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November 27, 2007
HIV Scare following Doctor's Misuse of needles
New York state health officials notified 628 former patients of a Nassau County anesthesiologist that they need to seek testing for HIV, Hepatitis and other blood borne diseases, because between 2000 and 2005 the medical practitioner in question reused syringes when injecting patients with more than one drug, New York Times reports.
Investigations into the practice of anesthesiologist Harvey Finkelstein of Plainview, N.Y. began in 2005 after two of his patients contracted hepatitis C. According to the Times, Finkelstein would use a new syringe for each patient. However, Finkelstein told investigators that in 2000 he began using the same syringe to draw medicine from more than one vial when giving a patient more than one type of drug by injection, which caused the potential contamination of multidose vials.
The blood of a patient with one virus could, by backing up through the needle and entering the vials, be transmitted to another person when that vial of medicine was reused.
Investigators in 2005 notified 98 of Finkelstein's patients who had received epidural injections in the three weeks before, during and after his two patients were infected, that they should seek testing for blood borne diseases. Of the 84 who were tested, no other cases of infection were traced to Finkelstein. The state then expanded its investigation to examine records from 2000 to 2005. New York Health Commissioner Richard Daines in a statement released this week said that "the department identified all 628 patients who had received injections between Jan. 1, 2000, and Jan. 15, 2005, after a thorough review of medical records at all sites where this physician practiced" (Vitello/Kershaw, New York Times, 11/16).
Timing of Notification
State health department officials said Thursday that they had planned as early as October 2006 to notify all of Finkelstein's patients that could have been infected with HIV, hepatitis B and hepatitis C, Long Island Newsday reports. However, Finkelstein hired attorneys to avoid submitting all the names of the patients to state and Nassau County officials, and officials then decided against issuing subpoenas. "Initially Dr. Finkelstein was very cooperative," Claudia Hutton, spokesperson for the New York State Department of Health, said, adding, "Then later on he retained an attorney and was not as cooperative." Amon, Long Island Newsday, 11/16).
Editorial
Finkelstein's "lax approach to infection control has raised troubling questions about the adequacy of medical oversight in New York state," a New York Times editorial says. According to the Times, state and county health officials have been "justifiably" criticized for moving too slowly to alert Finkelstein's patients of the possible transmission of HIV and hepatitis.
It "seems inexcusable" that it took the state almost three years to notify people under Finkelstein's care that they should be tested for HIV and hepatitis, the editorial says, adding that it will be necessary to determine if the state's investigatory and disciplinary process is "tilted too much toward protecting doctors rather than any patients who may have been harmed." Plans by state officials to eliminate multidose vials "would provide the surest protection against such contamination and not leave patients at the mercy of a doctor's ignorance or carelessness," the editorial concludes (New York Times, 11/17). It also goes to show that HIV infection is not a "gutter" or moral issue, so the infected should never be judged.