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Warning Issued on Reuse of Needles
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By NICK TROUGAKOS
The Associated Press
OKLAHOMA CITY (AP) - A hepatitis C outbreak that has infected 52 people in
Oklahoma has led to a national warning to nurse anesthetists against reusing
needles in intravenous tubes.
James C. Hill, a nurse anesthetist in Oklahoma City, told health officials he
reused needles and syringes up to 25 times a day to inject pain medication
through intravenous tubes at a pain management clinic in Norman and two
surgical centers in Oklahoma City. Such reuse of needles can spread the
disease, which can lead to serious liver damage, cancer and even death.
Hill is under investigation by the state Department of Health and the
Oklahoma Board of Nursing.
Health officials have sent letters to 1,220 patients treated by Hill, telling
them to get tested for hepatitis C, and 52 of the patients have tested
positive since late August.
Last year, 19 patients of a Brooklyn, N.Y., clinic contracted hepatitis C
when an anesthesiologist reused needles and a vial of medication.
The American Association of Nurse Anesthetists has sent 33,000 letters to
hospital administrators, nurse anesthetists and nursing students nationwide,
citing the Oklahoma outbreak and telling them not to reuse needles. Experts
say some health practitioners may not be aware that reusing needles is
dangerous because the needles are inserted into tubes rather than under the
skin.
"After discussion with infection control experts, we have concerns there may
be a widespread misunderstanding by health care practitioners of the dangers
associated with the reuse of needles and syringes," the letter said.
Dr. Elliot Greene, associate professor of anesthesiology at Albany Medical
College in Albany, N.Y., said studies done in the 1990s documented that
health care professionals sometimes reused needles when injecting drugs into
intravenous tubes.
"It was a shocking thing to see," said Greene, who serves on the task force
for infection control in the American Society of Anesthesiologists. He said
the problem has to do with a lack of education.
"There are a lot of people who started their practice before this was an
issue," Greene said. "They got into certain practice patterns that are now
considered bad technique."
Jeff Beutler, executive director of the nurse anesthetists association, said
that when a shot is given into an intravenous line, a needle can easily come
into contact with a patient's blood. Blood-to-blood contact spreads hepatitis
C.
Beth Bell, chief of the epidemiology branch in the division of viral
hepatitis at the Centers for Disease Control and Prevention, said research
clearly shows the danger of reusing needles.
"The way that these kind of intravenous tubes are placed, what often occurs
is that there is a back-flow of blood into the intravenous tube," she said.
State Epidemiologist Dr. Mike Crutcher said Hill believed he was practicing
safe medicine.
"He didn't think it was abnormal procedure," Crutcher said. "It's hard to
imagine that he would think it was normal."
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