Disease brings need for safety to light

The unsettling outbreak of hepatitis C cases at Exeter Hospital points out the fragility of public confidence in institutions entrusted with protecting a community’s health and well-being.

When patients go to a hospital to be treated, they assume effective policies are in place not only to ensure they get better, but that they are not put at an even greater health risk.

When it turns out, as in all likelihood it did at Exeter Hospital, a drug-addicted employee infected 19 patients with the potentially deadly disease when syringes used by that person were unknowingly reused, it raises questions not only about procedures and safeguards at Exeter Hospital, but at every hospital across the state.

That’s why New Hampshire has aggressively moved in on several fronts to define the scope of the problem, ascertain what went wrong, determine if criminal charges are warranted, work to establish remedial responses and explore what lessons need to be learned so it doesn’t happen again.

After a seemingly slow start to appreciating the full scope of the situation, Exeter Hospital, at the end of last week, came out of its shell and did a good job addressing many of the issues at hand, at least to the extent it could now that several lawsuits are in the works.

“We are deeply disturbed by the events that have occurred and for those patients that had to be tested and those patients that were tested and tested positive, our entire organization is deeply apologetic,” said Kevin Callahan, president and chief executive officer of Exeter Health Resources, parent company of the hospital. “I feel personally responsibility for everything that goes on at this institution. As a leader, how can you not?”

Obviously, the first order of business is to determine the total number of patients infected with hepatitis C. The current count of 19 could go higher once all of the testing is completed. Nearly 900 people have been notified they could be infected.

While management is confident the hospital’s long-term future is secure, there is no way to know for sure until the final numbers are in. No doubt leadership has a lot of work to do to reassure prospective patients the hospital is safe.

The Exeter Hospital situation is not unique. Similar hepatitis C contaminations have occurred over the past several years at other hospitals – in Colorado in 2009 and Nebraska in 2002. These outbreaks helped spawn the One & Only Campaign, a public health initiative led by the Centers for Disease Control and Prevention and the Safe Injection Practices Coalition, to promote safe injection practices. It estimates that since 2001, at least 130,000 patients had potential exposure to hepatitis and HIV due to unsafe injection practices.

Patients can visit www.oneandonlycampaign.org for tips on what to ask before having medical procedures that require injections.

It also may be time to consider random drug testing of health care workers. Federal law requires drug and alcohol testing of safety-sensitive transportation employees in aviation, trucking, railroads, mass transit, pipelines and other transportation industries. Why shouldn’t requirement be extended to health care workers whose conduct can mean the difference between life and death for millions of Americans every day?

The official Exeter Hospital hepatitis C outbreak investigation is 2 months old. It may take many years to be resolved.