Colonoscopies May Have Infected Miami Vets

It has recently come to light that as many as 3,260 veterans treated at the Miami Veterans Affairs Healthcare Center may be at risk for developing Hepatitis B, Hepatitis C and HIV. The cause of this potential problem is colonoscopies done on ex-service personnel when equipment used in the procedure was not properly sanitized. An investigation has been launched into this error and in the meantime all colonoscopies have been suspended at the hospital.

Patients who received colonoscopies at the hospital dating all the way back to May 2004 are considered to be at risk. These individuals are being notified of the error and the possibilities of developing a medical problem. In addition to the Miami hospital, similar errors have been discovered at veteran’s facilities in Murfreesboro, Tennessee, and Augusta, Georgia. The problem has occurred because tubing used on the colonoscopy equipment has not been properly serviced or sterilized according to guidelines provided by the manufacturer.

Response from the U.S. Department of Veterans Affairs has been two-fold. A team of officials was sent to the hospital to determine responsibility for the lapse in properly cleaning the equipment and to determine how veterans could have been affected. In addition, a campaign has been launched to inform all of the persons who had a colonoscopy at the hospital since May 2004 of the possible health concern. These individuals are being urged to visit a veteran’s facility in their area to be tested. It is estimated that some 2,500 of these individuals reside in the Miami area.

“Infection control is a critical concern for patients as well as healthcare workers,” said Congressman Kendrick B. Meek (D-FL). “Infection control measures are designed to combat everything from the spread of colds and flu to hepatitis B and C, SARS, HIV/AIDS, and other potentially life threatening diseases. That, somehow, these standard protocols were not followed will undoubtedly leave our veterans with serious misgivings about our VA system despite everything done in a short period of time to give them renewed confidence.”

The U.S. Veterans Administration sent a safety alert to all of its facilities in December 2008 regarding the cleaning procedures and the proper use of the tubing associated with the equipment. Following the discovery of problems with machine usage at the three veteran’s facilities, it remains a grim possibility that the full ramifications of the error and the extent of the potential problems nationwide have yet to be determined.

In the meantime, as Rep. Meek pointed out in his communication to Veterans Affairs, it is important that all potentially harmed veterans be contacted, tested and treated if so needed. “I know you are acting quickly to find and test the 3,260 patients,” said Rep. Meek. “We share in the hope that these veterans are found to be healthy and safe.”

Sources: The Office of Congressman Kendrick B. Meek. “U.S. Rep. Kendrick B. Meek Calls for Full Inquiry into Medical Mistakes at the Miami Veterans Affairs Healthcare Center.” March 2009. http://kendrickmeek.house.gov/apps/list/press/fl17_meek/pr_090323_veterans_healthcare.shtml.
U.S. Veterans Administration. “Safety Alert: Improper Set-up and Reprocessing of Flexible Endoscope Tubing and Accessories.” December 2008.” http://www.va.gov/NCPS/alerts/OlympusScopesAlertAL09-07-WWW.pdf

Are All Medical Tests Necessary?

According to the Archives of Family Medicine, for years medical doctors have been performing numerous tests on patients, especially those covered by insurance, when many of those tests may have been unnecessary.

The article describes several potential risks of screening tests with controversial benefits, including:

• Reliance on screening tests before the effectiveness of the testing procedures has been proven by adequate research.
• The patient can get the wrong idea that a test can reduce the patient’s risk of disease or illness to zero, possibly leading them to make uninformed medical decisions.
• Inaccurate, false positive test results which can cause profound anxiety for the patient and require additional testing that can be increasingly invasive, costly and in the end unnecessary.

The researchers claim that doctors often provide controversial screening tests because they fear a future lawsuit by a patient who later develops a disease.

In addition, patients request a test because they read an article about it in a magazine, or found out that their insurance company will pay for it.

Rather than educate patients about the risks involved, many doctors simply give the test upon demand – and charge patients for them.

The article suggests the ethical approach would be the physician explaining that tests with controversial benefits are unlikely to be helpful.

SOURCE: Archives of Family Medicine, Oct. 17, 1997 as reported in Health Watch Newsletter