VA unsure of extent of contamination

Updated: Friday, 27 Mar 2009, 8:19 AM EDT

* By BILL POOVEY, Associated Press Writer

CHATTANOOGA, Tenn. (AP) – Thousands of military veterans across the South are waiting to find out if they were exposed to infectious diseases by government clinics that performed colonoscopies and other procedures with equipment that wasn’t properly sterilized.

Veterans Affairs spokeswoman Katie Roberts said officials are working to determine if mistakes that may have exposed patients to infections at medical centers in Tennessee and Florida and a clinic in Georgia could have also happened at other VA facilities.

“We don’t know for certain,” Roberts said.

The VA recently warned some veterans who had colonoscopies as far back as five years ago at its hospitals in Murfreesboro, Tenn., and Miami that they may have been exposed to the body fluids of other patients and should undergo tests to make sure they haven’t contracted serious illnesses.

“What if you had to worry about giving your wife AIDS?” said Wayne Craig, a 52-year-old U.S. Navy veteran who lives in Elora and had a colonoscopy at the VA’s Alvin C. York Medical Center in Murfreesboro, near Nashville, about five years ago. “Why haven’t I been notified within five years?”

After the VA declined to answer repeated requests from The Associated Press during the past week about the results of what the department described as a nationwide procedure and training review that was to end March 14, Roberts said Thursday that the evaluation of the review was continuing.

Roberts said the mistake in Miami was discovered during the review.

Roberts also said she was confident that any other mistakes in operating endoscopic equipment at other VA facilities were corrected during the review. The VA has attributed the mistakes to human error.

The review of all VA medical centers and outpatient clinics followed reports in February that the department discovered “improperly reprocessed” endoscopic equipment used for colonoscopies in Murfreesboro and ear, nose and throat exams in Augusta, Ga.

Just this week, the VA acknowledged problems at a facility in Miami, too.

Veteran Gary Simpson, 57, of Spring City had a colonoscopy at the Murfreesboro clinic in 2007. He said his blood has tested negative for HIV and hepatitis, but he’s still worried because a nurse told him some diseases don’t show up for seven years.

“He talks about it every day,” said his wife, Janice. “It has really messed with him a lot. It is just too disturbing.”

Nashville lawyer Mike Sheppard said his firm is preparing to file claims on behalf of up to 15 colonoscopy patients, including several who have since tested positive for hepatitis B. He said an elderly man who had cancer when he had a colonoscopy died shortly afterward.

“We are investigating the death,” Sheppard said.

According to a VA e-mail, only about half of the Murfreesboro and Augusta patients notified by letter of a mistake that exposed them to “potentially infectious fluids” have requested appointments for follow-up blood tests offered by the department.

In February, the VA said it sent letters offering the tests to about 6,400 patients who had colonoscopies between April 23, 2003, and Dec. 1, 2008, at Murfreesboro and to about 1,800 patients treated over 11 months last year at Augusta.

The VA has now sent letters advising 3,260 patients who had colonoscopies between May 2004 and March 12 at the Miami Veterans Affairs Healthcare System that they also should get tests for HIV, hepatitis and other infectious diseases.

That revelation prompted two Florida lawmakers to demand an investigation by the VA Office of Inspector General.

Dr. Mark Rupp, president of the Society of Health Care Epidemiology of America, said the risk of infection following routine endoscopic procedures is 1 in every 1 million to 2 million procedures.

Rupp, a professor of infectious diseases at the University of Nebraska Medical Center, said that “tracking is very difficult” and that hospitals are not required to report mistakes that expose patients to infectious diseases.

“The people in the hospitals are encouraged to report,” Rupp said. “If there is any kind of outbreak usually the Public Health Service is notified.”

Roberts said the VA notified patients based on the installation date of equipment that was improperly operated.

Janice Simpson said an employee in U.S. Rep. Zach Wamp’s office in Chattanooga told her that the blood test notices sent to colonoscopy patients of the Murfreesboro clinic were timed to the date of a procedure on a patient with AIDS. A spokeswoman for Wamp said Simpson was mistaken.

The VA did say in an March 19 e-mail to AP that at the VA’s Murfreesboro colonoscopy facility “one of the tubes used for irrigation during the procedure had an incorrect valve.” The statement also said “tubing attached to the scope was processed at the end of each day instead of between each patient as required by the manufacturer’s instructions.”

The VA letter to Craig said he “could have been exposed to body fluids from a previous patient.” Craig said his follow-up test did not

show any infection.

He said he thinks the VA was saving money by not cleaning the tubing between its use on each patient.

“What if this was a public hospital?” said Craig, who has six grandchildren. “There’s no reason in the world a veteran can’t file a suit against a veteran hospital the same as a public hospital. This is veterans you are talking about.”