VA hospital may have infected 1,800 veterans with HIV

[Bob Hubbard]

VA hospital may have infected 1,800 veterans with HIV


http://www.cnn.com/2010/US/06/30/va.hospital.hiv/index.html?hpt=Sbin

A Missouri VA hospital is under fire because it may have exposed more than 1,800 veterans to life-threatening diseases such as hepatitis and HIV. John Cochran VA Medical Center in St. Louis has recently mailed letters to 1,812 veterans telling them they could contract hepatitis B, hepatitis C and human immunodeficiency virus (HIV) after visiting the medical center for dental work, said Rep. Russ Carnahan.

Hospital says problem stems from handwashing dental instruments.


Um, the autoclave was invented in the 20th century....I'm sure it's been suggested to them a few times.....

 

[CoryKS]

Dr. Gina Michael, the association chief of staff at the hospital, told the affiliate that some dental technicians broke protocol by handwashing tools before putting them in cleaning machines.

The instruments were supposed to only be put in the cleaning machines, Michael said.

I'm confused by this. Is the problem that the cleaning machine doesn't work, or that they're just not supposed to handwash them first? How does handwashing the tools prior to using the machine potentially infect patients? One would think that if the machine could remove whatever might have been on the tool after being in someone's mouth, it could remove whatever it picked up from the technician's hands.

 

[Bob Hubbard]

That part confused me also. This seems to clear it up a bit.

Dr. Gina Michael is the association chief of staff at the hospital, and says the failure happened because some dental technicians thought they were doing the right thing by washing the dental tools themselves.

Dr. Michael says the techs were using a sink and strong soap to clean the tools, when they should have sent them to the hospital sanitizing and sterilizing department.

The techs, says Dr. Michael, were trying to protect the delicate instruments by doing the cleaning by hand, but instead, they were breaking protocol.

...

Even though the dental instruments were washed by hand, they were still sterilized by machine. The hospital uses high heat and pressure to sterilize instruments, which kills most germs. However, some viruses can withstand the heat, that's why they are washed in special machines.

http://www.ksdk.com/news/local/story.aspx?storyid=205262&catid=3

 

[CoryKS]

I guess I'm slow, because I still don't get it. The tools still go through the machine, so the only way this makes sense is if washing and sterilizing are two separate stages and that the washing stage, which contributes to the sterilization, is being circumvented. This story could have been written more clearly.

So hepatitis B, hepatitis C and HIV are heat-resistant?

 

[Bob Hubbard]

I get the feeling that some missed that machine step, they just haven't admitted it yet.

 

[CoryKS]

I get the feeling that some missed that machine step, they just haven't admitted it yet.

Now that makes sense.

 

[Bill Mattocks]

OK, I think I'm following it.

Normally, you'd think an autoclave would do the job. High heat sterilization. Right? And that's apparently the procedure for tools that have been hand-washed first.

However, with dental tools, autoclave is not the proper protocol, because some viruses can withstand the heat of autoclave sterilization. So for those tools, there is a 'special washer' that does what the dental technicians were trying to do by hand before autoclaving.

They thought they were doing the right thing because the 'special washer' is not gentle and the dental tools are delicate.

A) Handwash + Autoclave = unsafe.
B) Special Washer = safe.

They were doing A, when they should have been doing B.

At least, that's how I am reading it.

 

[cdunn]

I guess I'm slow, because I still don't get it. The tools still go through the machine, so the only way this makes sense is if washing and sterilizing are two separate stages and that the washing stage, which contributes to the sterilization, is being circumvented. This story could have been written more clearly.

So hepatitis B, hepatitis C and HIV are heat-resistant?

Hepatitis B and C are extremely resiliant. They can survive an autoclave, if it is not run at sufficent time and temperature. HIV, on the other hand, is probably one of the most easily killed viruses, at least outside the body. It will die if you look at it crosseyed with a bar of soap in your hands.