Nearly 40,000 people learned this week that a trip to the doctor may have made them sick.
In a type of scandal more often associated with Third World countries, a Las Vegas clinic was found to be reusing syringes and vials of medication for nearly four years. The shoddy practices may have led to an outbreak of the potentially fatal hepatitis C virus and exposed patients to HIV, too.
The discovery led to the biggest public health notification operation in U.S. history, brought demands for investigations and caused scores of lawyers to seek out patients at risk for infections.
Thousands of patients are being urged to be tested for the viruses. Six acute cases of hepatitis C have been confirmed. The surgical center and five affiliated clinics have been closed.
"I find it baffling, frankly, that in this day and age anyone would think it was safe to reuse a syringe," said Michael Bell, associate director for infection control at the national Centers for Disease Control and Prevention.
Newer wmtc readers might not realize why I post these types of items. One of this blog's themes is the disintegration of the United States into a third-world country. That's what the category "US regression" denotes. Once I began to see the US through this perspective, the evidence started appearing everywhere.
Canada had its own tainted blood scandal in the late 1980s and early 1990s. The health system was not testing properly for Hepatitis C or HIV after a test was available, and thousands of Canadians contracted one of those disease through transfusions. There was a long public inquiry, leading to criminal charges against the Red Cross, a U.S.-based pharmaceutical company and several doctors. Procedural changes were made, the victims were awarded monetary settlements and a scholarship fund was set up for their families.
I note this because the differences between the US and Canada are often most apparent in how the two countries react to painful and shameful events. The terrible ordeals of Maher Arar and Robert Dziekanski are good illustrations of that, and this is another.
This is 2008, and the Las Vegas clinic was reusing syringes for four years. This won't lead to a large-scale public inquiry. There might be a class-action lawsuit, handled privately. Other than this one clinic being closed, nothing will change.
26 comments:
On a related topic: another for the regression files (I skimmed through yours, I don't think you have it)
The policy about no HIV+ tourists/immigrants.
http://joemygod.blogspot.com/search/label/HIV%2FAIDS
If, in a blue moon, there were to be an inquiry in the US about this issue generally and this clinic specifically, who's responsiblity would it be? CDC? Who ever regulates public health and inspections? State health? Federal health dept?
On a related topic: another for the regression files (I skimmed through yours, I don't think you have it)
The policy about no HIV+ tourists/immigrants.
Ah, yes. Thanks, Jen. I think I blogged about it but filed it under bigotry. If I missed it, I'll post about it soon.
If, in a blue moon, there were to be an inquiry in the US about this issue generally and this clinic specifically, who's responsiblity would it be? CDC? Who ever regulates public health and inspections? State health? Federal health dept?
That's a good question. I'm not really sure.
The clinic itself would have been regulated by a state agency (that clearly wasn't doing its job), a state Department of Health that would be responsible for licensing and standards. Every state has one of those. They inspect and certify hospitals and nursing facilities, among other things.
The public health alert, such as it is, would probably come from the CDC.
If it's drug-related, it's the FDA (which is now practically an arm of the pharmaceutical industry).
Any other Americans reading this know more?
Why would you re-use syringes? How much money does that save a clinic, really? At ResearchSupply.net, a box of 1000 syringes -- full syringes, not the type with interchangeable needles -- is under $200.
In the days before everything was disposal, syringes were sterilized before re-use. Do health facilities have sterilizers anymore? Or is that no longer necessary because of disposables? Maybe Jen or another health professional here can tell us.
Regulation of health care facilities is not centralized in the US, so having a national response is not likely, especially if this is a localized problem affecting just one clinic (although I am sure there are others). As the article indicates, it was the city that revoked the license. I am sure there is a local board of health as well as state and federal agencies with some oversight, each with different areas of concern, each with its own set of standards. Lack of centralized standards and control may be another problem resulting from not having a national health care program.
I do not think this is a sign of the US becoming a third world country; I think it is a sign that the owners of this clinic are greedy, immoral pigs. That may be a problem with a privatized health care system, but I don't think it is a basis for condemning health care here in general. I do not believe that most hospitals, doctors, or clinics would engage in that kind of abuse. And the government has engaged in the "biggest public heath notification operation in US history," so it is not like the government is covering this up or ignoring it.
I've actually heard people in the US discussing this scandal as another sign that "big government" doesn't work, i.e. more proof that nationalized healthcare would be bad. In other words, if only these clinics and doctors were completely unregulated by any kind of laws, this would never have happened because, out of the goodness of their hearts and a concern for their reputation, an individual or corporation operating a clinic solely for personal profit would surely have disposed of the tainted syringes immediately. Even though it would save them money not to. As if.
In other words, if only these clinics and doctors were completely unregulated by any kind of laws, this would never have happened because, out of the goodness of their hearts and a concern for their reputation, an individual or corporation operating a clinic solely for personal profit would surely have disposed of the tainted syringes immediately.
Those people must have some problem with logic or reality. That makes absolutely no sense. If they were suggesting that the feds would do a worse job of regulating than local or state regulators, that would at least be a logical reason not to want national health care (though probably wrong empirically). Are you sure you heard what they were saying? Could anyone really suggest that lack of regulation means that people will resort to their best nature and that it is regulation that makes them greedy and dishonest?
L-girl: "In the days before everything was disposal, syringes were sterilized before re-use. Do health facilities have sterilizers anymore? Or is that no longer necessary because of disposables?"
My mum tells me of re-sharpening needles on her night shift...
Anyways, there are still sterilization units, though generally no longer a nursing responsibility but rather techs. Surgical tools, scopes (like for laproscopic surgeries or colonoscopies), sterile linens as for surgery & suture kits(though that may be off site)--all of these can, and are sterilized and reused.
So are things like basins, urinals/bedpans, graduated cylindars and everything in the clean linen room that is not disposable. These items though may then be left open to air and so are only considered clean, not sterile, but they were sterilized initially.
Canada did recently have a (only slightly) similar case in Alberta (the most privatized, co-incidence? Probably. link at the bottom). A hospital in Vegreville was poorly sterilizing endoscopes (for colonoscopies) and consequently had a superbug out break of MRSA which is spread by fecal/oral route.
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http://www.cbc.ca/canada/edmonton/story/2007/03/23/vegreville-hospital.html
Could anyone really suggest that lack of regulation means that people will resort to their best nature and that it is regulation that makes them greedy and dishonest?
Aren't they called "Republicans"?
Aren't they called "Republicans"?
And don't forget, Dean lives in Texas. I don't doubt he heard exactly what he's written here.
Jen, thanks for the info. Sharpening needles?? Wow.
So your mum is/was a nurse? That's cool that you are following in her path.
Amy, what I mean by becoming a third-world country is not about government cover-ups or what most doctors or nurses would do.
I refer to the ever-increasing divide between rich and poor, where people with means have access to the best of everything, and low-income people are left to fend for themselves, where everything is run for profit, and where everything - air, water, safety, housing, education, health care - is available only to those who can afford it. And those people are becoming fewer, and the have-nots are becoming more numerous, and the middle class is disappearing.
In my view, a civilized, modern nation does not have stories like this popping up every other week. Although this story might be unusual in its size, it's not at all unusual in its basic themes.
I do not think this is a sign of the US becoming a third world country
Viewed in isolation, no.
Viewed in context with thousands of other pieces of information, yes.
OK, on that definition I can see your point about the US (though I tend to think of third world countries as those without the infrastructure, technology, educational system, etc., to provide a modern standard of living to its population). I am not sure how the Las Vegas story fits this as I don't see anything in the story that suggests it catered to the poor.
Yes, Republicans are opposed to regulation, but I don't think even they are saying that it is regulations that makes people greedy or immoral. Perhaps the people were saying that the regulations are an unnecessary expense, but Dean's quote makes it sound like they think the regulations MADE the clinic greedy. Don't Republicans believe that "greed is good" (with apologies to Gordon Gecko in "Wall Street")?
I was paraphrasing, but what I wrote was the gist of the argument. And it was by a couple of people who consider themselves "conservative," which in the US mean they're either Republican or the Republican's equally evil twin: Libertarian.
Don't Republicans believe that greed is good?
I think they and Libertarians do believe that and that's why the coworkers whose argument I paraphrased felt justified in making it (though I didn't probe): they honestly believe that if people are freed of government interference (regulation) that their own greed would result in improved performance in order to attract more patients and thus more money. In my guess about their view, the syringes would have been properly disposed of because not to do so would have negatively affected their reputation and thus their profits. But again, I didn't ask for a full explanation so I only got the soundbite version; my explanation is speculative based on arguments I've heard from other US "conservatives."
Thanks, Dean, for the clarification. It certainly is consistent with Republican/conservative ideology to say that acting out of greed (or profit maximization---a much less offensive sounding label) serves the public interest. "Competition and efficiency will produce the best products at the best prices," and all that jazz. I think where I was confused was when you said they were claiming that the regulations were what made them act immorally. It seems, rather, that they were saying they don't need regulations because the interest in making money will keep them from engaging in harmful practices.
Now I can echo your comment: AS IF!
(though I tend to think of third world countries as those without the infrastructure, technology, educational system, etc., to provide a modern standard of living to its population).
You don't want a list of all the places in the US that applies to, do you? :)
I am not sure how the Las Vegas story fits this as I don't see anything in the story that suggests it catered to the poor.
I'm not suggesting it catered to the poor. But I doubt these tainted, re-used needles were being used at an expensive, private facility.
I'm saying that in a modern, civilized society, things like this should not happen on a regular basis. But they do happen on a regular basis in the US, and they are ignored, as long as affluent people are unaffected.
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Anytime you want further elucidation on the US regression theme, just think one word: Katrina.
though I tend to think of third world countries as those without the infrastructure, technology, educational system, etc., to provide a modern standard of living to its population).
Just to clarify...
Most countries have the technology, education, etc. - but very few people get to access the resources. There's a very tiny, very wealthy class, and a whole lot of everyone else. To me the US is clearly devolving into that.
Yes, there are many places in the US with no infrastructure, etc., to provide a decent standard living. The two cities I live closest to, Springfield and Holyoke, MA, are evidence of that. No argument from me on that. And I do agree that it has gotten worse. But somehow my idea of the third world does not include a country that also has one of the highest overall standards of living. Just a different definition.
Could anyone really suggest that lack of regulation means that people will resort to their best nature and that it is regulation that makes them greedy and dishonest?
"I think they'd kill us in our sleep and sell our organs if the return on investment was good." -- Dilbert
Evidence: this incident, the entire tobacco industry, the beef lobby, etc.
Regulation is there to keep the ROI bad enough that they won't do it.
Anytime you want further elucidation on the US regression theme, just think one word: Katrina.
"Katrina was the best thing to happen to New Orleans because it finally provided an opportunity to a huge number of New Orleans residents living in passive dependency on welfare to get out of New Orleans and change their lives for the better." -- Charlotte Allen, recently in the news over her Washington Post article about how stupid women are.
No argument from me on that. And I do agree that it has gotten worse. But somehow my idea of the third world does not include a country that also has one of the highest overall standards of living. Just a different definition.
Right. I'd love to come up with a more precise term that exactly describes what I'm thinking of. The "third world" motif is just a convenient shorthand.
Then, in trying to think of something that encompassed both that theme and the idea of a crumbling democracy and creeping fascism, I decided on "regression".
In general I guess the word is collapse.
Katrina was the best thing to happen to New Orleans
How infuriating. How maddening. Just makes me wanna... grrrr...
In general I guess the word is collapse.
Got it. Now I will know what you mean when you refer to the US as "third world."
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