A 1999 case involving California phlebotomist charged with reusing needles resulted in similar widespread testing of thousands of patients
Because of possible exposure to HIV, hepatitis B, and hepatitis C from a healthcare worker, thousands of patients treated in multiple hospitals in different states are being offered free clinical laboratory testing. This situation is attracting national media attention and is a reminder to pathologists and medical laboratory professionals of the increased transparency that is being given to different types of medical errors that expose patients to risk.
A surgical technologist who allegedly stole the drug fentanyl from multiple hospitals provides an example of how the healthcare system can miss systematic misconduct by individual employees that can put thousands of patients at risk.
Colorado Hospital Offers Free Medical Laboratory Test to 2,900 Patients
In early February 2016, Swedish Medical Center in Englewood, Colo., announced it would be offering free blood tests to an estimated 2,900 patients who had surgery at the Denver-area hospital between Aug. 17, 2015, and Jan. 22, 2016, and who could be at risk for exposure to HIV, hepatitis B, and hepatitis C.
Swedish Medical Center surgical technologist Rocky Allen was fired in January after he was caught allegedly stealing a syringe filled with the painkiller Fentanyl from an operating room. The 28-year-old was indicted by a federal grand jury in February and has pleaded not guilty, the Denver Post reported.
Three hospitals in California and Arizona where Allen previously worked also have offered patients free blood tests, the Denver Post reports. Allen reportedly carries an unnamed blood-borne pathogen.
Previous Similar Thefts and Lawsuits Spark Comparisons
Allen’s arrest is reminiscent of the 1999 case involving Elaine Giorgi, a California phlebotomist who admitted to reusing needles and mislabeling medical laboratory samples at a patient service center in Palo Alto, Calif., operated by SmithKline Beecham Laboratory before the lab company was acquired by Quest Diagnostics Inc. (NYSE: DGX) later in the year. More than 3,600 people who had blood work performed at the SmithKline lab during the two years Giorgi worked there were urged to get tested. The case touched off numerous civil lawsuits.
Giorgi admitted to four charges of illegal treatment of medical waste and one misdemeanor charge of altering medical records. Though no one was reported to have gotten sick from her actions, the Los Angeles Times reported that Giorgi was sentenced in 2002 to a year in prison.
Allen, on the other hand, had a history of misconduct as a surgical technician before he was hired by Swedish Hospital in Colorado. The Denver Post reported Allen had been terminated from positions at four other hospitals in Seattle, California, and Arizona between 2012 and 2014. He also had been court-martialed in 2011 for the theft of fentanyl while he was serving with the Navy in Afghanistan. He was given a general discharge from the Navy in September 2011.
Class Action Lawsuit Filed against Swedish Medical Center
In a class action federal lawsuit filed on March 7 against Swedish Medical Center, attorneys argued that the hospital negligently put patients in danger by hiring someone who the hospital now acknowledges may have put their health at risk.
“Swedish Medical failed these patients when it hired Rocky Allen,” attorney Joseph Sauder of McCuneWright said in a statement. “The most cursory background investigation would have revealed that Allen was someone who should not have had access to surgical patients and the hospital’s medication,” Sauder concluded.
Allen Not the First to be Arrested for Drug Theft at HCA and HealthONE
In its statement, McCuneWright pointed out that Allen was not the first HCA-HealthONE employee to be fired for drug theft. Surgical technician Kristen Parker was terminated in 2009 after infecting dozens of patients from Rose Medical Center—another HealthONE hospital—with hepatitis C due to needle swapping.
During Parker’s sentencing, McCuneWright noted, HCA-HealthONE claimed it had upgraded the policing of medications in operating rooms. Yet a nurse at Swedish Medical was fired in 2014 for “diverting medication for his own use” and now Allen also has been terminated for alleged drug tampering.
Drug Addiction Among Healthcare Personnel at Epic Proportions
Hollynd Hoskins, a lawyer who sued in 2009 on behalf of patients infected by Parker, and who now represents more than 80 patients who had surgery at Swedish Medical Center, told the Denver Post that drug addiction among healthcare providers can no longer be ignored.
“Drug addiction and diversion by our healthcare providers has reached epic proportions. It occurs daily in all hospitals. And it’s a serious growing risk to patient safety,” Hoskins stated.
Surgical Technicians Not Regulated
One challenge facing hospitals is that surgical technicians, who have routine access to narcotic drugs, are not subject to national regulatory requirements, and only 37 states have passed state laws governing their education, training, and registration.
Among members of the surgical team, “we are the only ones that are not comprehensively regulated,” Catherine Sparkman, Director of Government Affairs for the Association of Surgical Technologists (AST), told the Denver Post.
Colorado passed regulatory standards for surgical technicians in 2010 following the Parker case, but the current law does not require background checks or verify applicants’ information. Though the state Department of Regulatory Agencies favors “sun setting” the 2010 law when it expires this year, the Allen case is causing state lawmakers to consider stronger regulatory oversight of hospital workers with access to narcotics, the Denver Post reports.
Steven Summer, President of the Colorado Hospital Association, told the Denver Post that oversight for nurses and doctors “is much more comprehensive, and it also connects all the states” because licensing boards share information. He suggests a national database is needed so that state borders are no longer “porous for an individual like [Allen].”
Despite Multiple Firing for Drug Offences, Allen Still Gained Hospital Employment
Despite Allen’s checkered employment history, he was able to move from one hospital to the next. The Denver Post reported Allen’s resume listed the following work history prior to being hired at Swedish Medical Center:
• January-March 2012: Northwest Hospital & Medical Center in Seattle.
• January 2012 to January 2013: CMC Contractor Corp. in Afghanistan, Iraq, Kuwait, and Yemen.
• May-June 2013: Scripps Green Hospital in La Jolla, Calif.
• May 2013-May 2014: CMC Contractor Corp.
• May-July 2014: Banner Thunderbird Medical Center, Glendale, Ariz.
• July-October 2014: HonorHealth John C Lincoln Medical Center, Phoenix.
The Denver Post reported that Allen was fired from HonorHealth after testing positive for fentanyl. He was fired from Banner Thunderbird after he was found going through a container holding used syringes and needles, and he was terminated from Scripps Green for allegedly switching a fentanyl syringe with a saline syringe. He also was terminated after working less than three months at Northwest Hospital. In addition, the medical defense contractor he claimed to have worked for—CMC Corp.—may not exist, the Denver Post points out.
Swedish Medical Center Defends Hiring Practices
In the same Denver Post story that alleged Allen may have fabricated CMC Corp. in an attempt to embellish his resume, Swedish Medical Center defended its hiring practices.
“Like most hospitals, our hiring process includes a background check by a third party, interviews by managers and peers, confirmation of training and certification, state registration, and pre-employment drug screening,” Nicole Williams, AVP of Marketing and Business Development at Swedish Medical Center, told the Denver Post in a statement.
The clinical laboratory industry has had multiple instances where recurring actions by laboratory workers put patients at risk. The case involving phlebotomist Elaine Giorgi while working at SmithKline Beecham Clinical Laboratory in 1999 is one example.
Another example that made national headlines involved the medical laboratory at Maryland General Hospital (now known as the University of Maryland Medical Center) in Baltimore.
According to an article in the Baltimore Sun, despite dire warnings from lab personnel to hospital leadership in 2002, a pattern of “poor lab practices and inadequate patient care,” in addition to faulty equipment, resulted in thousands of patients potentially receiving inaccurate results for HIV and hepatitis tests.
—Andrea Downing Peck