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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”



Cardiac surgeon likely source of hepatitis in patients

A cluster of seven cases has been diagnosed in people who have only the physician in common.

Gastrointestinal Infections

by Conni Ford Bergmann
Correspondent

 

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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