VA hospital may have infected 1,800 veterans with HIV

[swag]

Source: CNN

(CNN) -- A Missouri VA hospital is under fire because it may have exposed more than 1,800 veterans to life-threatening diseases such as hepatitis and HIV.

John Cochran VA Medical Center in St. Louis has recently mailed letters to 1,812 veterans telling them they could contract hepatitis B, hepatitis C and human immunodeficiency virus (HIV) after visiting the medical center for dental work, said Rep. Russ Carnahan.

Carnahan said Tuesday he is calling for a investigation into the issue and has sent a letter to President Obama about it.

"This is absolutely unacceptable," said Carnahan, a Democrat from Missouri. "No veteran who has served and risked their life for this great nation should have to worry about their personal safety when receiving much needed healthcare services from a Veterans Administration hospital."



Read more: http://edition.cnn.com/2010/US/06/30/va.hospital.hiv/index.html?fbid=dLNBFpjlLHe

[Robb]

1. "Handwashing tools before putting them in cleaning machines?"

Can someone explain this? Is the idea that then the sinks potentially carry infection?

[Catherina]

5. I don't understand either.

My mind understands that as handwashing dishes before putting them in the dishwasher. Obviously we must be missing something. Where are Mika and PCIntern when you need them? Yoohoo Mika, PC! Can you explain the problem? Where they maybe supposed to be sterilized before being put into the cleaning machines? Or maybe soap residue interferes with the cleaning machine?

[Warpy]

7. You're right, it doesn't make any sense

Gross contamination is always rinsed off surgical gear before it's sent to central supply for sterilization.

Lazy techs not following procedure would simply have skipped rinsing the glop off dirty instruments.

[mike_c]

9. and yet the OMG responses are beginning to pile up down thread....

Doesn't anyone read critically anymore? This is like that thread yesterday accusing the gynecological surgeon who corrects congenital adrenal hypoplasia of "female genital mutilation." Someone posts it and everyone else immediately believes the negative spin rather than engaging their brains and thinking critically about the information that's presented, and the author's inherent biases.

[Warpy]

11. Hysterics would rather run around with smoke pouring out of their ears

than bother to read the facts. That's as true on DU as anywhere else, it seems.

IMO, the potential for infection is pretty small if the dirty instruments were autoclaved. If they were just sent to gas decontamination, there's more likelihood of a problem. I don't know what procedure the VA uses, but the former is always a lot safer. It kills everything on metal except prions.

Nothing kills prions except maybe molten lava or a thermonuclear blast.

[Duppers]

14. I caught that too.

too many ADD people here who don't bother to read and think.

(Don't hop on me about the ADD comment --I'm ADD!)

[northernlights]

15. I wonder if the article got it backwards?

That techs were NOT handwashing stuff before putting into cleaning machines, and were NOT supposed to put stuff straight into cleaning machines.

Otherwise, it makes absolutely zero sense...

[muriel_volestrangler]

8. The best I can tell, they were missing out a step from the machine cycle

because they'd handwashed them already. But I could be wrong:

Dr. Michael says the techs were using a sink and strong soap to clean the tools, when they should have sent them to the hospital sanitizing and sterilizing department.

The techs, says Dr. Michael, were trying to protect the delicate instruments by doing the cleaning by hand, but instead, they were breaking protocol.
...
Even though the dental instruments were washed by hand, they were still sterilized by machine. The hospital uses high heat and pressure to sterilize instruments, which kills most germs. However, some viruses can withstand the heat, that's why they are washed in special machines.

http://www.ksdk.com/news/local/story.aspx?storyid=205262&catid=9

I think that's saying there should have been a two-stage machine process - washing (which the techs thought was breaking the instruments sometimes, hence the hadnwashing instead) and then sterilizing - and instead they were doing handwashing and then sterilizing. But the reporting in the various articles is pretty poor. There seems to be no specific reason to suspect HIV or another infection; that's just the most worrying one the writers can think of, so that's the one they've put in the headlines. Meanwhile, what actually happened has been poorly described.

[UTUSN]

2. K&R #3 n/t

[Brickbat]

3. My God. What a nightmare.

[femmocrat]

4. Dear lord....

That is just horrific.

[Renegades of Funk]

6. How will the GOP twist this one?

[kestrel91316]

10. The microbiologist and doctor in me does NOT understand how

an extra step of handwashing of instruments can INCREASE risk of disease transmission. This makes ZERO biomedical sense.

My guess is, protocol was violated (by overkill, but who are we to quibble over details) and that triggered a notification. The fact that the protocol violation might have DECREASED the risk of infection seems not to have come into consideration.

[Warpy]

12. I think the article was written by a medically ignorant person

who got it backwards.

We always rinsed the gross contamination off instruments in the hospital before we sent the tray back to central supply.

[qb]

13. This article is an example of ridiculous alarmism.

The VA hospital was evidently just following their standard operating procedure after discovering a breach of protocol, and they were correct to do so. However, the announcement should have been tempered with a dose of reality. The risk of contamination from conscientious hand-washing followed by sterilization has to be only marginally higher than the risk from following the approved procedure.

Incidentally, I am a VA patient and consider their care far superior to the crap the HMOs are doling out.

[qanda]

16. Infected or exposed?

Not sure the title fits what the article is saying.

[taught_me_patience]

17. Sensationalism at its worst

I'm willing to bet my entire life savings that nobody contracted HIV from this.

[pinboy3niner]

18. From another article: they used the WRONG SOAP

The department said that in March a routine inspection revealed that staff had been cleaning dental instruments by pre-washing them without the proper detergent before putting them in cleaning machines, "unwittingly compromising the cleaning process."

http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/20983