CLINIC HEALTH FEARS
Infection concerns over equipment
Patients on their way to Stittsville’s Main Street Family Medical Centre Tuesday were alarmed after learning improper cleaning of equipment at the clinic could have left thousands of patients at potential risk of hepatitis and HIV.
“Is it safe to go in?” asked Ravi Samani as he headed in to an appointment at the clinic above a Stittsville grocery store.
Ottawa Public Health announced the health threat at a news conference Tuesday, saying that although the risk is low, 4,600 patients of the clinic who had minor surgical procedures should undergo testing for hepatitis B, hepatitis C and HIV.
The city’s associate medical officer of health, Dr. Geneviève Cadieux, described it as a precaution.
“The protection of the public’s health is our top priority,” Cadieux said. “As soon as Ottawa Public Health identified the infection prevention and control lapse at the Main Street Family Medical Centre, they acted immediately to ensure no ongoing risk to the public.”
The clinic was open Tuesday with four physicians working, according to staff, and a handful of patients waiting to see a doctor. A receptionist said no one was available to comment.
“It is quite alarming, especially when we are talking about the potential exposure to younger patients who have weaker immune systems,” said Samani, a new patient at the clinic that other members of his family attend.
The clinic is mailing letters to the 4,600 people identified as potentially being at risk along with preauthorized prescriptions for blood tests to screen them for hepatitis B, C and HIV.
Ottawa Public Health investigated the clinic after receiving a complaint on April 24. The investigation identified a lapse in the cleaning and sterilization of medical equipment. Patients who underwent some minor surgical procedures — such as removal of skin tags, moles or cysts using blades or scissors, skin biopsies, incision, drainage or packing of an abscess or cyst, applying of stitches, removal of an ingrown nail or removal of a foreign object — might be at risk of infection and are being notified.
The potential risk does not extend to injections, drawing of blood, removal of skin lesions and warts using liquid nitrogen, pap tests, endometrial biopsies and swabs, said Ottawa Public Health.
Health inspectors found, among other things, some single- use disposable equipment was repackaged for re-use, some equipment was not being cleaned properly, hand sanitizers were out of date and records weren’t being properly kept on sterilizing equipment.
Cadieux stressed that the possibility is low that someone contracted a blood-borne disease as a result of the improperly cleaned medical instruments. There is a less than one-per-cent chance of a patient having one of the diseases, she said.
However, because there is a chance it could have occurred, Public Health is erring on the side of caution and asking patients to get tested.
Public Health has received no indication that any diseases have been transferred as a result of the cleaning lapse.
During its investigation, Public Health worked with officials from the College of Physicians and Surgeons of Ontario, which regulates physicians and their practices in the province. Public Health said the college is responsible for setting regulations and requirements for sterilization of all medical tools and devices and that doctors are a self-regulated profession.
In a statement, the college said it is “committed to working with physicians and members of the public to ensure that patients receive the highest quality care.
“We take any concerns about the safety of the care being provided to patients very seriously. We have been working in close co-operation with Ottawa Public Health to investigate the concerns raised and will determine next
steps based on the results of that investigation.”
The infection scare at the Stittsville clinic comes seven years after 6,800 patients at the Carling Avenue endoscopy clinic of Dr. Christiane Farazli were notified that they might have been exposed to infectious diseases because of poor sterilization procedures. No cases of infection were found as a result of the testing.
The risk was discovered during a routine inspection of the clinic by the college, which found “gross cross-contamination” from a dirty scope, among other things.
The college only began routinely inspecting such out-of-hospital surgical clinics in 2010, partly in response to the earlier death of a 37-year-old Toronto real estate agent who was undergoing liposuction at a private clinic.
Until then, inspections of out-of-hospital clinics that perform liposuctions,
gastroscopies and plastic surgery were done on a complaints basis — similar to the current procedure for doctors’ clinics.
In 2015, after an infection control lapse at a doctor’s office, the medical officer of health for Sudbury and Algoma called for more routine inspections of doctors’ offices, noting tattoo parlours and nail salons get regular inspections, but doctors’ offices only get inspected after a patient complains.
Meanwhile, Ottawa Public Health officials would not specify what the Stittsville clinic was doing wrong with its cleaning regimen. It simply said it found a number of “issues” that were cause for concern.