By Brian Bohl
New procedural safeguards could be implemented following five hepatitis C and hepatitis B outbreaks in New York during the past seven years.
After two cases of Long Island doctors using multi-dose vials to distribute medicines, State Health Commissioner Richard Daines said clearer guidelines and regulations for infection control procedures are needed.
Speaking on a panel of nine health professionals at the University Club last week, Daines said he will urge the Food and Drug Administration to stop distributing medicines in multi-dose vials. As part of the initiative, all licensed health care providers are required to go through infection preventing training courses every four years.
State Sen. Kemp Hannon (R-Garden City) led the panel, which produced a document listing requirements for inpatient and outpatient medical care settings intended to improve safety procedures like adhering to aseptic techniques while properly using syringes, needles and cannulae.
“It’s not something where you can just draw a statute to try and rectify,” said Hannon, chairman of the Senate Health Committee. “Many of the safe infection practices are already established. We’re looking at why there are two violations that we know of.”
Those two instances include the hepatitis C transmission spurred by Harvey Finkelstein, M.D., of Dix Hills Hospital who reused syringes in multi-dose vials. Last month, the state also said that Manhasset-based obstetrician-gynecologist, E. Jacob Simhaee, M.D., reused syringes while giving a flu vaccination. No reports of disease transmission in that case have been recorded.
Patients exposed to bloodborne pathogens are encouraged to get tested for hepatitis B and hepatitis C, as well as HIV. Daines actually credited media reports for bringing the public’s attention to the issue. As a result, one panel member said patients need to start asking questions and acting as their own advocate for safe medical practices.
“We need to beef up education in the outpatient setting,” said Perry Smith, M.D., the state’s epidemiologist.
Some medicines currently cannot be administered without multi-dose vials. Daines and the panel then discussed the possibility of developing syringes that cannot be reused to reduce the chances that a medical professional will use the same needle twice.
“You go in with a goal even though there may be exceptions,” Daines said.
Daines suggested that a disease prevention task force be implemented for quality control purposes. He stressed that there should not be “a death penalty punishment” for certain infractions while also purposing more hospital training programs to prevent future outbreaks.
“We need to face the fact that people are getting more sensitive to this and demand more explanations,” Hannon said. “My own research revealed that there are more instances than we ever imagined and going back further than we [thought.] This is not new, but it’s still a problem and previous attempts to address the issue have not been successful.”
The panel, which also featured Nassau County’s deputy executive for health and human services and the state director of communicable disease control, cited potential problems that could be addressed preemptively. Rachel Stricof, M.D., a state health department official, said yellow fever vaccines contain the potential for doctors to use multi-dose vials.
“We really need to look at what mechanical devices we can develop so that no matter what the human error is going to be, it will prevent [anything negative] from happening,” Hannon said. “If that takes money or a new law, we’ll pursue that.”
State Sen. Kemp Hannon leads a panel proposing new safeguards following outbreaks of hepatitis.