| May 2002
GREAT NECK, N.Y. — Three thousand patients who
underwent procedures by a hepatitis-positive cardiac
surgeon at the North Shore University Hospital in
Manhasset may have been exposed to the virus.
Health officials said that the operations took
place over a 10-year period at the hospital. After a
cluster of seven patients were found to have
hepatitis C, epidemiologists focused on the
physician they had in common. Detailed molecular
examination of the genetic mutation of the viral
sample supplied by the physician were found to be
highly correlated with samples from three patients;
the other four positive patients’ samples were still
being tested, according to the health department.
Because the surgeon is a patient, his name was
not released.
Outreach program underway
Working with the New York State Health Department,
officials at North Shore have established an
outreach program, which will involve notifying by
mail certain patients in the cardiac surgery
program, according to a statement from Dennis
Dowling, the hospital’s executive director.
“Patients since 1993 who may have been potentially
exposed will be advised to seek testing by the
hospital or by their private physician,” the
statement said.
Hospital officials said that the physician continues
to practice and operate, but informs his patients of
his infection and the possible risk to them. He
takes additional precautions, such as wearing two
pairs of gloves.
Dowling’s statement said: “We suspect that, in all
likelihood, the surgeon was infected by one of his
patients. When ongoing analysis by the hospital and
the department of health showed a possible link to
the surgeon, he voluntarily agreed to be tested and
preemptively changed his surgical practices to
minimize risk of virus transmission. These changes
in surgical techniques, aimed primarily at
preventing accidental needle sticks, were discussed
with and agreed to by the department of health.”
The surgeon’s infection was discovered in August
2001. None of the 200 patients he has operated on
since then have tested positive.The hospital has set
up a phone number for people seeking information.
There is not much in the medical literature on
reported cases of doctor-to-patient hepatitis C
transmissions. The CDC does not recommend
restriction of the professional activities of health
care workers infected with hepatitis C. A CDC
spokesman said it refers questions to guidelines for
workers infected with hepatitis B and HIV, but
leaves decisions to the hospital and state health
officials.
In a phone interview, a hospital spokesman said that
as of April 6, the hospital had received 1,500 phone
calls from patients regarding the situation. So far,
670 were advised to be tested. “Out of 304 patients
who have subsequently been tested, and for whom the
results are in, two are positive. But given that
fact you have 2% of the population walking around
with hepatitis C, that’s actually a pretty low
number,” he said.
The problem with doing this type of a retrospective
study is that there is no way to link any positive
cases with the surgeon, the spokesman said. These
people could have been infected at any time, before
or after their surgery. “The reason to do this is
really to alert the patients. Even the health
department acknowledges that is not really a
scientific exercise at this point,” he said.
Since the summer of 2001 the hospital has been doing
preoperative and postoperative blood testing on all
of this doctor’s patients. There are no plans for
the physician to stop performing surgery.
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