St. Louis, MOAs many as 1,800 veterans may be at risk for contracting hepatitis B, hepatitis C and HIV after undergoing dental procedures at a Veteran's Affairs (VA) hospital in Missouri. According to a CNN report this morning, John Cochran VA Medical Center in St. Louis issued letters to 1,812 veterans apprising them of the situation and urging them to get tested.
CNN affiliate KSDK reported that dental staff allegedly failed to observe proper cleaning and sterilization protocol, resulting in the potential contamination of dental instruments.
The issue appears to be the hand washing of dental instruments with soap and water prior to placing them in a sterilization machine. While this may appear thorough on the surface, experts in such matters cite that hand washing actually contributes to contamination.
Steve Streed, a member of the Association for Professionals in Infection Control and Epidemiology's board of directors, suggested in comments posted on CNN that under normal circumstances, used dental instruments would be placed into a washing device that dissolves biological debris. Following this process, the washed instruments are placed in a sterilization machine to clean microbes.
The problem, according to Streed, is that simple hand washing with soap and water will not reliably rid the instruments of biological debris. Given that the sterilization process removes microbes but not debris, it is conceivable that used dental instruments containing biological debris from a previous patient could be passed to subsequent patients.
Association Chief of Staff Dr. Gina Michael told KSDK that some dental technicians broke protocol at the hospital by hand washing the tools. The breach apparently began in February of last year and continued until March of this year, a period of 13 months.
Dr. Michael told KSDK in Missouri that dental techs at the hospital thought they were doing the right thing by washing delicate instruments in a sink with strong soap.
Just last month, Palomar Hospital in San Diego sent 3,400 certified letters to colonoscopy patients and others who underwent similar procedures to inform them of potential infection from tools re-used during procedures.
"This is absolutely unacceptable," said Russ Carnahan (D-Missouri). "No veteran who has served and risked their life for this great nation should have to worry about their personal safety when receiving much needed healthcare services from a Veterans Administration hospital."
He called for an investigation into the incident on Tuesday and has sent a communiqué to President Obama.
"I can only imagine the horror and anger our veterans must be feeling after receiving this letter. They have every right to be angry. So am I."
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