Sunday, March 2, 2008

HBV, HCV, and HIV scare: 15 minutes from my house!!!

That's right. The Endoscopy Center of Southern Nevada, located at 700 Shadow Lane in the heart of Las Vegas, was closed down last week after allegations of unsafe injection procedures related to the administration of anesthetics to patients that may have resulted in exposure to contaminated blood products. Like Thomas mentioned, 40,000 patients are being notified of their potential exposure. Any patient who had a procedure done at the clinic between March 2004 and January 11, 2008 is at risk. This all came to light when a cluster of three acute cases of Hep C popped up in January 2008, and six have popped up to date. Medical providers are required to report Hep C cases as they pop up and typically two acute cases are reported to the health district annually, making these six cases really stand out. FIVE OUT OF THESE SIX CASES WERE ALL SHOWN TO HAVE RECEIVED ANASTHETIC INJECTIONS ON THE SAME DAY.

It is important to highlight that the potential nosocomial infection allegations, if found to be true, stem from the unsafe administration of anesthetic and NOT the actual medical procedure of the scope. In depth investigations conducted in the clinic discovered that syringes, not needles, were being re-used to administer anesthetic to different patients. Apparently, the administration of anesthetic can really burn if injected directly. So, to ease the pain, a little bit of the patient's blood is taken up into the syringe so that the initial contents of the injection are not pure anesthetic, cutting down on the stinging. Now, we potentially have small amounts of people's blood products in syringes that are being passed along to the next room to be used on another patient. The needle is changed, but the syringe is not, the syringe is filled with fresh anesthetic, the next patient's blood is taken up into the syringe to ease the pain of injection, the anesthetic is administered...AND THE CYCLE CONTINUES. Thus, people's blood products were potentially being shared through the contaminated syringes.

The big scandal in town right now is that this clinic is part of a large, cheap HMO that has a reputation for cutting costs. The cost for replacing each syringe was estimated at a mere .57 cents...now, all that money saved on syringes (and more) will be spent in defense in court. Nurses and other healthcare staff that were aware of the potentially dangerous procedure are now coming forward, disclosing more information about how long this procedure has been in practice. Also bothersome is that there are two other clinics, under the same HMO that were using the same unsafe injection procedure. The practices of these two other clinics are currently being investigated.

Unfortunately, we have quite a few family friends who recently visited this clinic (during the high risk time period) and are very shaken up. They are all getting tested next week for HBV, HCV, and HIV. The worst part is a vast majority of the patients attending this clinic are patients over 50, going for their mandatory colonoscopy. By definition, this is a problem if the main demographic at risk is the elderly (not saying people in their 50s are "elderly" but you know what I mean). As we all know, the main problems with these diseases (especially HCV and HIV) is that they often have long periods of asymptomatic infection, making detection of nosocomial transmission cases exceedingly difficult.

Becca Briggs
http://www.southernnevadahealthdistrict.org/press_releases/2008/022708b.html

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