Posted on 03/05/2008 7:51:12 AM PST by MizSterious
Washington (AP) The head of the Centers for Disease Control and Prevention says an outbreak of Hepatitis C at a Nevada clinic may represent “the tip of an iceberg” of safety problems at clinics around the country.
The City of Las Vegas shut down the Endoscopy center of Southern Nevada last Friday after state health officials determined that six patients had contracted Hepatitis C because of unsafe practices including clinic staff reusing syringes and vials.
(Excerpt) Read more at nbc11news.com ...
Demaning more volume from our existing health resources (as in universal coverage) will A) Help clean up problems like this B) Stress existing systems more and make these problems more prevalent C) Bush’s fault
Tick, toc, tick , toc ...
Wow, you’d expect to read a story like this in some third world country.
It’s not just the clinics, either. These kinds of things are happening in hospitals, too. What a nightmare.
Hillary will fix it.
Avoid “for profit” clinics, especially those run by foreign trained doctors, or clinics that are owned by a doctor that is not on sight. Many times these for profit clinics are owned by a reputable doctor, but that doctor hires young, inexperienced doctors to work or even run the clinics and pay them very little. At least that is the case at large dental clinics.
Where in the world were these "clinicians" educated that they need to be alerted to this??!!!
6 more Clinics have been closed now and 8 more cases of hepatitis have been confirmed.
Unreal.
Lines are long for people getting tested and also 1,400 cannot be reached, no address.
Make em open the syringe in front of you or refuse
Might work in clinics, but in hospitals, patients are sometimes unconscious or so much in pain they’re not noticing anything—I don’t know what the answer is, but it’s shocking to think this is happening here, where we KNOW better.
Norman Hospital, in Norman OK, had a case similar to this a few years back. Several hundred patients got heptatitis c. The person in charge of the clinic was NOT third world, he was born, raised and educated in the US. So it’s worse than just watching which clinic or hospital you go to. For some reason, some personnel think they can just skip the rules.
this is disturbing.
bttt
My best friend died 2 1/2 yrs ago from cirrhosis of the liver that was a complication from Hep C. They figured she got it from when she was a nurses aid at a local hospital long ago.
Everyone is at risk.
I have had multiple endoscopy procedures done, and in no case is anything like a shot used. They hook up a IV and the only drug used is what the anesthesiologist uses to put you in a very relaxed condition,(LOL)
That's it, just one puncture to the skin and I'm betting this is all about the anesthesia.
They insert the drugs way up on the IV setup, so blood is highly unlikely to come into contact with the rig, that far up to the IV bag. The anesthesia drugs don't come in single dose bottles as the stuff is used according to body weight and need. If the anesthetist reused a syringe, yet changed the needle, I would think the idea was to curb costs, and reusing the same drug jug is common practice with those guys. They don't ever inject directly.
My guess is that if any hep B was transmitted, it came from improper sterilization of the camera rig, which is pretty common place. The older ones are hard to clean and they reuse it continuously.
That's where the problem is, and it can be solved by using a disposable rig, but at a very high cost to the patient and the insurance industry who has to pay for this.
This media fascination with this story, may well cause a doubling or tripling of the cost for the procedure, and many men will be victim to the do good highly profitable lawyers.....Again....and again.....and again....
Never assume that it’s ok to reuse needles, vials, or IV or other equipment without proper sterilization. Period. If you think the cost of proper sterilization is high, wait until the worst happens and someone comes down with hepatitis—and in Vegas, quite possibly HIV as well. Having both makes it almost impossible to recover, period.
I am not concerned about that. What I am concerned about is creating another knee jerk reaction that makes a endoscopy procedure too expensive to do. it is the only way to detect colon cancers before they kill you, and men have been dying from this crap for decades. Some women as as well, but the numbers of deaths in men is very high.
The reason is largely that men do not like things shoved up their orifices, (most anyway) and thankfully, over the recent past, the cost of these procedures has come down enough to make them more common.
If it were not for the anesthesia, we would not do this at all.
If this is radically altered, and the government makes it much harder to do this procedure, the common place aspect will disappear and we will be right back where we started. Cases of hep B is not good, and this is largely preventable, but if it goes too far to eliminate a rare risk, the entire procedure will e affected, and we just will not do it anymore.
Put the premature deaths of thousands up against a few cases of hep B, and you will see my point.
Perfection is something to be strived for, and not intended to be a requirement or mandatory,yet our legal system and government oversight ignores the obvious and continuously screws the pooch while trying to invent or mandate perfection.
Lastly, as I stated in my first reply, there is something wrong with the facts in this story. the facts are missing and imaginations have taken over. I seriously doubt the reusing of a syringe by the anesthetist is the causal factor. It's highly unlikely.
What's more likely, is the normal risk of hep b transmission by the camera rig. Something they have been dealing with since the procedure was invented.
LOL! Yes mommie......LOL!
In no case is the reusal of a needle or IV acceptable, but reusing a vial is, under certain controls.
In this story, there is not one single indication that a needle or IV was reused.
As to anesthetists reusing vials, it happens every single day of the week. They don't directly inject this stuff. It goes into the IV rig at the place designed for it.
This event is a load of crap designed to punish the medical field because of some A'holes idea of perfect medicine.
In the end, sanity may prevail, but not before killing thousands to save one case of hep b.
Typical government behavior.
This is more than HBV. It’s all of the “brands” of hepatitis, plus HIV. And I will restate my opposition to your dismissal of proper sterilization. When I was training to be a nurse (although I ultimately chose another profession), we knew better than to do such things. Treating the lives of patients so carelessly is outrageous. Kneejerk or not, having a lifelong disease that’s not easily cured could have been prevented. It wasn’t. And apparently people like you would rather look at the BOTTOM LINE than the lives of the patients.
No where in anything I said, are those words or anything even close.
What I am saying, short version for those in Rio Linda, is that this story is crap! That it is would be ridiculous to reuse a needle. It did not happen.the Feds shut down a institution on rumor and innuendo, and now profess to be backing up their insult with more insult to the intelligence of anyone with half a frigging brain.
As to what really occurred her, I don't know, but i have a suspicion that it is related to the cleaning of a camera rig that is damn hard to clean between uses when they are stacked up with men trying to find out if they are at risk for colon cancer.
I also believe this syringe business has something to do with anesthesiology, and from what I have seen in my lifetime, a common practice and not dangerous at all to the patient nor a violation of current protocol.
What irks me about this, is the same crap that has been irking me on all sorts of issues where people dive off the deep end because of one fact-less media story that infers some sort of accusation and where the accused party has yet to respond.
It happens so frequently on the Internet, and on this forum, that I am beginning to believe that people in general have been brain damaged by the Internet and become emotional cripples.
Every dead woman has a Scott Peterson angle, Every medical story has a Corporate fraud angle, Everything, Everybody, Every story is blown out of proportion by what I view are idiots!
The United States of America has become a country full of whackos!
The only hope now, as I see it, is for the "people" to get exactly what they are demanding.....whatever that is, and soon.....
One can only ope that after the damage is done, and the resulting cataclysms occur, that something is learned from it.
Either that happens, or we are all doomed to die soon, by our own stupidity while I watch in horror at the ignorance of it all.
The true ignorance here is in what these medical “professionals” did. Period. Unless you were there, you can’t know this story is “crap.” Get your head out of the sand—this not only IS happening in other places, it has for years. Trying to pretend it’s “knee-jerk” to demand better treatment is what’s “crap.”
And ps—I doubt these people will ever collect a nickel. Probably not even enough to manage their recently acquired illness—treatment for these things is very expensive (and not even very effective).
Avoid “for profit” clinics, especially those run by foreign trained doctors...
First, there are too few non-profit clinics to service to the general public. They are more likely to be staffed by young, inexperienced staffers.
Second, foreign trained doctors from third world countries with degrees from third rate institutions are recruited to work in America under a special visa program. They to retain cultural tendencies which makes them dangereous. I personally refuse to trust them with my health care. Unfortunately I often don’t know they are involved through various referrals until billing statements arrive.
By the way, I’m one of the 40,000+ Las Vegas victims of “Dr” Desai”. He is a graduate of Gaurat University of India, a world class cesspool, with residency at some Catholic medical care center. It is a perfect example of the above description.
Finally, if you think for profit health care is bad just consider what government universal health care will be like.
On Densai, mentioning problem that go back a few years...
Embattled Doctors' Backgrounds Questioned
Patients need to do their homework. A good doc won't be offended.
LOL! That's my point! What did they do?
All we have here is a unexplained number of Hep B infections, that with the gross number of patients involved, seems a bit low to me for any major medical error,and secondly, there is no factual information as to what was violated, except for one mention of a reused syringe, (not needle) and I suspect this has something to do with the anesthetist, yet even that information is not in this story.
The reason I suspect this, is that there is no punctures made except for one IV. The drugs are administered into the IV tap.
The fact is, that infection transmittal for this procedure is rare, but when it happens it is always traced to the camera, not some damn syringe. The only syringe used, is to administer the anesthesia.
This story is crap.
Doctor Discipline: Does Nevada do Enough?
Doesn't sound like much has changed.
Good to se ya! God Bless...
The results of my testing just came back negative. Cost of the test are $400. It is vague who will be paying for it. If my math is correct, 40,000 times $400= $16 MILLION. Thats just for the patients. Add some unknown number of families, friends, lovers and whatever, WOW. That’s only from the one clinic. The owners have several other clinics in the Las Vegas area. I can’t help wondering how widespread this kind of thing is nation wide.
You should re-read the reports. It involves the anethesia process. Reusing syringes to get the medication into the line makes it possible to transmit contamination to the patient. It’s not rocket science to figure it out. You are right about the instrument. They were cleaning it in the “dirty bath water”. It’s sort of academic to me as one of the 40,000 victims. Fortunately my test came back negative.
The third world.
Hey Misterious, six or more victims have proven to be infected in this mess. The rest of us have been sweating out the test. It makes no difference whether it was transmitted by the IV or the instrument. It is still a matter of deliberate violation of sanitary practices to save money. You do make some good points, but they are academic.
Glad to hear your tests came back ok.
I heard this morning on tv, it was Robert Massi the attorney,say something about being retested in 3 months. Did you hear that or were you informed of that?
I've seen this done before. The hospital protocols either prohibit it or they don't. And no, it's not rocket science that contamination would occur, and from what I can tell, it can't.
They were not really reusing the syringe, if what they did is what I witnessed when a anesthetist friend of mine allowed me to ask some questions. What they probably did is what he does, he loads the syringe up with goofy juice prior to setting up, and uses the same load for a number of patients, as some need more, or less or none, if they respond badly to the stuff.
They change the needle which only goes into the IV tap, and for blood product to reach that tap, you would know it, and the entire rig would be contaminated. For that to happen the bag and rig would have to fall on the floor. Then it's mandatory they change it. Gravity works in rocket science ways, and it always works the same way. That is why toilets are place higher than the sewerage lines.......
Apparently the CDC did not like what they were doing. I'm not familiar with Nevada laws, or if there is some suggested method they like, but I don't think they can enforce their way or the highway sort of medicine. This guy I am talking about works for the VA. I have had a series of these coloscopy's and I learned a bit. I also note that new machines are now in place that use disposable tips and throwaway stuff where the other machine did not. The VA rebuilt their entire unit and it's a much better experience now, as my last visit, a few weeks ago proved.
I'm betting the contamination came from the apparatus, as I really don't see how individual packaged anesthesia for patients is possible because they push it during the entire procedure, and the load depends on weight, and personality (tolerance) of the patient. I also cannot find a thing wrong with using a syringe like that. I get the abundance of caution thing, but some things are overkill and a huge cost to the patient, or the insurance company who pays a set rate for these simple procedures. I can see why they may do things to save money, but it should not have involved cutting the decontamination costs for the scope. That is bad medicine, and that scope gets a lot of blood on it if polyps are trimmed.
I have some theories as to why this has become a issue.
It is absolute mandatory protocol that syringes cannot be reused, but there are exceptions, that were never here to fore called reuse. The exceptions are where drugs are pushed through a IV system by a anesthetist that up till now has been considered safe. They don't reuse it again, but use it until the load is used up and keep track of the amounts given for billing. It makes it easier on them as they might well be required to throw away a large amount of drug unused, or they could find themselves with a fully awake patient and a empty vial and syringe when they need it, requiring a delay before they can push more. Patients have a nasty habit of suing if that happens.
If you look closely at the CDC, they have a axe to grind after that mess with the TB patient. The medical community cut them absolutely no slack, and I think you are seeing some payback.
Glad your test was negative. Hep is not a fun thing to have. There are many who have it, and don't know it, and there are many who do. The VA used to ask if you had it, and took your word for it, but I noted that they ran a hep test on me without my knowledge a few months ago. They said it was new protocol.
I'm not sure what I think about that. I was angry about it. But perhaps it was necessary to protect all. I still don't know what I think about that though....My Libertine side is pissed.
I hope this is not as bad as feared. It seems likely that dozens are infected and some of those may have already been infected. It appears that there is a national issue here. It could be that the CDC is right about that part. However, as most government things go, they dropped the ball much earlier and now are over compensating.
http://www.lasvegasnow.com/global/story.asp?s=7966180
Sixth Medical Center Closed, DA Looks At Criminal Charges
A sixth gastroenterology center in the valley has shut down. The latest one is in North Las Vegas and was closed late Tuesday afternoon.
The City of North Las Vegas sent out a cease and desist letter to one of the clinics, shutting it down until the at least March 19, 2008.
UMC Offering Help to Medical Center Patients
The city said the clinic demonstrated a willful failure to be sanitary and called it a public nuisance.
The following centers are now closed:
Endoscopy Center of Southern Nevada, 700 Shadow Lane
Desert Shadow Endoscopy Center, 4275 S. Burnham
Gastroenterology Center of Nevada, 4275 S. Burnham
Spanish Hills Surgical Center, 5915 S. Rainbow Blvd.
Gastroenterology Center of Nevada, 2610 W. Horizon Ridge Parkway
Gastroenterology Center of Nevada, 1815 E. Lake Mead Blvd. #207
It now has to stop all operations or face arrest. Management must go before the North Las Vegas City Council on the 19th to appeal.
Read the Health District letter sent to patients
Tuesday at the fifth clinic, a Henderson city inspector met with staff and went out to his car for contact information and paperwork. When he came back, the doors were locked and management told everyone to leave before the inspection even began.
The City of Henderson then pulled the license.
This is exactly the practice that infectious disease specialists are concerned about--re-using the syringes and vials for IV sedation.
The anesthesia drugs don't come in single dose bottles as the stuff is used according to body weight and need.
Again, the multi dose vials were re-used for multiple patients with re-used syringes. This was a public health disaster waiting to happen.
The re-use of syringes "to save money" is ludicrous because syringes cost literally a dime a dozen. I wouldn't be surprised to find they were re-using more expensive items like the IV tubing.
When a vial is labeled "single use only" and the fee charged to the patient/insurance company includes full fare for the whole vial, this practice reflects fraud. The alternative is simply single dose vials. Packaging costs are a pittance compared to the drug costs.
Well there is one case where it's ok to reuse needles, for lethal injection.
Cold Heat, your ignorance regarding syringes, vials, and physics knows no bounds. Those of us who have actually drawn fluids from a vial into a syringe know that an amount of air must be injected into the vial roughly equal to the fluid being withdrawn from the vial. Failure to inject air into the vial results in a vacuum in the vial, where no fluid can be removed. Where does this air come from? The air comes from the syringe. In this case, any and all contaminants from the re-used syringe and through the fresh needle are injected into the re-used single dose vial prior to withdrawing the fluid from the vial.
Before you go off half cocked, as I have witnessed before,the friggin IV that I have seen, some three or four times in the past two years has a shunt that the anesthesia needle is inserted into. I does not, and can not come into contact with the IV fluids at any time because the shunt is dry....
Got it!
The anesthetist attaches a short piece of tubing to what looks like a specially designed syringe that gives him the ability to control small amounts of drug, and the length allows him to old it in his hand while watching your face and monitors.
The dry and sterile nature of the practice is not, or has not been considered "reuse" to the best of my knowledge, until this week when this story came out.
This is why I say it is crap!
I still say it is crap, because people are going off wildly thinking they were using dirty syringes. It just ain't the case,in my experience, but surely I don't know what they were doing because the story does not reflect exactly what procedure they used.
However, I seriously doubt they were doing something that blatant.
My guess is that their protocol for cleaning the camera rig was faulty, or their autoclave was malfunctioning and not reaching a high enough temp to sterilize completely the metal parts they may put in it.
Now go right ahead and keep calling me stupid......stupid.
You admit you are guessing (and not very well at that), yet you call someone who DOES know how this is done—stupid? Cold Heat, I do hope you never have to find out first hand just how wrong you are.
Single use vials are not normally used in anesthesia, it is something a nurse rarely sees as they deal with inoculations, not pushing goofy juice.
Your dealing with a entirely different set of protocols and I do not know of any anesthesiologist that would do something to cut corners, they just don't...They are often more professional than the doctors and nurses....
The CDC does not have much of a reputation for accuracy. They are a feckless, mistake ridden, politically motivated organization that thrives on it's own ego.
Wait a few days until the other side of this story comes out. You may well feel very foolish. The odds are great.
So, the people who now have HCV, HIV or HBV are...what? Making it all up? Or did they all give it to themselves, just for the fun of having a fatal disease? The people who acquired these diseases from this incident are the evidence, CDC aside. For that matter, I don’t need the CDC to tell me those practices are just plain wrong.
I repeat: attitudes like yours are getting people not only sick, but in many cases, killed.
They found a issue with some single use vials that were used twice, and that is a technical mistake but it does not mean source of illness. I think the source, if there is one, is related to the camera and polyp nipper rig. This has been a problem since day one with these machines.
The CDC has a really bad habit of leaping to conclusions, and that is due directly to poorly trained and essentially unqualified people doing investigative work.
My opinion is based largely on the design of these IV rigs. If used correctly, they will not allow the contamination of a injection needle because the injection shunt is dry and by extension, the syringe would be isolated.
From the various articles, all copied from the original, I have managed to extract the fact that they(the clinic) did not always use single dose vials and usually use multi dose. Their protocol was not inclusive of single use vials. The difference being only that one is marked single dose....Big Deal! WOW!
Thinking they (the benevolent CDC) have the answer based on that bit of trivia is a real stretch and typical of bad investigation technique..Very bad.........
I have remarked earlier how ridiculous it is for me to watch as so called level headed conservative act like loony left wing liberals on various and sundry subjects. It's telling me that this country is ready and primed for a major social breakdown of gigantic proportions, and frankly, I can't wait for it to happen.
It is the only way to correct the course of this country, and save us from a emotional projection environment where sick has become the norm, and normal behavior is a rarity.
The inmates are indeed now running the asylum, and it's anything but amusing to me, but then one must retain a sense of humor. I still have my wry sense of humor, but it is getting ever so hard to enjoy it like I once did. Very hard indeed.
Cold Heat seems to be the only one bringing sanity to this discussion. Let me explain the IV set up from the point of contact with the patients vein to the bag of fluids. First the vein is entered with a catheter or needle which is obviously contaminated by patient fluids. Then a connecting tube of at least three feet is attached to the catheter(extension set). Then the extension set is connected to an infusion set (about six feet long) then the infusion set is connected to the IV bag. The IV bag is hung high above the patient to maintain adequate hydraulic pressure to keep a flow of fluid TOWARD the patient’s vein(the drip). Somewhere between the extension set or in the infusion set is a PORT(where you inject the drugs). Once injected the drugs then flows a long distance through small gauge tubing to enter the patients vein. No where does the needle or the drug injected come anywhere even close to contact with patient fluids. I have done this thousands of times and cannot imagine any scenario where needles or drugs became the source of cross infection with these patients. Look to the scopes and sterilization as the most likely source.
I am afraid knee jerks like this discussion will result in changes requiring single dose vials only. Then there will more complaints about the cost of medical care and the evil doctors gouging patients. Cross contamination is surgical offices is a serious issue and prevention is top priority in my office. I spent a hell of a lot of money and training to make sure we are the standard in my community. I see the hidden agenda which is to require more federal supervision into private business.
Emphasis mine in this story.
State to test 300 former patients for hepatitis C
NORMAN (AP) -- At least 300 former patients of Norman Regional Hospital's pain management clinic will be asked to have testing for hepatitis C, the Oklahoma Health Department said.
The notice comes four days after the hospital confirmed six former patients tested positive for the disease. State epidemiologist Dr. Mike Crutcher said appropriate medical procedures were not followed by a certified registered nurse anesthetist working at the clinic and syringes, intravenous lines and pain medicine were contaminated.
Grant Farrimond, the hospital's director of public relations, said the anesthetist apparently used ''sloppy infectious disease controls'' and ''wasn't following universal precautions'' during spine block procedures.
MY note: over 100 of these patients had one or another of the types of hepatitis.
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