According to results of an investigation published by the CDC, at least nine kidney patients were infected with hepatitis C while being treated at Life Care Dialysis Center. This fact may sound like just another story concerning hospital acquired infections; however, there is much more to the story. The Center's closing by state health officials was warranted in more ways than one.
On the surface, the clinic was described as a filthy place where employees did not wash their hands properly, disinfect equipment, or always wear gloves when treating patients. Dried blood was even found on treatment chairs. As it turns out, this was not just pure laziness; many staff members were unaware of the center’s written policies about cleaning and disinfection. Whether or not the staff was telling the truth remains to be seen, but it appears that the center has severe training issues; untrained staff should not have been dealing with patients in the first place.
Medical guidelines require strict testing and monitoring of dialysis patients for hepatitis C infection; however, the clinic tested patients on an erratic basis. Out of the patients that they did test, the aforementioned nine tested positive for hepatitis C.
Hold on, this is the worst part of the story. The clinic knew that these nine became infected after they started coming to the clinic, but it never informed them; it notified state health officials in only three cases. This deviance combined with erratic testing means that many other patients may also have been infected at the clinic.
Dr. Walter Wasser, the physician who was the operator and medical director of the dialysis center, was fined $300,000 and surrendered the clinic’s operating certificate, but the state Office of Professional Medical Conduct has not taken formal action against him. Where is the justice in that? Does a fine and a bit of public embarrassment make up for the patients' losses?
The future of these nine newly-positive hepatitis C patients may include cirrhosis, liver failure, and cancer. If you add the diminishing quality of life over an extended period of time, does this punishment seem fair? What about the family members of these patients? Who is reimbursing them for their inherent struggles and emotional setbacks due to the clinic's carelessness and deceit? Even if large sums of money were given to these patients and the careless were sent to prison, would it still be enough?
This is the type of story that makes me hope and believe in Karma….
Reference:
The New York Times Website. Rabin RC. Hepatitis C found in clinic patients page. March 2009. Available at: http://www.nytimes.com/2009/03/06/health/06clinic.html?_r=1&ref=health. Accessed 04 March 2009.
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2 comments:
This story is enraging. To think this is going on is different from actually knowing that it is going on. Why would the staff need written policies to know about following cleaning and disinfecting guidelines? Aren't they trained on those principles in nursing school? Better yet, don't they follow these rules at their home, or is their homes as filthy as the clinic.
I agree; what about the quality of life for these patients? You can't put a price on that, but $300,000 doesn't seem to be enough. Furthermore, can the community or the patients and their families demand retribution for their future suffering? Can they demand criminal charges be filed against this doctor? He broke the carnal oath of medicine - "to first do no harm." Couldn't it be argued that the doctor removed/reduced their quality of life in court? Ethically, can this doctor be allowed to walk the streets?
Believe me, the doctor and the staff members involved in this tragedy will be punished; the saying is true - what goes around always comes back around.
Unfortunately, this is a recurring story. Several years ago, there was a run on stories about clinics that were infecting people with hepatitis and HIV by re-using needles. Clinic staff, including RNs and LPNs, were unaware of the possibility of infection through re-use of syringes, including disposable syringes! While I agree that written policies and procedures, as well as staff training, are imperative and essential in any clinical situation, this is basic clinical hygiene 101 and should be the first thing taught in any medical program! This includes MDs, RNs, LPNs, and nurses aides.
I cringe every time I am in a situation where someone has to draw my blood or even clean my teeth: Technicians are wearing gloves but it seems the object is to protect themselves only because, by the time they have gotten to the patient, they have touched every other imaginable thing on the way to the vulnerable body part. MDs are no better: I have been in many a patient hospital room where the doctor came in, did not wash his hands, and proceeded to touch patients. This included pulling off bandages to inspect a wound and then leaving the bandage on the bed or tossing it into the regular trash, as opposed to the red biohazard bin, and walking out of the room without washing his hands, on to visit the next patient.
The simple act of handwashing is the single most important deterrent for the spread of disease. Yet early proponents of handwashing were ridiculed and even persecuted (http://en.wikipedia.org/wiki/Ignaz_Semmelweis). It boggles the mind that procedures such as handwashing and body fluid precautions that appear to be common sense to us today and are established practices of basic patient care are routinely met by ignorance and negligence by these clinic staff.
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