Thursday, April 02, 2009

Patients of Problem VA Clinics Infected

Viral infections, including hepatitis, have been found in 16 patients exposed to contaminated equipment at Veterans Affairs medical facilities, a department spokeswoman said Friday. So far, 10 colonoscopy patients from the VA medical center in Murfreesboro, Tenn., have tested positive for hepatitis, VA spokeswoman Katie Roberts told The Associated Press. In a later e-mail, she reported six patients at the VA's ear, nose and throat clinic in Augusta, Ga, tested positive for unspecified viral infections. The number of reported infections could rise.

More than 10,000 veterans were warned to get blood tests because they could have been exposed to contamination at those two facilities plus a medical center in Miami. All three sites failed to properly sterilize equipment between treatments, and the problems dated back for more than five years at the Murfreesboro and Miami hospitals.

Roberts said the department doesn't yet have results from most of the veterans it warned. A VA alert to patients said they "could have been exposed to body fluids from a previous patient."

Roberts said four Tennessee patients have tested positive for hepatitis B and six have tested positive for hepatitis C. No one has tested positive for HIV, she said.

Hepatitis is a viral infection of the liver. The most common form, hepatitis C, is potentially life-threatening and can cause permanent liver damage. Both the B and C forms are spread by contact with the blood or other body fluid of an infected person, according to the Centers for Disease Control and Prevention.

Roberts stressed that the source of the infections isn't known and may never be identified. "There's no way to scientifically, conclusively prove they contracted this due to treatment at our facility," Roberts said. But the VA will make sure those who tested positive "get the best possible treatment," she said.

The VA's inspector general office has started a review, spokeswoman Joanne Moffett said Friday. 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 department blood tests. Some veterans said they decided to seek tests from their private physicians, rather than the VA.

The public first became aware of problems in February, when the agency announced it had sent letters 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. Roberts said the problem in Tennessee was discovered in December and an internal alert was issued.

This week the VA announced it 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. "We feel that the risk of cross-contamination among patients is small, and many patients are at no risk whatsoever," Dr. William E. Duncan of the VA Health Administration said in an e-mail. "Since we cannot know which patients are at risk, we are notifying everyone we feel may possibly have been placed at risk."

Two weeks after a review of procedures and training at VA facilities nationwide, Roberts said the VA cannot yet say if patients at other locations were exposed to equipment that was not properly sterilized.

U.S. Rep Ileana Ros-Lehtinen, R-Fla., said VA officials told her and other members of Congress on Thursday that the Miami facility initially reported it was free from problems only to later backtrack. Ros-Lehtinen said the details were disclosed by the VA in a closed-door meeting convened by U.S. Rep. Steve Buyer, R-Ind., the top Republican on the House Committee on Veterans' Affairs.

Joe Davis, a spokesman for the Veterans of Foreign Wars in Washington, said he has notified his 20,000 newsletter subscribers about the situation. "We are obviously very concerned anytime anybody's health is at risk from going to see the doctor," he said Friday. "We believe the VA has done an adequate job in quickly notifying those veterans who might be affected."


UK: Mental services ’shut to elderly’

Older people are often denied access to the full range of mental health services available to younger adults, a watchdog has found. At four out of six mental health trusts examined in England decisions were based as much on age as clinical need, the Healthcare Commission found. Out-of-hours, alcohol and crisis services, and psychological therapies were often unavailable to the over 65s. A body representing trusts said new policies would benefit older patients.

Healthcare Commission chief executive Anna Walker called the findings "unacceptable".

The research showed that older people were often prevented from accessing care because of stretched services or a lack of age-appropriate care. Some staff said patient groups considered to be of high risk to the public or where government targets were applicable were often prioritised, leaving older people's services lagging behind with little funding.

Ms Walker said: "Trusts are not always providing appropriate mental health services to the over 65s. "It is truly unacceptable that out of hours and crisis services were often not available to older people. "There needs to be a fundamental shift towards providing care based on a person's clinical need rather than their age. "Considering a quarter of admissions to mental health inpatient services are over 65, this issue needs urgent attention."

Kate Jopling of Help the Aged said: "It's shocking to think that, despite the need, older people are routinely being denied treatment for mental health services. "The date on a birth certificate should not be the measure of whether or not someone receives the help they need for a mental health problem."

And Gordon Lishman of Age Concern said the services that did exist for older people were often chronically under funded and are not of the same quality to those offered to adults of working age. He said the situation was scandalous and urged the government to use laws to stamp out age discrimination.

Care Services Minister Phil Hope said any unfair discrimination against older people was unacceptable. "We are taking action and we expect NHS trusts to make improvements."

Steve Shrubb, director of the mental health network which represents the majority of mental health trusts said: "We have some of the best mental health services in Europe yet it is clear that there are still improvements to be made to mental health services especially to ensure that older people get access to the correct care when they need it." He said new policies, such as quality accounts, would put the needs of patients into sharper focus.

Meanwhile, a second study from the Commission of all 68 NHS specialist community mental health trusts in England, found that almost half of under 65s needing specialist mental healthcare still do not have an out-of-hours number if they are in a crisis. Half of people with schizophrenia have not been offered recommended psychological therapies, it suggested.


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