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


    

Doctor fails to change syringes between patients

Although chances of exposure to bloodborne disease are remote, post-exposure prophylaxis was recommended.

 

December 1997

MONROE, Conn. - Routine flu shots turned into a bad scare here amid allegations that a local doctor neglected to change syringes when giving residents influenza vaccine.

Claude Light, MD, who also doubled as the town's public health director, resigned from his directorship after it was alleged that he did not change syringes when immunizing about 468 residents against the influenza virus at a local high school. An assisting nurse who said she witnessed the doctor administering the doses without changing the syringe reported him to the state health department.

While calling the chance of exposure to a bloodborne disease remote, state health officials recommended that those who were exposed receive hepatitis B prophylaxis. Connecticut has documented only one case of hepatitis B in Monroe County since 1990.

Richard Melchreit, MD, of the state health department, said the population who received the flu shots is considered an extremely low-risk group for HIV and hepatitis. Those the doctor immunized included senior citizens, town and school system employees and several retired Roman Catholic nuns.

"Of all the infections that can be transmitted by blood, hepatitis B is our main concern," said Melchreit. "Exposure could come if an infected person's blood is drawn back into the needle as the plunger is pulled back and then somehow injected into the next person, but no blood was reported drawn back [by Light]."

  

Light insisted to state investigators that he used fresh needles for every patient, but did not realize that Centers for Disease Control and Prevention (CDC) standards required changing the syringe after each patient, as well.

He used one syringe for each vial of flu vaccine, which contains 10 to 12 doses. The CDC standards were adopted out of concern that patients inoculated with the same syringe might face infection with hepatitis B or AIDS. But exposure to HIV would be even more remote because the virus is not as easily transmitted as hepatitis B, said health investigators. Because of his actions, his 30-year medical practice is now in jeopardy.

"When the standards changed, I probably should have changed, too, but I just didn't know," said Light. "I thought what I was doing was perfectly acceptable and risk-free, no problem."

This is not the first time a doctor has been caught using the same syringe when immunizing patients. Two years ago, as part of a segment on the flu season, a national morning news show invited a doctor to give its news anchors their annual flu shots live on the air.

But the two reporters became unwitting participants in another story when the doctor was observed by millions of viewers to be using the same needle and syringe to inoculate the news team. The scene resulted in a series of reports by the program on proper immunization techniques and the inherent dangers of using tainted needles and syringes.

But single-use needles and syringes have been standard practice in the medical community for quite some time, and a spokesperson for the CDC said the agency has recommended the single use of needles and syringes since 1993.

  

The Connecticut Medical Examining Board has launched an investigation of its own to determine whether Light's actions warrant the board revoking his medical license. According to the statement of charges, the board members found that Light "failed to conform to accepted standards of medical practice in placing the public at unnecessary risk of contracting certain diseases and illnesses."

The town council has offered to pay for hepatitis B vaccine not covered by insurance. The extra vaccines could cost the town of 17,000 people more than $100,000. "What has us concerned is that people hearing this will decide not to get their seasonal flu shots," said Aaron Roome, PhD, MPH, epidemiologist with the state department of public health. "That would be a mistake."

 

 

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