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Loading ...MD: HIV infections will never be traced to VA hospital
05.11.2009 10:30am EDT
(Murfreesboro, Tennessee) Former patients who tested positive for HIV or hepatitis will not be able to show they were infected by tainted equipment at U.S. Department of Veterans Affairs hospitals, a top doctor for the agency says.
Dr. Jim Bagian, the VA’s chief patient safety officer, said the patients won’t be able to prove they were even exposed to endoscopic equipment that wasn’t properly sterilized. The equipment is used for colonoscopies and ear, nose and throat procedures. It was discovered in December that equipment was either not properly cleaned or set up.Five patients have tested positive for HIV and 33 have tested positive for hepatitis since February, when the VA started notifying more than 11,000 people treated at three VA medical centers to get follow-up blood checks because they could have been exposed to infectious body fluids. The hospitals are in Miami, Murfreesboro, Tenn., and Augusta, Ga.
The blood tests are continuing. The agency has stressed that the positive results for the diseases may not have come from the VA’s problems with dirty equipment.
“At this point I don’t think we’ll ever know” how the patients were infected, Bagian said.
Some veterans and members of Congress want more explanation than that.
“Some of them did not have these infections before their colonoscopies,” said Mike Sheppard, a Nashville lawyer representing some former VA patients who tested positive for HIV and hepatitis.
Sheppard said the only way to find out how the infections were contracted is by examining all medical records – all of which are in the hands of the VA.
The U.S. House Committee on Veterans Affairs has tentatively set a June hearing for the VA inspector general to report on a review of the mistakes.
A spokesman for the American Society for Gastrointestinal Endoscopy said although the patients recently tested positive, they could have had the viruses for years – and before the VA treated them – without showing symptoms.
“I don’t believe there is going to be any way to definitively link their HIV positive status to the facility,” Dr. David A. Greenwald said Friday in a telephone interview from the Montefiore Medical Center in New York.
The initial December discovery of an equipment mistake at Murfreesboro led to a nationwide safety “step-up” by the VA at its 153 medical centers. Since then, the problems have been discussed with staff at all VA hospitals and with representatives of the equipment manufacturer.
“We look at these as our patients,” Bagian said. “We are not going to quibble about ‘Was it caused because you are an IV drug user?’ … Suppose it was drug use. We are still going to treat them anyway.”
Bagian said it would “be being a weeny or gutless jerk to try to hide behind it. The point is, take care of the patient.”
Each of the three centers had a different problem operating the same kind of equipment made by Olympus American, according to the VA. In Murfreesboro, the equipment was incorrectly rigged because of a mix-up and may have allowed body fluid residue to transfer from patient to patient.
Bagian said the VA doesn’t know how frequently that happened after the equipment was installed in 2003.
In Miami, a tube that was supposed to be cleaned after each colonoscopy was instead cleaned at the end of each day, Bagian said. And in Augusta, the ENT scopes used for looking into the nose and throat weren’t properly cleaned. Everyone who may have been exposed because of those problems was notified.
All the problems were human error, he said.
Patient B has HIV. His virus is constantly mutating, but the rate of mutation can also be reverse-engineered to get an idea of what it looked like earlier. This isn’t 100% conclusive, but when you see the same markers in Patient A’s HIV, you have a strong indication that either A infected B, or they were both infected by the same strain, with A being infected first. This would cost a lot of money, and you notice the VA is once again looking to cover up all it can. These patients would normally have a right to access their records, though I don’t know if the VA has been exempted from that. Given the discontent in this country right now, and the notion that our srvicemembers are being treated in a dishonest and disrespectful manner, I wouldn’t be surprised if Dr Bagian is no longer in his position by the middle of summer.
How do these people keep their jobs???? Isn’t ANYBODY reviewing their work???? I don’t have to have a medical degree to see a medical failure here!
What a strange stanch to take. It comes off that he is defiant and will try and do his utmost to see that patients do not get their records and other information needed for a lawsuit.
This is no different from when the military tried to say Agent Orange exposure didn’t cause the problems the Vietnam Veterans had…Eventually, they’ll have to own up to it.
Ed,
Actually, the most important role of any “safety officer” is to ensure the organization that employs him doesn’t become a defendant in lawsuits. If it turns out that someone does, indeed, get hurt by the organization, then it becomes the safety officer’s job to try to ensure that evidence that can help the defendant in his lawsuit never makes it into the courts.
So, you’re absolutely right in your estimation of what’s going on. I was listening to an interview with Greenwald the other day on NPR in which he spent the entire time being evasive about what happened and why. He certainly came off more as someone who was under the guidance of legal counsel in answering questions in a way that would in no way incriminate the VA. He kept stressing that everything is merely speculative, with absolutely no admission of guilt or responsibility. That’s his main job as a safety officer, after all. It’s infuriating, to say the least, but that’s how business is done in this country. Accountability is a cuss word to these people.
Correction. I said the interview was with Greenwald. It was with Bagian. Brain fart on my part.