Magnitude of dirty VA hospital equipment unknown

[dnalexander]

Magnitude of dirty VA hospital equipment unknown
By BILL POOVEY (Associated Press Writer)
From Associated Press
April 24, 2009 4:12 PM EDT

CHATTANOOGA, Tenn. - A 60-year-old Navy veteran who had a colonoscopy last year got an unimaginable phone call recently - a blood test showed he had HIV. A second test by the Veterans Affairs Department was negative.

Now, the Tennessee man doesn't know what to think. He no longer trusts the VA and is seeking a third test from a private doctor. And, he's hired a lawyer.

The veteran is one of nearly 11,000 former sailors, soldiers, airmen and Marines who could have been exposed to infectious diseases like HIV and hepatitis because three VA hospitals in the Southeast treated patients with dirty equipment. Since disclosing the problem and warning patients to get follow-up blood tests, the agency has become tightlipped, fueling frustration among veterans nationwide.

On Friday, the VA revealed that another patient had tested positive for HIV, bringing the total to four such cases among patients who got endoscope procedures at hospitals in Miami, Murfreesboro, Tenn., and Augusta, Ga. The agency also said a new hepatitis case had been discovered, increasing the number of positive tests to 26. More than 4,270 veterans still have yet to get test results.

Beyond those skimpy facts, the VA has said little else, citing an ongoing investigation.

It hasn't answered questions from The Associated Press about why problems with cleaning the equipment - and possibly co-mingling infectious body fluids - went on for five years at the Miami and Murfreesboro hospitals and about a year in Augusta. The VA also refuses to say if it found similar problems at its other 150 hospitals or if more patients should get blood tests.

The VA has stressed that the positive tests are "not necessarily linked" to medical treatment at its hospitals.

Veterans are calling on the agency to release more information.

"This effort must involve continual updates on what the VA is learning about the extent of this situation," Vietnam Veterans of America President John Rowan said in a statement Thursday.

More facts are little comfort, though, to those who are already infected - and those that don't know.

"I screamed out loud, `No' and went over and held my wife and told her what happened," said the Tennessee Navy veteran, who spoke to The Associated Press on a condition of anonymity to protect his medical privacy and his security firm employer. "We had a nice, good cry. The things that go through your mind. You think your whole world is going to end. Her world could end, too."

It was not clear whether the Tennessee man was counted as a positive HIV test by the VA.

In December, the VA discovered that the Murfreesboro facility wasn't following cleaning procedures the manufacturer recommended. It issued an internal alert for hospitals to check their procedures. The problem at Augusta was discovered in January.

On Feb. 9, the VA announced a nationwide safety check of endoscopic equipment used in colonoscopies and ear, nose and throat treatments. The procedures involve a narrow, flexible tube fitted with a fiber-optic device such as a telescope or magnifying lens that is inserted into the body.

Some veterans were warned in February to get tested, and more were alerted in March when the Miami hospital backtracked on its previous conclusion that it didn't have a problem.

The day after the first HIV infection became public April 6, the VA announced that its top medical official, Dr. Michael Kussman, was retiring. Kussman still works at the VA but could not be reached for comment. VA spokeswoman Katie Roberts said there was "no connection whatsoever."

The endoscopic equipment is made by Center Valley, Pa.-based Olympus American Inc., and the company has said its recommended cleaning procedures are clear.

The VA and its inspector general have started investigations, and congressional members of the Veterans Affairs Committee have asked for a hearing in late May to discuss how the VA has been handling the problem.

U.S. Rep. Steve Buyer, R-Ind. and ranking member of the committee, said in a statement he and his staff have been briefed weekly by senior VA officials. His office declined to release more information.

Private hospitals have also spread infectious diseases with unsterilized equipment, but requirements to report such problems vary by state and there's no national regulation requiring disclosure, according to Barbara Rudolph, director of The Leapfrog Group, which advocates for quality health care.

The VA is providing a hot line for veterans and their families and posts the information it is releasing on its Web site. Because the VA hasn't ruled out other hospitals having had problems, some veterans are wondering if its more widespread.

In Cedar Rapids, Iowa, former Marine Allen Lusk had several colonoscopies at the VA hospital in Iowa City and tested positive for hepatitis B in December.

"I never had it till I started going to the VA," said Lusk, 51.

He started using the VA in 2006 after he was injured when a car fell on him and he didn't have health insurance. After seeing news reports about the contaminated equipment problems elsewhere, Lusk went to his county health department for an HIV test. He tested negative.

"To be honest, I'd like to see them come out and be honest about how big this really is," he said. "It might be embarrassing, but in the long run it might be better for them."

[sixdogsmom]

The quality of care in many facilities could stand some scrutiny IMHO. There is never anyone who is obviously 'in charge' so there is never anyone to be worried about catching the lax behavior. How many hours do these people spend on the internet shopping or playing games? Lots, I can tell you from first hand experience. Since everyone is trained for a specific job, they consider anything other than 'that' job is beneath them even if it benefits patients, the hospital or themselves to do it. I was under the impression that it all paid the same when you were at work. If you were asked to clean windows or the john, then that is what you did. I once fired a black woman from my crew because she refused to get on her knees and search for a device that she had lost. I was right down there looking too, as this affected the integrity of the test we were performing, and we could not have a device show up where it could not be documented. After all some of the devices we tested were used in medical equipment as well as military application. I guess the whole thing boils down to integrity, it is a tragedy that our military are suffering because of it.

[Diane Amberg]

So what's become of the infection control departments? That's their job, to be diligent, do spot checks and be sure people are doing what they should. At our big class I Trauma Center they are very diligent about infections. It can affect their ratings.

[Varmit]

Things like this really tick me off, it is just more evidence that our gov't doesn't care about our veterans.

[Diane Amberg]

It's much more local than that. The director of each unit is responsible.

[Varmit]

yeah, but these facilites lack oversight.  Partly due to being underfunded.

[sixdogsmom]

Sorry to disappoint you but money does not equal integrity.

[Diane Amberg]

Billy, I though you wanted less Government interference?  and yes, they do have Q and A. Pres. Bush had 8 years to work on VA hospitals. That mess at Walter Reed happened on his watch. I do wish he, or his assignees, had done better with that.

[Wilma]

IMHO you could go back much further than that.  When my husband was called in for a disability checkup in the early 50's we went to the VA hospital in Wichita.  I was not impressed with the atmosphere there.  There was something about it that said, we don't care.  One of my uncles, a veteran of WWI refused to spend the rest of his days there, even though he was eligible.  Instead he spent most of his savings to stay in a nursing home.

[Diane Amberg]

We have a huge VA hospital 20 minutes from us. I have taken many a patient there over the years. The care is very inconsistent in the ER, but is great in the rehab and nursing home area. I tried to talk a lady out of going there when I was sure her husband was having an active AMI and I told her why. Sure enough he went into cardiac arrest as we went in the door. There was no Doc or nurse anywhere on the floor.They had to page someone from one of the upper floors. In the meantime we're in the ER still trying to save this poor guy's life because there was nobody for us to turn him over to. The wife was about purple with rage. We did get his heart started again, but I don't know how he did later.  There is no excuse for that. ( By the way, Reagan was president at the time. No, I don't think it was his fault.) Our Chief of Ambulance lodged a formal complaint because we had radioed in long before we arrived and had given our report. They had agreed to accept the patient. Other times there was staff waiting outside to help us unload and they were interested in everything we had to say. Ya never knew. No, it wasn't a conspiracy of some kind. Sometimes stuff just happens.