Former patient files suit against Northwestern Memorial for alleged HIV exposure

[rakotomazoto]

Northwestern Memorial Hospital faces suit over alleged syringe reuse

Where I am training, there is a pretty strict one-use-per-syringe policy, so even re-using a syringe on the same patient would be considered a bad idea. Seems like common sense, but I have been at other hospitals where syringe re-use seemed pretty common. If you are getting sloppy with syringes, let this be a reminder. Before anyone rails against the high cost of only using a syringe once, just imagine how many syringes I could buy with the settlement money this patient is going to receive.

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[NICMAN]

I absolutely agree with not cross contaminating patients with syringes. That should never happen. But do you really throw away drugs (e.g., Fentanyl) every single time you give a single dose? That seems excessive and wasteful.

 

[caligas]

This is an issue of a few $hithead clinicians on the far extreme of lack of common sense leading to rules and regulations that defy common sense. (no vials used for multi dosing despite the fact that it can be done safely with minimal effort and care).

 

[Notorious T.E.E.]

I don't multidose the same vial for different patients, and I never have throughout my career. Unless it is something I carry with me, I have concerns about the person before me and their sterile technique. While it may be fine, I don't have the ability to confirm an open vial is clean and sterile. I have never used a drug that required multidosing enough to justify carrying it with me personally beyond phenylephrine, and even that generally gets used once per day so it isn't worth keeping track of it. I haven't worried about the legal risk too much in the past, but now it's one more reason to single dose everything.

 

[caligas]

I don't multidose the same vial for different patients, and I never have throughout my career. Unless it is something I carry with me, I have concerns about the person before me and their sterile technique. While it may be fine, I don't have the ability to confirm an open vial is clean and sterile. I have never used a drug that required multidosing enough to justify carrying it with me personally beyond phenylephrine, and even that generally gets used once per day so it isn't worth keeping track of it. I haven't worried about the legal risk too much in the past, but now it's one more reason to single dose everything.

Agree, if I didn’t open it I trash it

 

[Tuohy]

Get ready to write a big settlement check!!!


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[dannyboy1]

Get ready to write a big settlement check!!!


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Not sure about that. The patient did not end up contracting HIV. He is alleging “emotional damage”. Sounds like it was an honest mistake, there must have been a dirty syringe from the previous case that inadvertently got used. That being said, the anesthesiologist involved at least did the right thing and reported the incident. If this guy has his career derailed over this then most likely the next time this type of thing occurs to t will be swept under the rug. Just sayin’

 

[AdmiralChz]

If your group is so cheap they are reusing syringes between cases... the real question is what other corners are they cutting?

 

[Tuohy]

The issue here is that there was not immediate disclosure to the patient of what transpired the day of surgery. How would you like to be told about something like this weeks after it occurred???

 

[chocomorsel]

Northwestern Memorial Hospital faces suit over alleged syringe reuse

Where I am training, there is a pretty strict one-use-per-syringe policy, so even re-using a syringe on the same patient would be considered a bad idea. Seems like common sense, but I have been at other hospitals where syringe re-use seemed pretty common. If you are getting sloppy with syringes, let this be a reminder. Before anyone rails against the high cost of only using a syringe once, just imagine how many syringes I could buy with the settlement money this patient is going to receive.

Give me a break. Seriously, it's one thing to reuse syringes on the same patient. Another one completely to reuse dirty syringes on the next patient. If you aren't sure it's clean, waste it. Always start a new case with clean syringes.

Show me a study saying that reusing syringes on the same patient leads to higher complications. I did my research project on waste in the OR and this is one of the things I talked about. Look up green hospitals and what they do to limit waste and how this has affected their patient outcomes. This whole "one syringe/one use campaign" is completely wasteful and unnecessary.

I reuse all my syringes and for the most part I only use on average 3 to 4 syringes per patient because I am mindful on the effects of plastic on the environment. I reuse my multi dose vials only if I have opened them myself and I usually have some lido and sometimes Labetalol in my pocket for this reason.

I however come from a third world country so think a little differently about access and waste.

 

[deleted126335]

If your group is so cheap they are reusing syringes between cases... the real question is what other corners are they cutting?

It was almost certainly not “cheapness”. Very simply a mistake.

 

[BLADEMDA]

You know there is a legal issue when the CHAIR talks with the patient directly:

Doe was discharged soon after his surgery on Feb. 17, and it was not until his follow-up visit on Feb. 27 that he was told by Charles Hogue, chair of the Department of Anesthesiology, that the syringe had been reused. At this time, Hogue “intentionally” did not reveal the HIV status of the other patient, according to the complaint.

 

[anbuitachi]

Not sure how this accident even occured...

 

[dannyboy1]

What, you have never found a syringe from a previous case on or around your machine? All I takes is to accidentally pick it up..

 

[teeva]

You’re supposed to throw them out. Not pick them up.

 

[dannyboy1]

You’re supposed to throw them out. Not pick them up.

No $hit. Obviously the person did not realize that they were handling a contaminated syringe

 

[rakotomazoto]

I absolutely agree with not cross contaminating patients with syringes. That should never happen. But do you really throw away drugs (e.g., Fentanyl) every single time you give a single dose? That seems excessive and wasteful.

It is excessive and wasteful. But that is the enforced policy and culture and I am a humble resident. I do what I am told for six more months. Then, I will be free to use a little more common sense.

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[rakotomazoto]

Give me a break. Seriously, it's one thing to reuse syringes on the same patient. Another one completely to reuse dirty syringes on the next patient. If you aren't sure it's clean, waste it. Always start a new case with clean syringes.

Show me a study saying that reusing syringes on the same patient leads to higher complications. I did my research project on waste in the OR and this is one of the things I talked about. Look up green hospitals and what they do to limit waste and how this has affected their patient outcomes. This whole "one syringe/one use campaign" is completely wasteful and unnecessary.

I reuse all my syringes and for the most part I only use on average 3 to 4 syringes per patient because I am mindful on the effects of plastic on the environment. I reuse my multi dose vials only if I have opened them myself and I usually have some lido and sometimes Labetalol in my pocket for this reason.

I however come from a third world country so think a little differently about access and waste.

I am not suggesting that the policy where I work is the best way, but the further you move along the syringe reuse spectrum, the more likely you are to have an issue like the article mentions. Washing and reusing single use gloves is a very green method used in the third world, too. I am sure most people practice somewhere in the middle of these extremes.

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[anbuitachi]

What, you have never found a syringe from a previous case on or around your machine? All I takes is to accidentally pick it up..

Never... the room gets a turn over by either myself or the tech between every case, something mustve gone pretty wrong if you left a syringe on your machine and didn't realize it... mustve been day dreaming when turning/wiping down machine and equipments. I toss the syringe everytime i use it, go to the cart, and open a new syringe.

Edit: some people were confused. I mean I toss it after I finish using the syringe, not toss it after each bolus

 

[Ronin786]

Never understood the angst against multiple uses of the same drug vial. Of course, pharmacy companies prefer that you use one vial per patient so they can continue to make a profit. Just like their sham expiration dates.

 

[okayplayer]

Never understood the angst against multiple uses of the same drug vial. Of course, pharmacy companies prefer that you use one vial per patient so they can continue to make a profit. Just like their sham expiration dates.

Huh? May I reference you to the story 19 posts above yours?

 

[Ronin786]

Huh? May I reference you to the story 19 posts above yours?

They reused a syringe, not a vial. Show me the problem with drawing up 5 separate syringes from a 50cc propofol vial for GI or cardioversions.

 

[chocomorsel]

Never... the room gets a turn over by either myself or the tech between every case, something mustve gone pretty wrong if you left a syringe on your machine and didn't realize it... mustve been day dreaming when turning/wiping down machine and equipments. I toss the syringe everytime i use it, go to the cart, and open a new syringe.

This is completely wasteful and unnecessary.

 

[okayplayer]

They reused a syringe, not a vial. Show me the problem with drawing up 5 separate syringes from a 50cc propofol vial for GI or cardioversions.

You assume everyone (CRNA, junior resident, etc) use the same pristine sterile technique and good habits you do. If 1000 people do what you do, 1 will screw up. Not worth the risk to the patient/liability.

 

[Psai]

Never... the room gets a turn over by either myself or the tech between every case, something mustve gone pretty wrong if you left a syringe on your machine and didn't realize it... mustve been day dreaming when turning/wiping down machine and equipments. I toss the syringe everytime i use it, go to the cart, and open a new syringe.

???

 

[abolt18]

Never... the room gets a turn over by either myself or the tech between every case, something mustve gone pretty wrong if you left a syringe on your machine and didn't realize it... mustve been day dreaming when turning/wiping down machine and equipments. I toss the syringe everytime i use it, go to the cart, and open a new syringe.

I'm trying to understand this. You literally don't touch the same syringe to the patient's IV twice? What if your patient is requiring repeated doses of phenylephrine or ephedrine? You draw up single doses every time? Do you not have prefilled syringes at all in your facility? I know we have plenty. Do you give a small dose then thoss the remaining medication and syringe and get a new prefilled syringe, even though you only used 3 of the 10cc?

 

[Modanq]

This is the second major goof up at Northwestern Department of Anesthesiology. When I was a medical student there ~ 2006ish there were rumors of an OB anesthesiologist who was sleeping around and apparently resulted in a major neonatal complication. He did not respond to several pages while he was doing some hanky panky in the call room. The state had to step in and prevent the lawsuit from dipping into the University's endowment. Thats why NMH separated the finances from Northwestern University. I do believe perhaps thats what has led to turmoil in the Department with Interim Chair being a radiologist, residents education complaints (Not sure if true but I have seen threads here on SDN), massive turnover in attendings per my resident friends who are staff there. Not sure how much of this was conjecture at the time of the 2004 issues, but the lawsuit definitely exists
Family of boy disabled at birth to get $35 million

Maybe people on the ground can shed light.

 

[chocomorsel]

At one of the hospitals in town, the nurses scan the drug they pull from the Pyxis each and every time. Which requires a new vial each and every dose.
So if a patient needs 200mcg of Fent and you order 50mcg per dose, guess how many vials are pulled out for the total dose?

Such bull****. So wasteful. Because the computer has to scan an New Vial each time. I used to order small doses each time but sometimes I order the larger doses now to save waste.

 

[anbuitachi]

I'm trying to understand this. You literally don't touch the same syringe to the patient's IV twice? What if your patient is requiring repeated doses of phenylephrine or ephedrine? You draw up single doses every time? Do you not have prefilled syringes at all in your facility? I know we have plenty. Do you give a small dose then thoss the remaining medication and syringe and get a new prefilled syringe, even though you only used 3 of the 10cc?

I said between cases.. so for different patients.

And I mean I toss the syringe after I finish using it

 

[Psai]

At one of the hospitals in town, the nurses scan the drug they pull from the Pyxis each and every time. Which requires a new vial each and every dose.
So if a patient needs 200mcg of Fent and you order 50mcg per dose, guess how many vials are pulled out for the total dose?

Such bull****. So wasteful. Because the computer has to scan an New Vial each time. I used to order small doses each time but sometimes I order the larger doses now to save waste.

When I did that, the nurses freaked out over "large doses" that were no different from doses of other meds they gave but they were just unfamiliar with the numbers. Now we are getting informed that we have a critical shortage of medications. HMM I WONDER WHY

 

[chocomorsel]

When I did that, the nurses freaked out over "large doses" that were no different from doses of other meds they gave but they were just unfamiliar with the numbers. Now we are getting informed that we have a critical shortage of medications. HMM I WONDER WHY

This has got to be one of the most wasteful things I have seen recently. Do people who run these hospitals have any concept of how much money they are throwing away? Literally? In order to please the computers? Are you kidding me?

 

[TraumaLlamaMD]

Our PACU right now is down to 4mg vials of Dilaudid only... so anyone who gets a human dose is just pouring useful drug down the drain.

 

[deleted162650]

Our PACU right now is down to 4mg vials of Dilaudid only... so anyone who gets a human dose is just pouring useful drug down the drain.

Just ask pharmacy to split them for you.

 

[leaverus]

one use per SYRINGE on the same pt?? wtf. that's just plain stupid.