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Health Workers Expose 60,000 to Hepatitis

Feb 6, 2009 | Parker Waichman Alonso LLP

A recent federal report found that over 60,000 people were exposed and about 400 were infected with hepatitis because of lapses in injection safety practices, reports the Associated Press (AP).  The contaminations involved 33 outbreaks and were mostly caused by violations of simple safety standards, said the AP.

It seems that syringe reuse is the major culprit.  Apparently, a number of health care workers believed that discarding used needles was sufficient to prevent the transmission of deadly blood borne diseases, and continued administering injections with the same syringe barrel, thus enabling the potential for infection transmission.  Contamination can occur in the medicine vial and in the barrel when shots are administered in this manner, noted the AP.

The Centers for Disease Control and Prevention (CDC) called the shoddy injection practice trend “a wider and growing problem.” One such example of such a health care practioner cited by Newsday wasHarvey Finkelstein,the Dix Hills, NY doctor who in 2007 was blamed for exposing thousands and infecting at least one because of his negligent practices.

Authors of the study concluded that all the infectious outbreaks were caused by "failure of health care personnel to adhere to fundamental principles of infection control," quoted Newsday.  The piece was published in a recent issue of the Annals of Internal Medicine

Mentioned in the piece was Finkelstein, who, in addition to exposing and infecting patients, was observed by health officials reusing syringes in multidose vials.  Also cited was the Nevada endoscopy clinic that put 40,000 patients at risk for hepatitis contamination, reported Newsday.  In that case, said the Wall Street Journal, six patients contracted hepatitis C.

The researchers also note that the CDC’s findings represent just a small piece of a larger problem and point out that part of the problem has to do with “a lack of oversight,” according to chief study author Nicola Thompson, said Newsday. "Outpatient settings often do not have the same type of focus on prevention and infection control.  There's been a lack of oversight," Newsday quoted Thompson as saying.

According to the WSJ and based on CDC data, one of the leading causes of infection in outpatient settings, such as doctors offices and long-term care facilities, is shoddy injection practices.  The Journal reported that it is not necessarily healthcare workers understanding that needles cannot be reused, but rather, their knowledge that syringes must be disposed after use, which means that those in the health care industry are not always following the CDC’s guidelines for injection administration.  As a matter-of-fact, the CDC and others are kicking off a "One Needle, One Syringe, Only One Time" campaign next week, to bring education around the issue.

Blood borne diseases can be transmitted when an infected person is given a shot and either the needle or syringe is reused.  Microscopic backflow can enter the syringe from the contaminated person and then also enter a multi-use medicine vial, which puts future patients at risk from the needle, the syringe, and the multi-use vials explained the Journal.  Hepatitis C is the most common chronic blood borne viral infection in the U.S. said the CDC, with about 3.2 million Americans suffering from lifelong, chronic infection; about 1.4 million Americans are infected with chronic hepatitis B.  Both forms can lead to liver disease and death.

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