This is one of a hospital patient's worst fears. You go to the hospital for surgery, the surgery thankfully goes well and you go home. Several months later, you get a letter from the hospital asking you to return to the hospital for blood tests to determine if you were exposed to hepatitis C or other diseases due to the negligent acts of a hospital employee.
That is what happened to 6,000 patients who underwent surgery at a Denver-area hospital over a six-month period.
Kristen Diane Parker, 26, is a surgical scrub nurse formerly employed at Rose Medical Center in Denver, Colorado. She's been accused of using syringes filled with painkillers meant for patients on herself, then refilling the syringes with saline solution. Parker was addicted to painkillers and was feeding her addiction by stealing drugs intended for use in surgical patients. By reusing the needles she used to inject herself on patients, officials say Parker exposed thousands of patients to hepatitis C due to the fact that she had tested positive for hepatitis C during her tenure at Rose Medical Center.
Rose fired Parker in April after finding her in an operating room where she didn't belong. She then failed a drug test. On April 24, Rose filed a report explaining her termination with the Health Facilities Division. Rose's report did not mention the fired employee had hepatitis C. State employees determined later in April that there were two hepatitis C cases linked to Rose's surgery rooms and discovered the link.
What Is Hepatitis C?
Hepatitis C is a disease carried in the blood which can result in severe liver problems, including liver cancer and cirrhosis of the liver. Symptoms of hepatitis C infection may include nausea, diarrhea, fatigue, pain and jaundice. However, many people don't show any symptoms. It's technically incurable, but very effective treatment has been able to eliminate the disease in some people.
The most common means of hepatitis C infection is through injection drug use. The US Center for Disease, Control and Prevention has estimated that 60% to 80% of all recreational drug users in the US have contracted hepatitis C from sharing dirty needles. Hepatitis C and other blood borne diseases, such as HIV, can also be spread in medical facilities that do not follow the proper standards of medical care or properly sterilize equipment.
This is not the first case of such these types of infections. Last year, Las Vegas health officials shut down two endoscopy centers that were linked to over 100 reports of hepatitis C caused by technicians reusing needles and vials of medication intended for only one patient. At least 40,000 people treated at the clinic between March 2004 and January 2008 were notified that they may have been exposed to hepatitis and other blood borne diseases.
Earlier this year, about 11,000 veterans treated clinics in Tennessee, Georgia and Miami were notified that they may have been exposed to hepatitis and HIV infection due to improper use and cleaning of equipment used for colonoscopy tests and ear, nose and throat exams.
What Is Going to Happen to Parker?
Parker was suspended from the hospital on April 13 after officials at the hospital discovered her actions. At that time, she tested positive for Fentanyl, a strong painkiller commonly used to alleviate pain from surgery. After leaving Rose Medical Center, Parker was able to get a job at Audubon Ambulatory Surgery Center in Colorado Springs, and worked there for two months. Officials now say thousands of surgery patients treated at both hospitals may have been exposed to infectious hepatitis C due to Parker's actions.
Parker has been arrested and remains jailed on criminal charges of tampering with a consumer product, obtaining a controlled substance by deception, and creating a counterfeit controlled substance. She faces up to 34 years in prison if convicted of the charges.
What Will Happen to the Hospital Patients?
Rose Medical Center has contacted every patient who had surgery at the facility while Parker worked. Patients have been offered a free blood test to determine whether they are carrying hepatitis C. So far, at least ten patients have tested positive for hepatitis C.
Is the Hospital at Fault?
Some say that the hospital was at fault for hiring Parker and then not uncovering what she was doing. Parker had a shady past and the hospital may have been negligent in failing to discover it and employing her. She was fired from Northern Westchester Hospital in New York in 2008 for "poor performance," and it's been reported that she had trouble labeling specimens correctly and keeping track of instruments during surgery while she worked at that hospital. The New York State Department of Health said that it has information suggesting Parker engaged in similar conduct in New York as well.
Rose Medical Center said it conducted its usual background and reference checks on the applicant, as well as the physical and drug tests once she'd been offered a job. Parker had no felony criminal background at the time, said Rose spokeswoman Leslie Teegarden. However, it has been discovered that Parker had two prior arrests for petty larceny in 2008. Rose's background check did not uncover these offenses because they were misdemeanors.
Rose also checked Parker's references, which proved adequate enough to hire her. Audubon conducted reference checks as well, and explained that when Parker first contacted them about a job in April, she was still employed at Rose and they had no reason to suspect her job status. Parker asked Audubon not to check Rose for a reference, as that might jeopardize her job there, and Audubon complied. However, they checked her other references in Texas and New York, which checked out fine. "We were not made aware of any termination of her employment," said Joe Hodas, a spokesman for Audubon.
Lack of Licensing Requirements
There is no licensing or registration system for surgery technicians that would alert a prospective employer to drug problems or regulators' discipline. If a nurse, by contrast, is suspected of using drugs and endangering patients, the Colorado nursing board can immediately suspend a license while it investigates the allegations. Any prospective employer can then check a free, nationwide database that alerts regulators and the public to problems attached to any nurse's legal status.
Hospital Officials Seeking Changes
State health officials and Rose Medical Center officials have ordered changes in investigative procedures and drug handling to quickly repair what they call a breach in public trust amid a cluster of hepatitis C cases.
The state health department said disease investigators will now check a database of problems and complaints at a facility like Rose if they link a disease case to that hospital. Such a crossover between divisions at the Colorado Department of Public Health and Environment may have sped up attributing hepatitis C cases to the incident, said state chief medical officer Ned Calonge. At Rose, anesthesiologists have been told they aren't allowed to walk out of a room after laying out their drugs before surgery. The hospital has locked cabinets in surgery rooms that only certain staffers have access to, but anesthesiologists often set out drugs in advance.
"There was a recognition that, 'Gee, we didn't believe that this possibility existed,' " said Dr. Melvyn Klein, a doctor at Rose. "Now we know it and we have to fix it." Rose will also buy new medication dispensing machines for each operating room that are accessed by fingerprints and will begin using tamper-resistant, prefilled fentanyl syringes.
What Can You Do?
Unfortunately some things are out of your control. When you are a hospital patient about to undergo surgery, it's difficult to determine who will be injecting you with needles. The best you can do is investigate the particular hospital's hiring policies, regulations and procedures to make sure that they comply with the upmost standards. You can also ensure that hospital staff remove syringes from their original plastic packaging in front of you.
Regular blood testing is also a good idea to identify any diseases you may have caught. If you suspect exposure to hepatitis C, get a blood test at your physician's office. If you suspect that you contacted hepatitis C or another blood disease due to this or a similar occurrence, you may have a claim of negligence against the hospital.
Questions for Your Attorney
- What's the time limit for filing a lawsuit against a medical provider if you think you contracted an infection or disease during treatment? Doesn't it take a long time for some illnesses to show up?
- How are cases in our area decided against hospitals or employers when an employee, such as a nurse, is doing something that's clearly wrong and not within her job duties? Is the employer still held liable if a patient is hurt?
- Is there anything that patients and consumers can do if they see something wrong at a hospital? Should a report be made to hospital authorities? A regulatory agency?