Issued on Reuse of Needles by Jason Scott McClure
of Quantum Media Group September 1, 2003
NICK TROUGAKOS The Associated Press
OKLAHOMA CITY (AP) - A hepatitis C outbreak that has
infected 52 people in Oklahoma has led to a national
warning to nurse anesthetists against reusing needles
in intravenous tubes.
James C. Hill, a nurse anesthetist in Oklahoma City,
told health officials he reused needles and syringes
up to 25 times a day to inject pain medication through
intravenous tubes at a pain management clinic in Norman
and two surgical centers in Oklahoma City. Such reuse
of needles can spread the disease, which can lead
to serious liver damage, cancer and even death.
Hill is under investigation by the state Department
of Health and the Oklahoma Board of Nursing.
Health officials have sent letters to 1,220 patients
treated by Hill, telling them to get tested for hepatitis
C, and 52 of the patients have tested positive since
Last year, 19 patients of a Brooklyn, N.Y., clinic
contracted hepatitis C when an anesthesiologist reused
needles and a vial of medication.
The American Association of Nurse Anesthetists has
sent 33,000 letters to hospital administrators, nurse
anesthetists and nursing students nationwide, citing
the Oklahoma outbreak and telling them not to reuse
needles. Experts say some health practitioners may
not be aware that reusing needles is dangerous because
the needles are inserted into tubes rather than under
"After discussion with infection control experts,
we have concerns there may be a widespread misunderstanding
by health care practitioners of the dangers associated
with the reuse of needles and syringes," the
Dr. Elliot Greene, associate professor of anesthesiology
at Albany Medical College in Albany, N.Y., said studies
done in the 1990s documented that health care professionals
sometimes reused needles when injecting drugs into
"It was a shocking thing to see," said Greene,
who serves on the task force for infection control
in the American Society of Anesthesiologists. He said
the problem has to do with a lack of education.
"There are a lot of people who started their
practice before this was an issue," Greene said.
"They got into certain practice patterns that
are now considered bad technique."
Jeff Beutler, executive director of the nurse anesthetists
association, said that when a shot is given into an
intravenous line, a needle can easily come into contact
with a patient's blood. Blood-to-blood contact spreads
Beth Bell, chief of the epidemiology branch in the
division of viral hepatitis at the Centers for Disease
Control and Prevention, said research clearly shows
the danger of reusing needles.
"The way that these kind of intravenous tubes
are placed, what often occurs is that there is a back-flow
of blood into the intravenous tube," she said.
State Epidemiologist Dr. Mike Crutcher said Hill believed
he was practicing safe medicine.
"He didn't think it was abnormal procedure,"
Crutcher said. "It's hard to imagine that he
would think it was normal."