Infection protocol breach risks 7000 lives

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About 7,000 patients of a Tulsa, Okla., dentist were warned that they may have contracted HIV or hepatitis from poor sterilization practices, health officials said. State and federal agencies are investigating Dr. Wayne Harrington, an oral surgeon, because one of his patients tested positive for hepatitis C and HIV, the virus that causes AIDS, and didn’t have known risk factors other than receiving dental treatment, as reported.

Harrington stopped practicing voluntarily when the investigation began. “The dentist is cooperating with investigators through his attorney,” the Tulsa Health Department said. A State Board of Dentistry investigation said there were “numerous violations of health and safety laws and major violations of the State Dental Act,” the health department said.

The department said the Oklahoma Bureau of Narcotics and the U.S. Drug Enforcement Administration were assisting in the “multifaceted and ongoing” investigation.

When it learned of the infected patient, the Oklahoma Board of Dentistry inspected Harrington’s practice March 18 and reportedly found many problems, including regular use of rusty instruments on patients with known infections. A complaint filed by the dentistry board indicated Harrington and his staff told investigators he treated a “high population of known infectious disease carrier patients” and allegedly allowed unlicensed dental assistants to administer medication.

The complaint said drug cabinets were unlocked and unsupervised during the day and inventory logs weren’t kept. Harrington also allegedly reused needles, contaminating drugs with potentially dangerous bacteria and trace amounts of other drugs, the complaint said.

Centers for Disease Control epidemiologist Joseph Perz told that it is “extremely rare” to see dental transmission of HIV and hepatitis B or C.

        

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The ADA has responded to the investigation of an oral surgeon in Tulsa, OK, who may have exposed thousands of patients to HIV, hepatitis B, and hepatitis C, with a statement describing infection control procedures in dentistry and reassuring the public of their effectiveness.

The organization encouraged patients to talk to their dentists about any concerns they may have, so that dentists can describe or demonstrate their infection control procedures.

Regulations for dental office inspections are determined on a state-by-state basis by the state dental board, the ADA said. The organization added that it has long recommended that all practicing dentists, dental team members, and dental laboratories use standard precautions as described in the U.S. Centers for Disease Control and Prevention’s (CDC) Infection Control in Dental Healthcare Settings guidelines. If proper infection control procedures are followed, studies have shown that risk to patients is extremely small, the ADA said. 

        

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The American Dental Hygienists’ Association (ADHA) has issued a statement reassuring the public that dental hygienists maintain high standards in infection control to optimize patient safety and health.

The incident involving Tulsa, OK, oral surgeon W. Scott Harrington, DMD, "in no way reflects the level of care expected of dental hygienists," the group stated in a press release.

Oklahoma health officials have notified approximately 7,000 of Dr. Harrington’s patients about potential exposure to HIV, hepatitis B, and hepatitis C following an investigation that found rusty instruments and lax sterilization procedures in his office. The investigation came after one of Dr. Harrington’s patients, who had no known risk factors, tested positive for HIV and hepatitis C after being treated by Dr. Harrington, according to a 17-count complaint filed last month by the state dental board.

As part of its Standards for Clinical Dental Hygiene Practice, ADHA advocates for dental hygienists to maintain compliance with established infection control standards that follow the most current evidence-based guidelines to reduce the risks of healthcare-associated infections in patients, and illnesses and injuries in healthcare personnel.

The ADHA advocates the development and utilization of emerging technologies that maximize human health and safety. The association also supports the Occupational Safety and Health Administration (OSHA) standards relating to workplace training and safety, according to ADHA policy. 

        

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The Dental Assisting National Board (DANB), the only national certification board for dental assistants recognized by the ADA, is encouraging dental professionals across the U.S. to utilize its services to ensure dental team members are appropriately trained.

On March 28, 2013, the Oklahoma Board of Dentistry filed a 17-count complaint against a Tulsa, OK, oral surgeon, with charges of being a menace to public health and gross negligence. Specific allegations include using rusty instruments, reusing needles, not properly sterilizing instruments, not properly maintaining or using the autoclave, using expired medications, keeping incomplete drug logs, and allowing unlicensed dental staff to start IVs.

"After thorough research, we have determined that neither of the dental assistants involved in the Oklahoma case are DANB-certified, nor have they ever taken any DANB exams," the organization stated in a press release.

Dentists are ultimately responsible for ensuring the practice is in compliance with state law. To assist dentists in their hiring decisions, DANB provides a free online credential verification database to verify the names of dental assistants who have earned DANB national certifications, as well as those who have earned certificates of knowledge-based competency in areas such as radiation health and safety, infection control, coronal polish, sealants, topical anesthetic, and topical fluoride.

DANB provides a number of services to assist in public protection, including offering national certifications and exams for dental assistants, such as DANB’s certified dental assistant, certified orthodontic assistant, and certified preventive functions dental assistant certifications.

While each state determines its own education, exam, and credentialing requirements for dental assistants, DANB is available to assist state agencies in meeting their public protection missions. Currently, 38 states, the District of Columbia, the U.S. Department of Veterans Affairs, and the U.S. Air Force recognize or require DANB exams. 

        

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 Oklahoma health officials say more than 60 patients have tested positive for hepatitis and HIV since their investigation began last month into a Tulsa oral surgeon’s practice.

 

But it is unclear whether the patients contracted the diseases from the Owasso or Tulsa practices of W. Scott Harrington, DMD. Public health officials have been advising current and former patients of Dr. Harrington that they may have been exposed to blood-borne viruses at his practices.

 

The ongoing investigation has so far identified 57 patients who tested positive for hepatitis C and three for hepatitis B. Positive results have been reported for HIV, but Oklahoma State Department of Health data security policy regarding HIV disclosure prohibits public reporting of numbers fewer than 3, the Tulsa Health Department stated in a press release.

 

Health officials are now notifying people who participated in the screening of their test results. Those who tested positive are being personally contacted and counseled about information specific to the disease for which the test was positive, and they will be directed to resources for appropriate care and follow-up, the health department noted. If warranted, testing will be recommended for a spouse or partner.

 

The state dental board launched an investigation of Dr. Harrington on March 15 after being notified that Tulsa health officials were looking into a complaint about potential hepatitis C contamination at his practice. The group has asked prosecutors to file criminal charges against Dr. Harrington, who was cited as a health "menace" after investigators found rusty instruments and lax sterilization procedures in his office.

 

One of Dr. Harrington’s patients, Christina Quin, has filed the first lawsuit related to the case. Quin had four third molars extracted by Dr. Harrington in 2009 and was illegally given IV sedation by a dental assistant during the procedure. She was subsequently diagnosed with an infection and liver problems after developing a rash and a high fever following the extractions.

        

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The cost of blood tests for thousands of patients treated by a Tulsa, OK, oral surgeon who has been accused of potentially exposing his patients to blood-borne pathogens is nearing $700,000 and will likely go much higher, according to an Associated Press (AP) story.

The Oklahoma Board of Dentistry launched an investigation of W. Scott Harrington, DMD, on March 15 after being notified that health officials were looking into a complaint about potential hepatitis C contamination at his practice. On March 28, public health officials began notifying 7,000 of Dr. Harrington’s patients that they may have been exposed to blood-borne viruses at his Tulsa and Owasso offices and should be tested for hepatitis B, hepatitis C, and HIV.

As of last week, 3,568 of those patients had taken advantage of the free blood tests at county health departments, with each test costing about $195, according to the AP. So far, 65 have tested positive for hepatitis C, three tested positive for hepatitis B, and one or two for HIV.

However, it would be highly unusual for those patients to have contracted the illnesses at the doctor’s two Tulsa-area clinics, health officials told the AP. Officials also noted in their investigation that Harrington’s staff had said they knew several patients came to the clinic already infected, the story noted. 

        

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The Oklahoma Office of Juvenile Affairs (OJA) is currently working with the Oklahoma Healthcare Authority to identify juveniles who were patients of W. Scott Harrington, DMD, while at the L.E. Rader facility and Juvenile Services group homes.

Records date back to 1995 when the agency came into existence. Any juvenile covered by Medicaid in need of medical care would have been seen by providers — including Dr. Harrington — contracted with the Oklahoma Healthcare Authority.

Under Oklahoma law, any files or information regarding OJA youth are confidential and not for public review. However, OJA is actively working with the health department to identify the juveniles that were patients of Dr. Harrington and notify them by letter to contact the Oklahoma Health Department in order to be tested for HIV and hepatitis.

The Oklahoma Board of Dentistry launched an investigation of Dr. Harrington on March 15 after being notified that health officials were looking into a complaint about potential hepatitis C contamination at his practice. On March 28, public health officials began notifying 7,000 of Dr. Harrington’s patients that they may have been exposed to blood-borne viruses at his Tulsa and Owasso offices and should be tested for hepatitis B, hepatitis C, and HIV.

In related news, three more former patients of Dr. Harrington have filed lawsuits against the doctor, including one alleging that he caused the patient to contract hepatitis C, according to a story in Tulsa World. 

        

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Oklahoma health officials now say 70 people who were patients of Tulsa oral surgeon W. Scott Harrington, DMD, have tested positive for hepatitis C.

A fourth round of testing identified one new case of hepatitis C but no new cases of hepatitis B, according to an Oklahoma State Department of Health press release. In addition, four people have tested positive for hepatitis B and three have tested positive for HIV infections so far.

As of May 8, 3,820 former patients of Dr. Harrington have been tested.

Those whose tests are positive are being personally contacted and counseled about information specific to the disease for which the test was positive, and they will be directed to resources for appropriate care and follow-up. If warranted, testing will be recommended for a spouse or partner.

 

        

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The Pennsylvania Department of Health is advising patients of a York County dentist that they might be at risk for infection after an investigation discovered the dental facility did not follow appropriate infection-control procedures.

The health and state departments conducted a joint, unannounced site visit of the office of Jacqueline Marcin, DMD, on April 24. To date, the investigation has found that Dr. Marcin and her employees did not properly clean, disinfect, or sterilize devices at her York dental office.

State health officials have so far not received any related reports of disease transmission or illness. However, as a precautionary measure, they are recommending that current or former patients of Dr. Marcin who underwent dental procedures such as fillings, tooth extractions, or denture fittings get tested for hepatitis B, hepatitis C, and HIV. Testing is not currently advised for patients who only received routine cleanings or checkups performed by other staff members.

The Pennsylvania State Board of Dentistry temporarily suspended Dr. Marcin’s dental license on April 29.

The health department has set up a toll-free hotline — 855-265-4613 — as part of this investigation.

 

        

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Oklahoma health officials now say 73 patients of Tulsa oral surgeon W. Scott Harrington, DMD, have tested positive for hepatitis C.

 

Eight rounds of testing have identified three new cases of hepatitis C, according to the Oklahoma State Department of Health. In addition, five people have tested positive for hepatitis B and three have tested positive for HIV infections so far.

 

Patients whose tests are positive are being personally contacted and counseled about information specific to the disease, and they will be directed to resources for appropriate care and follow-up. If warranted, testing will be recommended for a spouse or partner.

 

The Oklahoma Board of Dentistry launched an investigation of Dr. Harrington on March 15 after being notified that health officials were looking into a complaint about potential hepatitis C contamination at his practice. On March 28, public health officials began notifying 7,000 of Dr. Harrington’s patients that they may have been exposed to blood-borne viruses at his Tulsa and Owasso offices and should be tested for hepatitis B, hepatitis C, and HIV.

To date, 3,927 people have visited county health departments throughout Oklahoma to have their blood tested. An unknown number have sought testing through their private healthcare provider. The state lab has tested for 4,018 people so far. The difference is due to the lab also testing people from other states, private physicians, and local county health departments.

 

        

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