02 August 2012

Thousands Await Testing for Hepatitis by ‘Infector’

 Story first reported from nytimes.com

BOSTON — Thousands of former patients at a New Hampshire hospital must wait at least another week to learn if they were infected with hepatitis C through syringes used by a traveling medical technician now known as the “serial infector.”

Testing will be delayed as officials continue to try to develop an orderly process that will allow patients from the Exeter Hospital to be tested quickly and without having to wait too long in line, said Dr. José Montero, director of the state health department’s division of public health.

“Several groups are working on the approach,” he said in an interview on Wednesday. He said that he hoped to announce a plan by the end of this week and that testing could begin next week.

The New Hampshire health department announced last month that it intended to test more than 3,400 people who had been hospitalized while the technician, David Kwiatkowski, 32, who is believed to have contracted the disease at least two years ago, was working at Exeter Hospital, and it planned to set up mass clinics last weekend at the local high school. Mr. Kwiatkowski was charged with federal drug crimes last month, accused of stealing drugs and injecting himself with syringes that were later used on patients.

But officials pulled the plug on the plan after several former patients complained about the lack of privacy in a mass clinic setting. There were also questions of liability for the volunteers taking blood in such a setting.

Mr. Kwiatkowski has worked at an estimated 13 hospitals in eight states and potentially could have infected thousands of patients.

Already, patient advocates are pushing for ways to tighten the rules regarding such technicians to try to prevent cases like this from happening again.

Elenore Casey Crane, a former state representative in New Hampshire and co-founder of a group called The Patients Speak (www.hepcvictimsnetwork.com), is calling for a national registry to which hospitals and staffing agencies would be required to report issues of professional misconduct by medical technicians. She said that at the moment, beyond calling previous employers for a reference check, hospitals have no way of knowing whether a technician has previous violations.

Ms. Crane said she was meeting next week with representatives of Senator Kelly Ayotte, Republican of New Hampshire, to discuss federal legislation to establish such a registry.

Her group is also calling for national licensing of all medical technicians; licensing requirements now vary from state to state. And it has also prompted legislators in the eight states involved to file bills to require random drug testing of technicians at hospitals twice a year.

“Why does the guy who loads your car at Home Depot have drug testing and the men and women with you in the operating room do not?” Ms. Crane said. Her goal is nothing short of changing what she said was the culture of secrecy around medical workers.

In addition, her group has set an informational meeting for Tuesday at Exeter to discuss the medical and legal issues surrounding the outbreak.

Triage Staffing Inc., of Omaha, the agency that placed Mr. Kwiatkowski in many of his more recent jobs, has been sued by Domenic Paolini, a malpractice lawyer and former cardiac surgeon in Boston, on behalf of several patients. He has filed a class-action lawsuit on behalf of people whom the health department has recommended be tested, as well as infected patients.

Dr. Montero said Wednesday that almost 1,300 people had been tested, including many hospital employees.

About 30 people who tested positive with strains of hepatitis C matched the strain found in Mr. Kwiatkowski. Fourteen others tested positive but were not a match.

Originally the health department said that 6,000 people would have to be tested but found some names were duplicates.

The F.B.I., the Food and Drug Administration, the Centers for Disease Control and Prevention, the United States attorney in New Hampshire and various other agencies are investigating the case.

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