Making Hepatitis History Part 5: Purchasing records reveal dangerous penny pinching
When undergoing an invasive procedure, such as a colonoscopy or biopsy, patients trust that the equipment being used is clean.
Nurses often open syringe containers in front of patients to emphasis that they are using the syringe for the first time. When they are done, they throw it into a biohazard container, often on display for the patient's benefit.
At the Endoscopy Center of Southern Nevada, the staff had a different – and ultimately dangerous – technique.
In trying to trace the origins of the country's largest hepatitis C outbreak, the Southern Nevada Health District decided not to take it on faith that the clinic was following safe and sterile protocols. It looked at the clinic's purchasing records and found some disturbing gaps between the number of procedures being performed and the amount of equipment being used. Here's one example:
Purchasing records for bite blocks indicated that the clinic had purchased approximately 2,000 bite blocks in 2007, while procedure logs indicated that the clinic performed 5,800 EGDs.
These bite blocks, used to keep the mouth open during a procedure, are disposable. They are designed to be used once and thrown away, like the syringes you see nurses tossing into biohazard boxes. The staff members at the center, though, said they were only allowed to use four bite blocks per day per procedure room.
Makes your teeth hurt, doesn't it? It gets worse.
Purchasing records for biopsy equipment indicated that in 2007, clinic staff purchased 6,200 biopsy forceps and polyp removal wires, while procedure logs indicated the staff performed over 7,800 biopsies and polyp removals.
Of course, "clinic management denied the reuse of any single-use biopsy equipment or bite blocks". That's why the purchasing records are so important.
How might you get a copy of the purchasing records?
I've written about bankruptcy court, where they are certain to turn up. They also could become part of a lawsuit. If the place is truly falling apart, it doesn't hurt to check the dumpster behind the clinic.
The best case scenario is that you track down the person in charge of purchasing.
That's why it's crucial to spend some time building your beat. Get out of the office and actually meet people in the hospitals and clinics in your area. Arrange a tour and hand your business card out to as many people as possible, especially if you suspect a place is in trouble. I have done numerous tours like this and continue to receive tips as a result. I also have asked hospital management to show me the records.
If it's a public clinic or hospital, they have to show you. If it's private, you have to ask them, "What do you have to hide?"
Friday: Why you should regularly check state inspection records for hospitals, clinics and nursing homes.
Related posts:
Making Hepatitis History Part 1: Michael Jackson's deadly drug strikes again
Making Hepatitis History Part 2: Sterilization logs can help uncover medical negligence
Making Hepatitis History Part 3: Bankruptcy court holds dirty secrets little and large
Making Hepatitis History Part 4: Time stamps can separate medical fact from fiction