Americans have a well-established capacity for healthcare freakouts. But when hospitals themselves are the cause of illness, and the federal agency tasked with oversight has been caught flat footed, questions tend to raise themselves. Such has been the case with the reusable duodenoscopes believed to have been the source of a bacterial “superbug” that has exposed as many as 179 patients at UCLA’s Ronald Reagan Medical Center in Los Angeles. This, despite the fact that the FDA had been aware of the issue since 2009, but hadn’t issued alarms.

As this Reuters graphic shows, according to an article published in the New England Journal of Medicine (NEJM), hospital-acquired infections disproportionately affected critical care patients and infants between 45 days and one year old. In studying 11,290 patients in 183 hospitals spread over 10 geographically diverse states, large hospitals proved more likely than smaller ones to see infections occur within their walls.

According to the NEJM article, “The most recent estimate produced by the Centers for Disease Control and Prevention (CDC) and published in 2007 — 1.7 million health care–associated infections per year — relied on historical data combined with contemporary hospitalization data.” That’s a lot of presumably avoidable infections. In this case, the FDA is working with the CDC to issue updated protocols to mitigate the problem, but given the recent outbreak, the agency’s past inaction should be a prescription for more investigation.