Exeter Hospital employee led to an outbreak of hepatitis C

TheCommuter, BSN, RN · Jun 15, 2012

Did the drug-addicted employee not display any signs and symptoms of injection drug use earlier? The time frame being given is October 2010 through May 2012, so I find it incredulous that this employee worked for a year and a half with no telltale clues of drug abuse. This is sad and disgusting.

Click on the link below for more information on hepatitis C. It is actually a bigger threat to public health in the U.S. and worldwide than HIV and AIDS.

https://allnurses.com/infectious-disease-nursing/hepatitis-c-more-742594.html

Altra, BSN, RN · Jun 15, 2012

I read the article and watched the video ... where am I missing discussion of a "drug-addicted employee"? Drug diversion is one thing, but reusing syringes/needles among multiple patients is quite another.

Could it be an issue with some other equipment?

TheCommuter, BSN, RN · Jun 15, 2012

I read the article and watched the video ... where am I missing discussion of a "drug-addicted employee"? Drug diversion is one thing, but reusing syringes/needles among multiple patients is quite another.
Could it be an issue with some other equipment?

Here's what I read. It sounds like a case of diversion to me:

the patients were likely infected when someone used their needle to inject medication before injecting them.

Altra, BSN, RN · Jun 15, 2012

Yes, Commuter, I read that line. But that is what I'm questioning. Diversion is one thing. But re-use of needles/syringes requires a very different, larger, systems breakdown.

Esme12, ASN, BSN, RN · Jun 15, 2012

There isn't much out there...I've got my feelers out. Word on the street is it was the use of prefilled Fentanyl.....injecting and refilling the syringes with water......some places prefill with regular syringes. An anesthesia tech "prefills" and lables for the cases of the day....... but after a while you would think someone would notice the patients were not responding to the meds.

I agree with Commuter....2 years? But you never know the personal burdens of others, but you would think there would be evidence of an obvious problem....I KNOW there is more to this story. I have always said that I was more afraid of Hep C than HIV.

This has happened before.......

The lab was closed for a week in late May but was allowed to re-open after authorities determined there was no evidence that disposable equipment was being misused, that no permanent equipment was contaminated and that there was no further risk of transmission via lab employees, Montero said.
State and local health departments aren’t required to report such outbreaks to the Centers for Disease Control and Prevention, but the agency was notified of 13 outbreaks nationwide between 2008 and 2011. Of those, seven occurred in outpatient facilities, and most were traced to unsafe injection practices. At least two have resulted in criminal charges, including a Colorado woman who was convicted of stealing syringes filled with painkillers from two hospitals where she worked and replacing them with used syringes. The syringes were later used on surgical patients, and up to three dozen were found to have hepatitis C after being exposed.
In New Hampshire, Montero said about 730 people have been tested so far, and several hundred more are expected. The state had been notifying those who did not test positive by mail but is now calling them, recognizing that patients are anxious to learn the results.

Drug diversion suspected in NH hepatitis C cases - Lifestyle - Boston.com

The Centers for Disease Control and Prevention records show that three hepatitis C outbreaks at U.S. hospitals in the past 10 years were started by junkie doctors who injected patients with used syringes.
Last month, a former radiology technician at the Mayo Clinic in Jacksonville, Fla., pleaded guilty to infecting patients with hepatitis C.
Steven Beumel, 48, stole syringes of the painkiller Fentanyl, injected himself and then refilled the empties with saline.
Between 2006 and 2008, two patients tested positive for hepatitis C, and one later died from complications related to the disease.
Read more: Hepatitis C outbreak at N.H. hospital could be tied to worker who shot up, injected patients with dirty needles: report - NY Daily News

Home Health Columnist / Guide · Jun 15, 2012

This could be a case of syringe reuse from multidose vial injecting into IV tubing. Just takes one backflow into syringe, draw up next dose from vial = contamination. Department Health is looking at drug diversion and having meeting tonight at local high school as expansion testing recommended.

6/6/12: DHHS Announces First Round of Test Results in Exeter Hospital Hepatitis C Investigation

6/13/12: DHHS Announces Update on Hepatitis C Outbreak at Exeter Hospital

DPHS is also today announcing the expansion of patients to be tested. Now, anyone treated at the CCL or its recovery room on or after October 1, 2010 through May 25, 2012, is being asked to be tested for hepatitis C. This is a change from testing recommendations set last week at April 1, 2011. Exeter Hospital is in the process of contacting these newly identified patients.
In addition, DPHS believes the most likely explanation of this outbreak is drug diversion. Drug diversion is when a person injects themselves with medications intended for patients and consequently infects patients with a disease such as hepatitis C. “This has been a complicated and time-consuming investigation and it is not over yet,” said Montero. “We will continue to follow up leads and will announce new information as it becomes available.”
Because of the lengthy and detailed investigation, DPHS had previously determined that the Cath Lab was safe to return to normal operations because there was no evidence of contaminated equipment, which can be another cause for this type of outbreak. Full operations of the CCL resumed on June 5th.

GitanoRN, BSN, MSN, RN · Jun 15, 2012

to much much of a twist and turn to the story which enables one to offer an educated criticism regarding this issue without having the true facts on hand. however, i shall pray in the interest of those involved in this matter.

Esme12, ASN, BSN, RN · Jun 15, 2012

NRSKaren I agree they haven't pin pointed it. They know it's not equiptment contamination and they know it's one cath lab employee that is infected so far. It's a nice hospital and always had a good reputation. Commuters post about the prevalence of Hep C made me think of this as where I live it's incessantly on the news.

Just another thing to be aware of in our practice.

GitanoRN, BSN, MSN, RN · Jun 15, 2012

just another thing to be aware of in our practice.

i love your new avatar for a sec. i didn't recognize you... 2/ awesome

sauconyrunner · Jun 15, 2012

Woweeee. I would hate to be the Infection Prevention team at that hospital...

PrimaFacie · Jun 15, 2012

For how long have stores had surveillance cameras all over the place to pick up shoplifting? Aren't there enough mysteries in the hospital that maybe it's about time to put cameras up all over the place? I can hear the moans of "NO Big Brother!, but think about it.....if there was surveillance cameras in med rooms, pt rooms, nursing stations, wouldn't it be easier to track down the behavior that starts a good deal of the outbreaks and situations of abuse? Are these outbreaks less serious than shoplifting?