Multi-dose syringes, at the center of two Long Island medical malpractice scandals, should be banned to prevent further problems, according to one New York State health official. Health Commissioner Richard Daines last week asked the U.S. Food and Drug Administration (FDA) to put an end to the manufacture and distribution of medications delivered via multi-dose vials, after it was discovered that two Long Island doctors habitually reusing syringes on multiple patients. In the first case, the notorious Dr. Harvey Finkelstein of Dix Hills sickened at least one person with hepatitis C and jeopardized countless others. The second, Dr. E. Jacob Simhaee, a Manhasset-based obstetrician-gynecologist, admitted to reusing syringes last fall on 36 patients.
Daines made the recommendation during a talk at Hoftstra University and acknowledged that even if the ban is immediately effective, it must allow for exceptions, as some medicines require multidose vial usage. “You go in with a goal even though there may be exceptions,” said Daines. Daines was one of nine doctors and health officials at the talk on infection control headed by state Senator Kemp Hannon (Republican-Garden City), chairman of the Senate Health Committee. Daines explained doctors must sometimes use multidose vials in order to deliver the correct dosage, but did acknowledge that “engineering out” the possibility of human error is the best way to ensure infection control. Both the needle and the syringe are supposed to be used only once, if they are not, eliminating multidose vials would eliminate one possible contamination source.
The health department was spotlighted in November after it was revealed it waited three years before advising the public that Finkelstein reused syringes in multidose vials, exposing patients to blood-borne pathogen infections such as hepatitis B and C and HIV/AIDS because of shoddy injection practices. The state Department of Health contacted nearly 11,000 of Finkelstein’s patients, urging them to be tested. Because of his practices, one patient contracted hepatitis C; six other patients tested positive for hepatitis B and six more for hepatitis C. Unbelievable that Finkelstein—who has far more malpractice settlements than any other pain-management specialist on Long Island and, in 1995, was sued, on average, once or twice yearly—remained under the radar for so long.
Earlier this month, the state announced that Manhasset obstetrician-gynecologist, Dr. E. Jacob Simhaee, reused syringes in a multidose vials when administering at least 36 flu vaccines. As with Finkelstein, Simhaee used a single syringe, which held up to six doses, on multiple patients. Simhaee contacted signed a letter composed by the state, which initiated its investigation following a complaint filed with the Nassau County Department of Health.
Daines said despite “numerous guidelines and recommendations,” some doctors continue to misuse needles and syringes, leading to contamination of multidose vials.
New York is the only state that requires infection prevention training every four years as well as strict infection control requirements in hospitals and office-based surgeries. Despite this, Daines listed five hepatitis C and B outbreaks caused by poor infection control in NY since 2001. Hannon said because eliminating use of multidose vials may not be possible, he favored development of a syringe that cannot be reused. There are several models to prevent reuse, but they can be altered and reused.
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