......and what's with
all these male nurses?
Posted on 10/12/2002 10:50:54 AM PDT by joesnuffy
Health officials say nurse reused large syringe
2002-10-11 By Jim Killackey The Oklahoman
A nurse anesthetist who might have exposed hundreds of Oklahomans to hepatitis C used a large syringe and needle over and over again to inject small doses into patients' intravenous lines, the state Health Department said Thursday.
James C. Hill used the improper and dangerous practices involving syringes, needles and IV portals on patients' hands or arms at Norman Regional Hospital and at two Oklahoma City pain management clinics, state epidemiologist Dr. Mike Crutcher said.
"By my understanding, this is the biggest outbreak of hepatitis C that has taken place as the result of transmissions within a health care facility," Crutcher said.
The Norman Regional situation is prompting the testing of 850 patients since May 1, 1999.
Hill's accrediting agency can't explain why a nurse would do such a thing.
"What Mr. Hill did is completely contrary to our infection control guidelines," said Chris Bettin, public relations director for the American Association of Nurse Anesthetists.
"At no point in time and in no way, shape or form would we endorse or advise the reuse of needles or syringes. By doing so ... the results could be catastrophic," Bettin said.
On Thursday, Crutcher gave the most specific details yet surrounding allegations that Hill repeatedly using the same syringe and needle to treat as many as 25 patients a day at Norman Regional.
Crutcher said Hill used a 20- cc syringe, considerably larger than the 3-cc syringe used in many procedures. The needle also was reused, he said.
"Mr. Hill didn't think he was putting anyone at risk," Crutcher said. "Is that reasonable? No. Most medical practitioners these days would think that's extremely abnormal."
Hill was tested and does not have hepatitis C, Crutcher said.
Crutcher discounted whether Hill's own chronic back pain was a factor in his reuse of syringes and needles.
The Health Department, Crutcher said, doesn't know which patient or patients originally were infected with hepatitis C and then passed the virus to others.
At least 52 Norman Regional patients have tested positive for exposure to hepatitis C.
It is unknown how many patients have been exposed to the virus at two Oklahoma City pain clinics where Hill practiced: Northwest Surgical Hospital and the Oklahoma Center for Orthopedic and Multi- Specialty Surgery.
Hill was trained at St. Joseph Hospital School of Anesthesia in Fort Worth, Texas, and was originally certified in 1978 by the American Association of Nurse Anesthetists. Re- certification is every two years, with a required 40 hours of continuing education.
Hill, 55, was recognized as a certified nurse anesthetist in Oklahoma in 1991.
With his nurse-anesthetist training in the 1970s, Crutcher said, Hill's knowledge of blood- handling warnings associated with AIDS in the 1980s and 1990s should have prevented him from taking chances with syringe and needle re-usage.
Hill, in most cases, was the middle man in routine three- step procedures along with Dr. Jerry W. Lewis, who was charged with overseeing Lewis.
In step one, another hospital staffer would set up the intravenous line equipped with a portal known as a heparin lock.
To calm patients who suffered from chronic back or neck pain, Hill would use a syringe and needle to inject mild anesthetic medications such as Versed, Fentanyl and Propofol through the portal into the IV line.
In step three, Lewis performed a spinal block or a more extensive pain-reducing technique.
Because a patient's blood can easily back up into intravenous- line portals, nurses and doctors are supposed to use needles only once to avoid the risk of transmitting diseases through reuse. Hepatitis C can be transmitted through blood transmissions.
Safer hypodermic needles that can only be used once do exist, health officials said.
But for the safety mechanism of one such device to work, the syringe has to be emptied. It is unclear if those needles would have prevented Hill's repeated- use actions.
Hill, a 1965 graduate of Mineral Wells High School in Texas, received a bachelor's degree in education from the University of North Texas before attending the University of Texas Nursing School in Fort Worth.
He became a registered nurse in 1975 and later attended the St. Joseph Hospital School of Anesthesia.
Crutcher said he does not believe Hill intended to cause harm. He said Hill's actions apparently resulted from a misunderstanding of proper procedure.
The American Association of Nurse Anesthetists has reminded its members that needle reuse is not acceptable, Crutcher said.
More than 4 million people in the United States are infected with hepatitis C, the most virulent form of the virus that can lead in a small percentage of cases to liver damage and cancer.
Many patients can fight off the hepatitis C virus, but an estimated 50 percent to 70 percent of those infected with hepatitis C remain chronically infected. The disease is treated with a combination of interferon and the drug ribavirin.
Normal Regional suspended Lewis' staff privileges and barred Hill from working at the hospital.
Hill no longer is working, and he told the Health Department he has discontinued the reuse of needles and syringes.
Lewis, who repeatedly has said he didn't know of Hill's improper procedures, sued Norman Regional to regain his privileges.
Hill remains under investigation by the Health Department and the Oklahoma Board of Nursing.
Hill's attorney, Steve Peterson, said his client is cooperating fully with authorities.
More than 20 people exposed to hepatitis C have filed lawsuits against Lewis, Hill and Norman Regional.
Apparently there wasn't a huge deal of oversight on this guy for this many people to be infected. The initial story was just a few individuals and now it's 850 plus, and they still don't have a handle on an exact number.
I don't say this often, but:
UNCHAIN THE LAWYERS!
Or take this stupid S.O.B. and give him a shot from his own dirty needle. He deserves it.
Of course, I am not all-knowing all-seeing. I am just using a little common sense. I could be wrong.
Who's the third guy, Dean Martin?
FMCDH
Why the hell is the state epedemiologist defending this guy?
This is criminal, plain and simple.
I think somebody needs to look into Crutcher's background to determine why he is defending Hill.
Mmmmm....demerol... :P~~~~~~~~~~~~~~~~ (homer simpson drool)
Look how long it took for them to require dentists use sterilized equipment. They weren't doing much with the instruments between patients even after HIV came out. The problem with inspections in hospitals and clinics is that they are scheduled well in advance so people get everything in tip-top shape for the inspectors and then they can get back into their usual routines afterwards. If inspections were reasonable but spur-of-the-moment, they might reveal real things going on.
Perhaps. That changes nothing when it comes to punishment.
And a crime like this deserves SEVERE punishment.
I have, as you have, as many FReepers have, been trusted with responsibility for the lives of others. This is a tremendous responsibility and excuses are not permitted.
Both are in positions which are indefensible and deserve to be sued. Tragic...Very Tragic!
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