Hepatitis C investigation continues

PeaceHealth, county health officials say no proof of exposure so far

By Marissa Harshman, Columbian health reporter



Did you know?

• Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that damages the liver, according to the Centers for Disease Control and Prevention.

• Hepatitis C is spread primarily through contact with the blood of an infected person.

• The CDC estimates 3.2 million people in the U.S. have chronic hepatitis C virus infection but don’t know they’re infected because they don’t look or feel sick, according to the CDC.

• Each year, about 500 cases of hepatitis C are reported to Clark County Public Health. That includes new cases as well as existing cases that move into the county or people who have had the virus for some time, according to the health department.

In the days since health officials announced a former hospital employee may have exposed patients to hepatitis C, more details about the situation are coming to light.

Clark County Public Health and PeaceHealth Southwest Medical Center officials announced Monday they are conducting a joint investigation into whether a former hospital employee suspected of diverting drugs at the hospital exposed any patients to the contagious, blood-borne liver disease.

So far, the investigation has not uncovered any proven instances of hepatitis C transmission to hospital patients, said Tim Strickland, a spokesman for PeaceHealth Southwest Medical Center.

But the announcement did spark questions from the community.

The day after the announcement, the hospital's patient support phone line received nearly 80 calls. Of those calls, a small percentage were from patients expressing anxiety and concern, Strickland said. Most callers asked general questions about hepatitis C and the investigation, he said.

The joint investigation is ongoing and centers around the former employee.

The employee — who hospital officials have declined to identify — began working at the hospital in the middle of 2012. In March, hospital officials had "reasonable suspicion" that the employee was diverting controlled substances, Strickland said.

"As soon as we became aware of the concern with the former employee, that person was suspended and removed from patient care," Strickland said.

The hospital did not say whether that employee had hepatitis C.

The employee left the organization in March, though hospital officials are not disclosing whether the person quit or was fired. Hospital officials aren't disclosing what position the employee held or in which department the employee worked, but Strickland said the employee did provide direct patient care.

When hospital officials learned of the possible drug diversion, they looked back at the patients for whom the employee had provided care. That's when they learned the employee was a member of the care team for a patient who, a few months after receiving care at PeaceHealth Southwest Medical Center, was diagnosed with hepatitis C, Strickland said.

The patient, who was diagnosed in late 2012, had no known risk factors for hepatitis C. At the time of the diagnosis, public health officials investigated whether any other known cases of hepatitis C in the county had a connection to PeaceHealth Southwest. They found no other cases with links to the hospital, Strickland said.

But the employee's suspected drug diversion and involvement in the patient's care prompted health officials to take another look at the case, Strickland said.

"What we're doing is acting with great caution to ensure the wellbeing of our patients," he said. "It is possible that a hepatitis C exposure happened here, but we don't know if that's the case."

As public health and hospital officials continue to comb through patient files, they will make a list of people to notify about potential exposure. Letters will be mailed to those patients no later than May 20, Strickland said.

In the meantime, hospital and public health officials are keeping law enforcement and other regulatory organizations informed of the investigation.

"Because the situation involves controlled substances and a reportable condition, we have certain notification obligations," Strickland said.

The Washington State Department of Health stipulates which type of health care providers can prescribe controlled substances — advanced registered nurse practitioners and physicians, for example — and which providers can administer the drugs ordered by authorized prescribers. Licensed practical nurses and registered nurses, for example, can administer the drugs under the direction of prescribers.

Individuals and entities that prescribe and distribute narcotics and other controlled substances are required to have a registration number with the Drug Enforcement Administration, which has regulatory oversight to ensure the drugs aren't diverted.

While the hospital has declined to identify the employee, if the circumstances of the situation were to change — if criminal charges are filed, for example — the hospital may reconsider its position, Strickland said.