More Worries on VA Hospitals Following Inspections

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We have been following the VA contamination debacle in which veterans have been testing positive for HIV, hepatitis, and other life-threatening pathogens following <"">shoddy colonoscopies and endoscopies at three Veterans Affairs (VA) hospitals.

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Because of the scandal, surprise inspections were conducted last month reports the Associated Press (AP). The AP said that less than half of the facilities were found to have had proper training and guidelines in effect for endoscopic procedures, which include colonoscopies; of serious concern, given that the inspections were conducted after the mistakes were made public and it was widely reported that the VA might be responsible for the transmission of the dangerous pathogens.

The VA has maintained that it is unable to confirm if the cases are connected to treatment at its sites, but did warn nearly 11,000 veterans who received care at three of its hospitals to undergo blood testing. Many believe dirty equipment is to blame and, last month, the AP reported that other VA patients were not warned about similar mistakes with the same equipment at more than 12 other VA centers.

The shoddy tests were conducted as far back as five years ago and put VA patients at risk because they were treated with equipment that was not appropriately sterilized, thus exposing them to the bodily fluids of other patients, noted the AP in a prior report. The VA acknowledged in its warnings letters that the invasive procedures potentially exposed them to other patients’ bodily fluids. Also, the VA admitted in late March that water tubes and reservoirs it used in colonoscopies and endoscopies were rinsed—not disinfected—between procedures, which could expose subsequent patients to contamination.

The AP reported that it obtained the findings from the VA’s inspector general and noted that the findings suggest that problems in the procedures performed at VA facilities are potentially more commonplace than first realized. The report is scheduled for release today at a hearing before a House Veterans Affairs subcommittee, said the AP, pointing out that VA officials will likely take questions and Representative Harry Mitchell (Democrat-Arizona) will act as the hearing’s chair.

In an earlier Washington Times article, the VA admitted that three hospitals did not appropriately sterilize colonoscopy equipment on a variety of occasions since 2003. Also, WSMV said in an earlier report that, late last year the VA found a wrong tubing valve might have been used during procedures as far back as April 2003, which could have resulted in body fluid transmission between patients.

The VA’s chief patient safety officer, Dr. Jim Bagian, would not name the additional facilities where incidents may have occurred, but argued that the three VA facilities identified previously—Murfreesboro, TN, Miami, FL, and Augusta, GA—are the only ones with “any kind of appreciable risk” of contamination, reported the AP previously. To date, five former patients at the three hospitals tested positive for HIV; 34 tested positive for hepatitis, said the AP in a prior report.

HIV and hepatitis B and C are spread by contact with infected body fluids, especially blood. HIV—the human immunodeficiency virus—is the virus that causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV infection. Hepatitis B and C are liver diseases that can lead to cirrhosis or cancer of the liver. Vaccines exist only for hepatitis B. HIV/AIDS and hepatitis B and C can all be fatal.

The VA has admitted to the mistakes which, it said, were caused by human error, reported the AP.

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