Colorado Dentist Found to Be Reusing Needles
We all know that it's unacceptable to recap---let alone reuse---dirty needles and syringes, right? Right??
Apparently, former Colorado oral surgeon Stephen Stein didn't get the memo. Between 1999 and 2011, Stein potentially exposed thousands of patients to hepatitis and/or HIV by injecting their IV sedation through used needles.
Stein, who is also under investigation for prescription fraud, stopped practicing last year after being suspended by the Colorado Board of Dental Examiners. But the information about his re-use of needles only recently came to light, prompting the Colorado Department of Public Health and Environment to notify about 8,000 of Stein's patients that they should be tested. Unfortunately, since Stein's records only go back to 2005, there's no way to contact the people he treated before then.
At this point, it's unknown if Stein's conduct actually infected any patients. The chance of infection may even be relatively small. So for argument's sake, let's give Dr. Stein the benefit of the doubt for a minute. Let's say that he always used strict aseptic technique when drawing up sedation from multi-dose vials. Let's say that he only ever injected the sedation through IV ports that were at least 6 feet upstream from the insertion site. Let's say that there was never any blood in the IV tubing. Let's say that the IV fluid was always running wide open to prevent any backflow...
Even so: No! No, no, no, no, NO!
Hepatitis kills. HIV kills. Re-using needles under any circumstances is simply unconscionable.
So why would Dr. Stein---or anybody--- do such a thing?
It can't be a lack of information. This concept has been drilled into every healthcare worker in the world for decades. How ignorant would Dr. Stein have to have been to violate, or allow his staff to violate, such a basic standard of care?
It can't be due to environmental or organizational factors. There are places in the world where it's logistically difficult to observe universal precautions, but Denver isn't one of them.
It can't be about saving time. How long does it take to walk to the sharps container, throw away a used syringe, then reach into the drawer for a new one?
It can't be about saving money, either. A quick search of Internet medical supply sites reveals that 3cc syringes with plain 1 inch needles can be purchased in quantities of 100 for about 23¢ each. If you want to get fancy and splurge on shielded needles, the price only goes up to 34¢. Of course, hospitals and clinics buy them in bulk and get them for even less. Dr. Stein was probably able to procure his needles and syringes for pennies a piece. How cheap would someone have to be to reuse needles? I haven't crunched the numbers lately, but I'm thinking a human life must be worth more than a few pennies.
So if the problem wasn't knowledge or logistics or money or time, the only thing we can conclude is that Dr. Stein considered all of the information and all of the options available to him and made a fully informed decision to put his patients at risk.
It's too bad his patients weren't fully informed as well.