Debbie Ford winds the key on a stuffed horse and a music box begins plinking a simple lullaby. Her friends, some of her own family, don’t want to hear it. It’s just too painful.

“Her legs probably weren’t as big as my finger,” Debbie says, flipping through an album of baby pictures coupled with tiny foot and hand prints. Baby pictures are the only pictures she has.

Debbie went to Carolinas Medical Center in 2004 to give birth to twin girls. At age 40, with teenagers of her own still at home in Rutherfordton, Debbie learned she was pregnant with twins.

“It brought a whole new spirit to the house which hadn’t been there for a while,” she says.

Her infant daughters got an antibiotic-resistant infection at CMC. To be fair, we don’t know if infections were any worse at CMC that year than at any other hospital in the area. That’s because even when there is an outbreak of infections in a hospital, hospitals in North Carolina are not required to disclose that outbreak to patients. And the Center for Disease Control estimates that 90,000 Americans die each year from infections they acquired while inside a hospital.

When you walk into any restaurant in the Carolinas you can read the sanitation score right on the wall. It’s state law. You can go online in Mecklenburg County and read the health inspector’s actual comments. But if you want to know the infection rate at your local hospital in North Carolina, it’s a mystery.

Debbie delivered prematurely after an ultrasound showed one of her twins wasn’t growing as fast as the other. The two girls, Olivia and Lydia, went immediately to the Neonatal Intensive Care Unit, referred to by its acronym “NIC – U.”

Debbie saw a lot of sick babies on the NICU. Compared to some of them, Debbie thought her girls were “pretty healthy.”

So when the call came nine days later, Debbie was surprised. “They called and said if you want to spend some time with her, you need to come on.”

It was Olivia.

Her medical chart details her last moments on earth:

12:10 p.m. Mom holding infant.

12:15 p.m. Parents holding.

12:20 p.m. Dr. at bedside to pronounce.

The doctor listed the cause of death on the death certificate as “sepsis” - infection.

But the medical records also show that Olivia had MRSA, a staph infection resistant to treatment by antibiotics.

Debbie said, "My first response when I found out what it was do you not need to tell the other mothers in here what she died from because it was contagious?"

MRSA isn’t limited to hospitals. In early 2004 just before Olivia and Lydia were born, MRSA became more prevalent in Charlotte, detected in places like high school locker rooms.

And at the same time, CMC found more babies than usual had MRSA.

CMC spokesmen say the medical center responded by cleaning the NICU, isolating infected babies to limit the spread of the infection, and reminding nurses and doctors to use gloves and gowns when handling babies that were known to carry the infection.

But there’s one thing the hospital was not required to do: tell the public.

Debbie now says, “If I had the right to ask their infection rates I would’ve asked to go somewhere else.”

Dr. Roger Lovell is an infectious disease expert at CMC. He says, “Right now MRSA is not state reported.”

Lovell did not treat Debbie’s twins so he can’t speak directly to their cases. But he can and does talk about hospital infections.

Lovell concedes that doctors may not volunteer information about the presence of hospital-based infections. But, he says, “They may give you some general statements that MRSA has been a problem in the NICU's throughout the United States.”

Premature infants are more vulnerable to infection than babies carried full term. There is some research to suggest that the smaller the infant, the more prone it is to infection. So doctors are hard-pressed to say whether deaths like Olivia’s are preventable.

Lovell says, “It's hard to say whether someone died with the infection or because of the infection.”

Debbie’s second twin lived for almost five more months, long enough to go home to Rutherford County. She went to the hospital there with pneumonia and things took a turn for the worse.

Debbie says, “The doctor finally came out and he was trying to tell me that they did all that they could do and I looked and him and said ’you're not gong to make me do this again.’ “

But she did have to go through it again.

And Lydia’s death left Debbie with what seems like a simple question: how many babies died that year after getting infections while in the hospital?

Answering that question proved to be anything but simple.

The 6NEWS Investigators used a statewide database, which chronicles causes of death to identify hundreds of death certificates for infants who died in Mecklenburg County in 2004.

Only 98 of those infants lived more than a week. Of the 98, more than a fourth had some form of infection.

But the state’s epidemiologist Dr. Jeff Engel said death certificates are notoriously inaccurate because they’re not filled out consistently. Dr. Engel says death certificates don’t answer the question of mortality rates due to infection but he says hospitals know the answer.

It’s just that – in his words – “Over the years what's evolved has been a very, very protective system.”

Doctors say it’s frequently difficult to conclude whether the infection originated in the hospital or if patients or their families brought the infection in with them.

And it turns out there is a record that provides a clue if conditions exist in a hospital, which might lead to the spread of infections – conditions like bloody gloves contaminated by one patient which were then used to touch another patient.

But these are not records readily available to the public.

The 6NEWS Investigators drove to Raleigh to the campus of the state Department of Health and Human Services on the campus of the old Dorothea Dix Hospital off Western Boulevard. There in the basement of an institutional brick building you find filing cabinet after filing cabinet with hospital inspection reports. The reports contain records of infection control violations but they do not report infection rates.

We culled through inspection reports for 33 hospitals in the greater Charlotte area stretching from the mountains to the South Carolina border. Eight of the 33 hospitals – or almost a fourth – had some infection control violation in the last seven years. But CMC’s main hospital was not among them.

Engel told us, “I think every patient should ask their surgeon ‘what is your infection rate for this procedure?’ … and if your surgeon doesn't know that you should ask for a new surgeon!” he chuckles.

The notion that reporting infection rates – like many other hospital scorecards – encourages health care providers to improve their practice is not a new one. For thirty years the CDC has encouraged hospitals to inform surgeons of their individual infection rates. Studies found when surgeons learned their numbers, infection rates fell.

But hospitals are not required to report such numbers to the surgeons or to the public.

Dr. Engel says, “I think you would need new legislation to do that.”

South Carolina has already passed such legislation. And the North Carolina Public Interest Research Group is proposing that North Carolina follow suit.

NC PIRG’s Rob Thompson says, “We're going to be saving human lives, secondarily it’s going to be saving tons of money."

The two largest hospitals in the Charlotte market, Presbyterian and CMC, both say they support the idea of uniform public reporting of infection rates. The key word is uniform. Hospitals want to make sure they’re compared fairly – not punished for treating patients who might be more prone to infection by offering a trauma unit for example when another hospital might not have one. But the hospitals support the idea of reporting in principle. Dr. Stephen Wallenhaupt, the Chief Medical Officer at Presbyterian, says, “You can only improve those things that you measure.”