Author:
PATRICIA ANSTETT AND HUYI JIN ELIZABETH KIM
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Date Posted: Tue, June 25 2002, 10:14:42 PDT
In reply to:
Anna Lok, MD Thomas Shehab MD Mauricio Orrego, M.D. UMich
's message, "Doctors/Patients Not Following Through on Hepatitis C Screening" on Mon, July 30 2001, 8:16:52 PDT
June 25, 2002
BY
FREE PRESS MEDICAL WRITERS
Henry Ford Hospital in Detroit is warning 268 patients who underwent a common sinus, nose and throat test to be evaluated for hepatitis B and C infections because instruments used in the procedure may have been contaminated in a carrying case.
The alert underscores concerns addressed last week at a national meeting about diseases transmitted from endoscopy, a term used to describe a wide range of tests and procedures to detect and treat medical problems.
Endoscopes -- or scopes, as doctors call them -- are thin, narrow tubes inserted in the nose, throat and other body cavities. Some 10 million endoscopic procedures are performed in the United States yearly. Though generally considered safe, numerous alerts have been issued in recent years about contamination of tubes used in the procedures.
Ford Hospital's alert, believed to be the first of its kind in the country, involves two children and 266 adults who underwent nasal pharyngoscopy tests at Ford in 2000 and 2001. Patients can call 800-700-4476 to obtain information about testing.
In the test, doctors thread a long, flexible tube, or endoscope, into the nose or throat to detect sinus infections, foreign objects and vocal chord obstructions.
Instruments used in the test can be cleaned effectively with chemicals that kill germs, Ford physicians said at a media briefing Monday. But in the Ford case, instruments were stored in a suitcase with a foam pad, and carried from one floor to another. The instruments are shipped in the suitcase when purchased.
The pad and suitcase can't be cleaned effectively, raising the risk that two hepatitis viruses capable of staying alive for as long as a week might be passed from patient to patient, said Dr. Daniel Nafziger, an infectious diseases physician who heads Ford's patient safety program.
Ford has alerted state and federal officials, as well as the device manufacturer, Olympus America Inc., a Melville, N.Y. company, about the potential problem. "If there's a problem, it's a national problem," said Dr. Mark Kelley, chief executive officer of the Henry Ford Medical Group.
Dr. David Barlow, director of technology assessment for Olympus, said the firm's instruction manuals make it clear that the suitcase merely is a packaging and shipping device, and should not be used for storage.
"We are constantly involved in educating our customers about how to properly maintain and clean endoscopes . . . Patient safety is our No. 1 concern here," Barlow said.
Geralyn Lasher, spokeswoman for the Michigan Department of Community Health, said the department has not been notified of any cases in which patients have contracted an infection from the test.
"Frankly, the possibility of that happening is quite low," she said.
Ford decided to alert patients because they consider even the threat of infection important, Kelley said. The hospital now uses disposable pads in the case. The precautionary step to replace the foam pad is "like having on a belt with suspenders," Kelley said.
Ford will pay for medical care of any patients diagnosed with either disease, officials said.
Nafziger estimated that patients who underwent the test face less than a 1 percent chance of contracting hepatitis B or C.
Both diseases are treatable but can cause serious health problems, including liver failure. (www.hcop.org)
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