The letter that Evelyn received informing her that she was exposed to Hepatitis C
Three more patient notifications have been announced this week, for a total of five this year. During a patient notification campaign a health facility (the state health department or healthcare provider) sends a letter to patients who were potentially exposed to disease through unsafe practice while receiving healthcare. Since HONOReform started in 2007, there have been countless patient notification events, all prompted by evidence of unsafe injection practices. Nearly 200,000 Americans in the past thwelve years have been told they may have been placed in harm’s way because one healthcare worker (or more) wasn’t doing injections the right way.
After a thorough investigation by health officials, 50 of these patient notifications have become confirmed outbreaks of bloodborne pathogens, usually hepatitis C.
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Sharon Bradley, RN CIC, of the Pennsylvania Patient Safety Authority.
We are just two of many citizens and patient advocates who remain concerned about the safety of our nation’s many outpatient clinics—and ambulatory surgery facilities, in particular. Perhaps, it is because trips to these type of healthcare settings resulted in the Hepatitis C virus for both of us.
Since the founding of HONOReform in 2007, there has been a migration of care from the hospital to the outpatient setting. Very few of us do not know someone who described their surgery or procedure, which appeared quite complicated, yet they were released the same day.
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It has been almost five years since many of my fellow Coloradoans and I were wondering if we would be okay, if we would live. I had learned of my hepatitis C diagnosis months earlier than the others, as I was symptomatic, most of the victims were not. I kept asking how this could happen to me, all the while fearing that it wasn’t just me suffering. I feared for my future. I feared for the future of my daughter, Lucy, who was just one year old. A few months later, in July 2009, we learned that Kristen Parker, one of three known drug diverters in recent years to infect patients, had been the source of this deadly disease. Thousands of letters went out to patients who may have come into contact with Kristen and therefore put into harms way.
Unbeknownst to me at the time, I was following in the very brave footsteps of Evelyn McKnight and HONOReform. So with the support of some vital people, I tried to make a difference. I could not stay silent. I spoke to media and told my story and the story of the outbreak. I tried to put a name and a face to this tragedy, as some of the victims were too ill to speak out for themselves. Soon some Colorado lawmakers approached me to work with them to help make some real changes. And we did! I am proud of the two bills that were passed in 2010 HB 1414, concerning the reporting Identity in Injectable Drug Diversion (Benefield/Foster) http://tornado.state.co.us/gov_dir/leg_dir/olls/sl2010a/sl_338.htm and
HB 1415, Sunrise Surgical Tech Registration (Gagliardi/Morse) http://tornado.state.co.us/gov_dir/leg_dir/olls/sl2010a/sl_339.htm.
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Back in the summer of 2012 news reports invaded my inbox regarding the Hepatitis C outbreak discovered in Exeter, NH. My friends and colleagues in the patient safety world were concerned. How could this happen again, they asked. I recall my own sadness at hearing the news, understanding all too well what those victims, their families and the community might be feeling. This incident was so similar to the one we experienced in 2009 in Denver, CO.
My heart broke a little more just this past week when David Kwiatkowski, the medical tech who was responsible for infecting 46 patients with Hepatitis C as he diverted syringes of fetanyl for his own use and reused those same syringes, filled with saline, on patients. The infectious disease he carried had spread to 46 innocent people. When all was said and done, it was reported that Kwiatkowski had worked in 7 different states, putting so many patients under his care at risk. One patient died and health officials have stated her death was directly related to her acquiring Hepatitis C from David Kwiatkowski.
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Lauren Lollini spoke at the NAADDI Health Facility Diversion Conference in Cincinnati, OH on October 28th.
Kim New, Lauren Lollini, John Burke
Once I was found to have Hepatitis C, while the walls appeared to be crumbling around me, I saw a light and chose to walk toward it. That light was the opportunity to share my story and reach out to others in an effort to make a difference. I did nothing more than relate the facts, share my emotion and help others understand the possibility of change.
My work with HONOReform became a very easy collaboration. Working with others who were as passionate as I to reach out and educate and explore the solutions to stopping outbreaks. HONOReform had made great strides forward in safeguarding the medical injection process.
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“I learned to live one day at a time, Barbara Burlingame writes in this poignant summary of her experience as an outbreak victim. She comments on the ongoing situation in Tulsa, and she encourages fellow patients to “please ask for help”.
Barbara Burlingame and her faithful dog Clara
The recent incident in Tulsa, in which as many as 7,000 dental patients may have been infected with bloodborne pathogens while receiving treatment from Dr. Scott Harrington, has brought a lot of thoughts and feelings back in to my life. Honestly some of these feelings have been buried deeply and it is a little painful to have them bubbling back to the surface, but it is also very therapeutic. I think daily of the people in Tulsa and the way that they have been blindsided by all of this information and these emotions. It is tough. read more »
Lauren Lollini is a survivor of an outbreak caused by drug diversion
I applaud all who took part in the New Hampshire Hospital Association meeting September 22-24 which discussed ways to tighten up systems in an attempt to stop drug diversions which will ultimately help to prevent patient harm like the Hepatitis C outbreak which occurred in New Hampshire.
As a victim of a similar outbreak, I can attest to the fact that so often we just do not feel heard by the people who can make the most difference. read more »
Preventing Drug Diversion Panel, NHHA meeting
I am grateful I had the opportunity participate in the annual New Hampshire Hospital Association meeting, September 22-24 in Bretton Woods.
The staff of NHHA, led by Steve Ahnen, the president, along with the board of directors, is clearly committed to the prevention of drug diversion—in New Hampshire and beyond. read more »
How can a person go in for a routine surgery and come out with Hepatitis C?
Perhaps this is a question you have never thought to ask, and before April of 2009 it was not even in the realm of curiosity for me either. But as I entered the urgent care for what I thought might be bronchitis, only to be asked by the medical assistant, “Do you know you are yellow?” my world was immediately turned upside down. A trip to the ER and several other doctor’s visits and blood tests later confirmed I had Hepatitis C.
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