Cingles Info

80 test positive for hepatitis virus, health officials say
2002-11-27
By Jim Killackey <mailto:jkillackey@...
The Oklahoman
NORMAN -- Eighty of 750 patients treated at a Norman Regional Hospital pain
management clinic have tested positive for hepatitis C, health officials said
Tuesday.
The virus outbreak apparently happened between mid-December and May, and
involved patients treated at the hospital by nurse anesthetist James Charles
Hill and anesthesiologist Dr. Jerry W. Lewis.
While the two practiced at the clinic between May 1999 and August, the shorter
time span is thought to be when patients were most at risk.
State epidemiologist Dr. Mike Crutcher said Tuesday that of the 80 patients who
tested positive for hepatitis C, "strong evidence" indicates 38 cases were
directly related to pain management injections. In 25 cases there was not enough
evidence to determine how the virus was acquired, he said.
"Strong evidence" suggests 17 patients might have unknowingly contracted the
disease elsewhere, Crutcher said.
Crutcher and David Whitaker, Norman Regional administrator, said blood
contamination at the pain clinic wasn't an isolated incident.
"It is happening more than I would have ever thought ... by highly trained
professionals," Crutcher said.
He said similar incidents occurred in Nebraska and New York.
Hill admitted re-using needles and syringes during as many as 25 procedures a
day.
Hill has been accused by the Oklahoma Board of Nursing of "regularly engaging in
the practice of re-using the same needle and syringe to inject anesthetic
medications such as Versed, Fentanyl and Propofol to patients through their
existing heparin locks" and intravenous lines.
Because a patient's blood can easily back up into intravenous- line portals,
nurses and doctors are supposed to use needles only once. Hepatitis C can be
transmitted through blood transmissions.
On Tuesday, Hill's attorney, Mike McMillin, said, "Mr. Hill is deeply regretful
that any patient of his has contracted hepatitis, and he wants to assure
everyone that he never intentionally placed any patient at risk of harm."
Hill worked with Lewis at Norman Regional in parts of four years -- 1999, 2000,
2001 and 2002.
Hill worked previously at Norman Regional without Lewis, but hospital officials
said Hill would not have been in a nursing situation or environment where he
could have endangered patients through blood contaminations.
The attorney for Lewis, John Hastie, said his client was completely unaware of
Hill's reuse of needles and syringes even though Lewis was assigned to supervise
Hill.
Hastie said Lewis accounted for his own needles and syringes used during pain
management procedures, but wasn't responsible for keeping track of needles and
syringes used by Hill.
Since Norman Regional suspended Lewis' staff privileges, Lewis has been
"absolutely devastated" by a drop in referral patients, Hastie said. Office
visits have decreased by 67 percent and referrals from other doctors have
dropped by 87 percent, Hastie said.
More than 50 malpractice and negligence lawsuits have been filed against Norman
Regional, Hill and Lewis.
During a Tuesday news conference at Norman Regional, the latest results were
released from the Health Department's investigation of patients exposed to the
hepatitis virus.
Of 840 patients treated by Hill and Lewis, 750 have been tested. Attempts are
being made to reach the others.
Another 150 people were provided "courtesy testing." Norman Regional offered to
test patients from two Oklahoma City pain management clinics where Hill and
Lewis practiced.
Hill has tested negative for hepatitis C. Public health officials have been
unable to determine which Norman Regional patient had hepatitis C and was
originally responsible for the blood-contamination dilemma.
Part of the investigative challenge, Crutcher said, was distinguishing between
those patients who may have contracted hepatitis C as the result of their pain
management injections and those patients who got the virus from some other blood
contamination.
It is estimated 2 percent or more of all Americans have the hepatitis C virus
and don't know it, Crutcher said.
Blood tests, records checks and other medical and personal data were used to
determine the strongest possible relationship between those patients treated by
Hill and Lewis and those who contracted the virus, Crutcher said.
About 75 percent of those with hepatitis C will have chronic medical problems
for some length of time, while 25 percent will pass the virus out through their
bodies.
Of those with chronic problems, many can be successfully treated with a
combination of the drugs Ribavirin and Interferon.
Dr. Ted Bader, a hematologist at Integris Baptist Medical Center in Oklahoma
City, said cure rates range from 60 percent to as high as 80 percent.
With expectations for new and even-more-effective drugs in the next few years,
those cure rates could go higher, Bader said at the news conference.
Whitaker said, "The health and welfare of patients always has been Norman
Regional's first priority.
"From the beginning of this investigation, Norman Regional has taken the lead in
focusing on the identification of those patients who may have been exposed,
arranging testing of these patients, personally contacting patients with their
screening results and offering to provide immediate referral to experienced
physicians when needed," he said.
Whitaker said the hospital has become a resource for other hospitals and local,
regional and national health care organizations dealing with hepatitis C
problems.
---
Outgoing mail is certified Virus Free.
Checked by AVG anti-virus system (http://www.grisoft.com).
Version: 6.0.419 / Virus Database: 235 - Release Date: 11/14/2002