Contaminated in Canada: Syringes Re-used for Nearly Two Decades

High Prairie, ABIt's happened again. Reminiscent of the syringe scare at the Endoscopy Center of Southern Nevada, a Canadian hospital has been put on alert after reused syringes were found to have been used on a host of patients across nearly two decades. As the American parallel has shown, the multiple use of a syringe needle can promote the spread of infection.

Following the revelation, it was confirmed that up to 2,700 patients who underwent procedures at the High Prairie Health Complex in northern Alberta would need to be tested.

This isn't the first time that the issue has clouded Canada's health care system. Early last year the 25-bed St. Joseph's Hospital in Vegreville, a community east of Edmonton, was closed for several weeks after poor sterilization techniques led to the outbreak of a superbug. Up to 3000 patients had to be tested after it was determined that surgical instruments contained flecks of blood and dead tissue were recirculated.

Part of the tragedy of this most recent concern is that many of the patients who will undergo testing, will be children. While blood tests are currently being arranged for some 1300 patients who underwent endoscopy procedures at the High Prairie facility over a 4-year period dating back to March of 2004, an additional 1400 patients who had dental surgeries at the same hospital will require testing. Those surgeries date back almost two decades to 1990. "We are assuming at this point that a large number of them will be children," said Dr. Albert de Villiers, the Medical Health Officer for the region, in statements made at a news conference Monday, "because it's more children that get dental surgery."

On October 27th it was revealed that a 'handful' of nurses working at the High Prairie facility routinely injected drugs into patient's intravenous (IV) lines with the same syringe. Endoscopy, for which a scope is inserted into a patient's bowel or stomach in order to aid doctors in detecting the presence of cancers, colitis or digestive issues—is preceded by the sedation of the patient, by way of a syringe inserted into the IV line.

However, IV lines can sometimes have blood seeping in from a vein. It is not without precedent that a syringe has come in contact with that blood. Were that same syringe to be used on another patient, the potential for the spread of contamination and infection is enormous. The potential for the spread of HIV and Hepatitis C comes to mind.

The Centers for Disease Control and Prevention (CDC) in Atlanta has long since identified the re-use of syringes as a primary culprit in several hepatitis C outbreaks since 2001.

This writer recently joined with a colleague in mourning the loss of his mother, who died after receiving tainted blood while undergoing a medical procedure. She contracted hepatitis C and died in her 50s.

Had a manager not observed a High Prairie nurse re-using a previously used syringe, the issue may have come to light. However, as a result of the observation a 3-week process of breaking out patient names was completed, and health officials have now begun the arduous task of attempting to contact people.

That could be difficult, with the potential for unknowing insensitivity. The surviving spouse of one former endoscopy patient in the US received a letter advising her husband to be tested for hepatitis C more than a year after her husband died. Until that day, she had no idea as to why he died.

Now she does. Given that the concern goes all the way back to 1990, it is conceivable that a warning letter may go out to a patient far too late, to be of any use.

While it has been reported that the risk of infection is relatively low, the community is concerned nonetheless. Pearl Calahasen, the government member for the area said Monday she has been getting dozens of calls from people who may need to be tested. "People are very frightened and rightfully so," she said.

"I think when people's lives are threatened in any way, shape or form that fear sets in."

Phil Hassen is the chief executive officer of the Canadian Patient Safety Institute in Edmonton. He says it's too early to conclude whether, or not the sterility lapse was incompetence on the part of nurses.

"Why did the nurses do what they did?" Hassen asked in an interview by CTV. "So often there are a series of things that contribute to this.

"We need to be sure we know what the problem is. We need to fix this thing and we need to learn from it, so it never happens again."

Margaret Hadley, president of the College and Association of Registered Nurses of Alberta, is not about to let her membership off the hook quite that easily. Hadley says there's an onus on registered nurses to be aware of infection control standards and to ensure that they're being followed.

"Part of that behavior is expecting them to question any policy or procedures that are inconsistent with (patient safety)."

Following the 2007 sterilization debacle at St. Joseph's Hospital in Vegreville, a class action lawsuit was filed, accusing the hospital of failure to properly clean instruments.
It is reasonable to assume that this latest syringe scare over reused syringes will result in a similar response at some point in the future. After all, patients are routinely up against a veritable army of natural health disasters—everything from cancer to environmental toxins—without being delivered a death sentence through a syringe needle.