, we're running many, many more operating rooms than most other hospitals," she says.

The Vancouver hospital is committed to continuing the program for the next year.

. . .

The support and acceptance of VCH and VGH has been a major step in the right direction for Cross.

"I cannot say enough about the team at VGH and Dr. Elizabeth Bryce," she says.

"The world doesn't understand this yet, but she has just changed how patient safety is going to be handled. She's done a world's first and it's extraordinary," she adds.

In light of her work on the project, Bryce was honoured Dec. 11 with the first-ever Champion For Change Award, co-sponsored by the Women Presidents' Organization and GroYourBiz. The provincial award was developed to bridge a gap in the recognition of innovation-based leadership.

"This project could not have been done without a team approach so it was very gratifying for all of us," says Bryce.

Bryce and her peers are currently working to disseminate the results of their year-long pilot. They've just started presenting the information throughout Vancouver Coastal Health and are in the process of writing an article for wider publication. She's hopeful the information will be well-received.

"We saw a 39 per cent reduction in our surgical site infections, that's very significant," she says. "Each hospital, it's their own decision. All we can do is present the information and everyone has to decide for themselves," she adds.

UBC Hospital is looking at the possibility of introducing the procedure for selected surgeries.

"Part of (VCH's) mandate is to innovate for the best quality of care and I think this is a good example," says Bryce. "And that's for all the sites, including Lions Gate, we just all pick different projects and we were fortunate enough to pick this one. I'm hopeful that it will roll out to the other facilities."

. . .

While driving to the hospital in an ambulance following the crash, Cross asked paramedics where she was headed.

"VGH," was the answer.

"I was going to be in great hands," she recalls thinking.

Her list of injuries was extensive, including compression fractures of the spine, her knee bones were injured, almost all of the ligaments of her left knee were torn off, she had hip fractures, seven fractured ribs, head trauma and a concussion, and had chipped or broken nine teeth.

During her two-week hospital stay, Bryce and other hospital staff she knew through the MRSAid pilot project spent hours with her, keeping her company. And, as her technology was already in use, she underwent the procedure herself.

Cross remains committed to her mission of getting MRSAid into other hospitals around the world. She's also is focused on the further development and implementation of a number of other Ondine photodisinfection therapies.

Product Periowave is currently in use by dentists, a process that inactivates bacteria and toxins left behind after scaling and root planing. Vitalwave is a treatment designed to decolonize the birth canal with a goal of preventing vertical transmission of HIV and other pathogens from mother to child in the developing world. Exelume is focused on preventing ventilator associated pneumonia by using photodisinfection to eradicate bacterial biofilms on the inner surface of endotracheal tubes and is currently in trials in the United States. And, Steriwave is a product to control infection on burns and wounds that's being tested in Calgary.

Ondine is also working on technology serving those with chronic sinusitis, safely getting rid of fungus, viruses and bacteria, launching in a Montreal hospital in February and at a Vancouver hospital shortly thereafter. And finally, in partnership with University College London, the company has developed a product that prevents bugs from growing inside catheters to prevent urinary tract infections with a scheduled release in 2014.

Cross hopes to one day implement a program where a percentage of Ondine's profits goes back into direct research to develop infection control protocols and prevention technologies to make further gains in saving lives and improving patient outcomes.

"I'm just running with the passion and what's coming out through the heart to make this technology survive," says Cross. "I won't stop until it's at a footing that it's going to be sustainable and it's going to be OK."

For more information on Ondine Biomedical, visit ondinebio.com.

emcphee@nsnews.com

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