Endoscopy Center of Southern Nevada Linked To Hepatitis C

Armen Hareyan's picture
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The Southern Nevada Health District said Thursday that one of the patients was known to be a carrier of the disease at the time of the procedure, the Las Vegas Review-Journal reported. We visited the website of Endoscopy Center of Southern Nevada and found the following information on Hepatitis C.

"The Southern Nevada Health District is advising patients who received injected anesthesia medication at the Endoscopy Center of Nevada (700 Shadow Lane) of a risk for possible exposure to hepatitis C and other bloodborne pathogens. The health district is recommending patients who had procedures requiring injected anesthesia at the clinic between March 2004 and January 11, 2008, contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV."

The Southern Nevada Health District also released this Memo on Hepatitis C Investigation (PDF)

Why is the health district making these recommendations?
The health district received notification of three acute cases of hepatitis C in January 2008 and has identified a total of six cases to date. Five of the cases had procedures requiring injected anesthesia on the same day.

Following a joint investigation with the Nevada State Bureau of Licensure and Certification (BLC) and with consultation from the Centers for Disease Control and Prevention, the health district determined that unsafe injection practices related to the administration of anesthesia medication might have exposed patients to the blood of other patients.

The exposures did not result from the medical procedures performed.
How were the cases discovered?

The cluster of illnesses came to the attention of the health district in January 2008.

These cases were reported to the health district by area physicians.

Nevada law requires that medical providers notify public health officials when they identify a number of different diseases, including hepatitis C.

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The common link between cases was identified through the routine investigation of the cases reported by medical providers, which includes an interview of the patient.
Why did it take several months for this to come to the attention of the health district?

Most people infected with hepatitis C virus do not develop symptoms and do not know that they have been infected. As a result, these infections would not have been reported to the health district.

An infection with hepatitis C that results in the patient developing symptoms (acute disease) is rare so it is an unusual occurrence that brought this problem to the attention of the health district.

On average, two cases of acute hepatitis C are reported each year in Clark County. Six cases have been identified in relation to this investigation.
How were patients exposed?

A syringe (not a needle) that was used to administer medication to a patient was reused on the same patient to draw up additional medication.

The process of redrawing medication using the same syringe could have contaminated the vial from which the medicine was drawn with the blood of the patient.

The vial, which was not labeled for use on multiple patients, was then used for a second patient (with a clean needle and syringe).

If that vial was contaminated with the blood of the first patient, any subsequent patients given medication from that vial could have been exposed to bloodborne pathogens.

What is being done to prevent this from happening again?

The Southern Nevada Health District, the Nevada State Health Division and the Bureau of Licensure and Certification are providing technical bulletins and educational materials to medical facilities and providers in an effort to educate the health care community and prevent these types of incidents from happening in the future.
What are the recommendations for people who test positive for hepatitis C, B or HIV?

Options for disease management and possible treatment options, as well as regular health monitoring, should be discussed with a physician, who can determine the appropriate next steps for the patient.

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