Hepatitis C Outbreak from Unsafe Needle Use at Las Vegas Clinic

May 19, 2008

A Hepatitis C outbreak was confirmed by the CDC to be caused by improper needle safety and syringe safety at an Endoscopy Center in Las Vegas.

Employees at the clinic were routinely reusing syringes and medicine vials, endangering the health of thousands of patients and ignoring the practice of needle safety, which could lead to dangerous skin punctures. Of the 50,000 patients who were notified for testing, 84 cases of liver disease have been linked to the clinic. The Centers for Disease Control and Prevention was originally contacted due to suspicion after two people treated at the center were diagnosed with Hepatitis C, a disease that can be contracted by needle puncture.

It was during a visit to the clinic that the CDC noticed the lack of needle safety and syringe safety and employees reusing syringes to administer a sedative. CDC investigators noted this information in a report to the Nevada State Health Division, along with knowledge from interviews performed at the clinic that the syringe reuse and lack of syringe safety was common practice resulting in unnecessary skin punctures.

Their report acknowledged that syringe reuse was the most likely mode of transmission of Hepatitis C. The use of safety needles would have eliminated the chance that employees could reuse the same needle more than once, or possibly puncture themselves with infected needles. Retractable needles are one such type of safety needle designed to prevent needle reuse and infection-carrying punctures.

The CDC witnessed one syringe being used several times on an individual patient to re-administer sedatives as needed. This allowed backflow into the syringe from a Hepatitis-infected patient, contaminating the entire vial of sedatives, which was then passed along to the next patient, and the next, and the next.

Patients at the clinic could have been exposed to even more deadly diseases because needle safety was not practiced and may have caused skin punctures, such as HIV; however hepatitis is a serious disease of the liver, which causes it to swell. Symptoms of Hepatitis C are stomach pain, fatigue and yellowing of the skin. The disease may eventually cause liver failure. Even while no symptoms are present or noticeable, the virus gradually damages the liver over time.

This particular endoscopy center and many other clinics were led by doctors, Dipak Desai and Eladio Carrera, who had their medical licenses in the state of Nevada suspended until state Board of Medical Examiners hearings. The clinic is currently not operating and Las Vegas police have removed their medical records. A criminal investigation is undergoing, clinic owners gave up their business licenses, and are paying $500,000 worth of fines for their lack of needle safety.

This outbreak incident resulting from lack of needle safety or syringe safety is not an isolated one. Since 1999, the CDC has reported 14 hepatitis outbreaks in the U.S. due to incorrect syringe safety and needle safety practices. From 2001 to 2002, 99 cancer patients were infected at an oncology center in Fremont, Neb. and one of them died in what was the largest outbreak of hepatitis due to the lack of safety needles and needle safety practices.

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Source:

Unsafe Injections in the Developing World and Transmission of Bloodborne Pathegens: A Review.
Simonsen L, Kane A, Lloyd J, Zaffran M, Kane M. Bull World Health Organ. 1999;77(10):789-800. World Health Organization, Geneva, Switzerland.

Read this entire source

Source:

The Global Burden of Disease Attributable to Contaminated Injections Given in Health Care Settings
Anja M Hauri, Gregory L Armstrong and Yvan J F Hutin

Read this entire source