The Hoffmann Goldsword Foundation is a public safety and education initiative built on a simple premise: systems cannot prevent what they are not designed to see. We exist to change what healthcare systems are designed to notice — so that patients are protected, clinicians are informed, and the gaps that allow serious harm to go unrecognized are finally closed.
Making invisible medical risks visible.
OUR MISSION
The U.S. Food and Drug Administration’s adverse-event database has recorded 52 anaphylaxis cases linked to chlorhexidine across 46 years. Perioperative-anaphylaxis audit rates from the UK — the Royal College of Anaesthetists’ sixth National Audit Project, NAP6 — applied to U.S. surgical volume predict something closer to 300–400 a year. That projection is a model and travels with its caveats; but even cut well below its estimate, the two numbers do not live in the same world. The gap between them is not a measure of how rare the danger is. It is a measure of how rarely the system manages to see it.
The number that looks reassuring is the problem.
"The rarity was never real. It was the shape of a blind spot."
What we actually do
We did not discover chlorhexidine allergy, and we did not invent the science. The facts already exist — scattered across allergy, anesthesia, infection prevention, regulation, and clinical informatics, and owned in full by no one.
What we do is close the distance between what is known and what actually protects someone. We connect the fragmented evidence into a single, sourced picture. We surface the overlooked pathways that quietly raise the risk — like the way ordinary grooming before surgery can increase how much antiseptic the skin takes in. We turn what we find into specific actions a patient or clinician can take today. And we press for the reforms that would close the gap for everyone — coding, labeling, surveillance, safer defaults — then stay with the problem long enough to help see them through. We do not stop at naming the problem: wherever we can, we work to define the practical safeguards, implementation paths, and system changes that reduce risk in the real world.
Awareness is where this starts, not where it ends. Knowledge that never reaches the bedside protects no one. The failure here was never an absence of evidence; it was the distance between the evidence and the moment it could have mattered. Closing that distance is the work.
Why we are here
We write as the two people who built this — and one of us is the reason we know it from the inside.
In October 2024, Katherine went in for a routine surgery and went into cardiac arrest. The cause was an anaphylactic reaction to chlorhexidine that no one in the room identified at the time; it was confirmed months later through allergy testing. The search for that answer became more than a year of investigation.
Our first objective was never reform. It was safety. If Katherine ever needed surgery again, we had to understand exactly what had happened, and exactly what it would take to keep it from happening again. Following that one question pulled us outward: protecting a single patient, it turned out, meant understanding the products, the workflows, the exposure pathways, the documentation systems, and the communication gaps surrounding chlorhexidine. The same knowledge it took to keep one person safe could help protect many.
What it revealed was not a failure of any one caregiver but a structural one: the risk was real, the evidence existed, and no part of the system was built to connect them in time. We built the Foundation to be the part that was missing.
Patient Guidance
What you can do today
Here is the most concrete thing we can hand you, and the thing we wish someone had handed us: intact skin is a barrier; disrupted skin is not. Freshly shaved or waxed skin absorbs more of whatever is applied to it, chlorhexidine included. That makes hair removal before a procedure a dose decision — and dose is one of the few variables in this you actually control.
- Don’t shave the area for about 48 hours before a procedure. A razor leaves micro-cuts that disrupt the barrier — real disruption, but short-lived, usually measured in hours to days.
- Leave longer after waxing — weeks, not days. Waxing pulls hair from the root, and that deeper trauma can keep skin more permeable even after it looks completely healed.
- If you have ever reacted to chlorhexidine — a surgical scrub, antiseptic wipe, mouth rinse, coated catheter, or wash like Hibiclens — say so before your next procedure, and ask whether a chlorhexidine-free prep can be used.
Who this can happen to
Chlorhexidine is in so many surgical preps, wound products, catheters, and over-the-counter washes that exposure is close to universal — which means this is not a danger for a narrow group of people. It belongs, in effect, to everyone who passes through care. No one is currently mapping who inside that group is most at risk, and that absence is part of the gap we work to close.
The honest version is the gap itself: no one is even asking whether the people most exposed — newborns and others with a more permeable skin barrier, and those who shave or wax often, of any gender — carry more risk. The fact that no one is asking is the failure.
The risk also belongs to more than one specialty. It lives at the intersection of surgery, allergy, anesthesia, nursing, pharmacy, infection prevention, and patient advocacy. So does our work.
The future this foundation is building toward
Success, for us, looks specific. It looks like intake forms that ask about grooming practices before surgery. It looks like chlorhexidine listed clearly on every product that contains it. It looks like a dedicated diagnostic code that lets clinicians track, flag, and learn from chlorhexidine reactions across the healthcare system. It looks like hospitals with established chlorhexidine-free surgical pathways — so that a patient with a confirmed, life-threatening allergy is never again told that no facility in their region can safely perform the procedure they need.
These are not radical changes. They are the natural result of making an existing, documented risk visible to the systems that were always meant to prevent it.
We have seen the system do exactly this before. A generation ago, latex went from a material almost everyone in a hospital touched to a mass allergy — until labeling, safer defaults, and active surveillance made the hazard visible and brought it down. Chlorhexidine is the same problem, one stage earlier. What worked once can work again.
Informed clinicians
Every care provider understands that chlorhexidine allergy exists, how to recognize it, and how to plan around it before a procedure begins.
Trackable data
A dedicated diagnostic code means reactions are recorded, counted, and visible — not absorbed into catch-all categories where patterns disappear.
Safer intake
Pre-surgical assessments routinely ask about grooming practices, chemical sensitivities, and prior reactions.
Accessible care
No patient with a documented allergy should have to search the country for a single facility willing and able to treat them safely.
Survivor-led. Evidence-bound.
The Foundation is survivor-led — meaning our work is grounded in the lived experience of navigating a system that could not see the risk it was creating. That experience is irreplaceable. It tells us where the gaps are, what questions to ask, and what patients actually face when documentation fails them.
But lived experience is not where our work ends. Every claim we make is governed by evidence, documentation, and restraint. We do not overstate what is known. We do not assign fault to individuals. We focus on patterns — the structural, repeatable conditions that allow serious harm to occur — because that is where prevention lives.
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We move at the pace the evidence supports. Getting it right matters more than getting it out fast.
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Our focus is upstream — on the intake questions, documentation practices, and protocols that stop harm before it reaches a patient.
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Risks that are known but unnamed cannot be acted on. Naming them clearly is the first act of prevention.
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We focus on the systems and structures that allow harm to occur — not the individuals working within them.
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Educational materials produced by the Foundation are freely available for non-commercial use, adaptation, and sharing. Prevention should not sit behind a paywall.
What we don't claim
Part of how we stay trustworthy is being clear about what we don't say. We argue that the danger is the blindness — not that a hidden epidemic is secretly unfolding. We name structural patterns, not individuals or institutions at fault. We claim only what the record supports, and we label what is still uncertain as uncertain. When the evidence and the headline disagree, we keep the evidence. Restraint isn't a limit on the work; it's what makes it credible.
Building a lasting record
Our work begins with chlorhexidine, but the lesson is larger than any one substance. Public-health failures often persist not because the evidence is missing, but because no system exists to connect it, count it, act on it, and keep at it until the gap is closed. Chlorhexidine is where we start, because we have lived it — but the principle is the point: systems cannot prevent what they are not designed to see, and seeing a risk is only worth something if it changes what happens next.
We are working to become a lasting home for this issue — a sourced public record of what is known about chlorhexidine hypersensitivity, and a steady voice for the changes that would close the gap. Our research library, organized across the evidence, is in preparation for public release.
This is not a campaign that ends when attention moves on. We mean to identify the problem, explain it, put practical actions in people’s hands, press for the reforms that would make the risk visible and preventable, and stay engaged long enough to help see real change through. We are early, and we say so — but the aim is durable: to be here for the next patient, long after the first wave of attention has passed.
A note on method: we are two people, and the body of research behind this site is large. To build it, we used AI research tools to gather and organize the published literature — and then held every load-bearing claim to one rule: it has to resolve to a real, external, verifiable source, or it doesn't go in. The tools helped us read widely and quickly. They did not get a vote on what is true.
If this is part of your story too, we want to hear from you.
Whether you're a patient or family member who has had a chlorhexidine reaction, a clinician who has seen one, or a researcher working on any corner of this — there are three things that help most right now: share it with someone facing surgery, support the work while our 501(c)(3) status is in progress, or reach out to collaborate. You can write to us anytime at info@hoffmanngoldsword.org.
About the foundation.
We are Kenneth Hoffmann and Katherine Hoffmann Goldsword, and we founded the Hoffmann Goldsword Foundation in 2025, after Katherine's near-fatal perioperative anaphylactic reaction to chlorhexidine. We run it as a public safety and education initiative, governed by accuracy, transparency, and open knowledge. We are independent — not affiliated with any hospital system, manufacturer, or litigation effort — and our work is evidence-based and focused entirely on prevention and education.
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