Hepatitis C Outbreak: How Did It Happen?
Taking a closer look at a public health disaster.
The concern in the doctor's voice was palpable.
"We are taking this very seriously," declared Dr. Richard Hollister, Exeter Hospital's chief of medicine, during a news conference at the hospital May 31.
Officials had just announced a hepatitis C outbreak at the hospital affecting four people. The discovery was certainly out of the ordinary, but its scope appeared limited.
Clad in a white lab coat, with a stethoscope draped around his neck, Hollister gripped a podium as he spoke to about a half-dozen local reporters. The initial outbreak garnered state and regional – but not national – news coverage.
Hollister projected confidence as he described how the outbreak was discovered in the cardiac catheterizaton lab and how the hospital would work with state health officials to get to the bottom of it.
It was typical boilerplate for mishap management.
But at the end of his remarks, Hollister's tone turned personal.
He talked about how he was also a "member" of the Exeter-area "community."
It seemed apologetic, as if the whole situation was a burden he – and the community – would have to bear.
'No one expects to go to a hospital to get sick'
It wasn't long before the outbreak went from bad to worse.
A week after the news conference, state health officials announced six more patients tested positive for hepatitis C – a chronic and sometimes deadly liver disease. On June 10, another four cases were announced. Officials delivered both of the announcements to the media through prepared statements.
The next announcement required more than a press release.
New Hampshire Public Health Director Dr. Jose Montero called a news conference in Concord on June 13. He said another six people tested positive for hepatitis C, bringing the total to 20.
Then came the shocker.
Montero announced the likely cause of the outbreak was a hospital worker who was stealing drugs. The worker, who was likely infected with hepatitis C, probably relied on a tactic called "drug diversion," Montero said. That's when a hospital worker feeds a drug habit by injecting him/herself with drug-filled syringes, replacing them with saline or water, and then allowing them to be used on unsuspecting patients as if they were still filled with drugs.
"It's disturbing," Montero said. "No one expects to go to a hospital to get sick."
Officials have not identified the rogue employee. They are currently focused on testing hundreds of patients who may have been exposed to the outbreak. Montero said the victim toll will likely rise as more results come back.
Victims worried for their lives
Outbreak victims are worried for their lives.
One of them is a man who made it through open heart surgery before contracting hepatitis C.
"I'm scared," he said. "My family is scared, my friends are saddened.
"It saddens me that I made it through open heart surgery only to be beat down by a virus ... I am faced with the fear of more complications or death."
He added that Exeter Hospital's staff has been handling everything in a "responsible" manner.
The wife of another victim has a different take. She told Exeter Patch on June 11 that the hospital hadn't apologized and that her husband hadn't been provided a treatment plan to fight hepatitis C. Her husband is also battling lung cancer.
"We aren't getting a lot of information," the wife said. "All the information I have presented him has been from (the media)."
On June 14, Exeter Hospital CEO Kevin Callahan went on WMUR-TV and apologized for the outbreak, adding that the hospital is willing to pay for the health care costs of victims.
A pending court battle
Criminal charges, new legislation, and huge lawsuits are likely in the coming months and years.
On the same day of Callahan's televised apology, the New Hampshire Attorney General's office said it was launching a criminal probe. This week, the FBI joined the investigation.
If the hospital employee is indeed found to have caused the outbreak, that person will likely face serious charges.
In 2010, a Colorado woman was sentenced to 30 years in prison for infecting 36 patients with hepatitis C in a drug diversion scheme.
Kristen Parker, who has hepatitis C, was convicted of injecting herself with the narcotic Fentanyl at the hospital where she worked. She replaced the needles with saline, and they were then used on patients.
Prosecutors originally recommended 20 years in prison for Parker, but a judge added on 10 more years because of the severity of the case, according to CBS News.
In the aftermath, Colorado lawmakers created legislation introducing enhanced security measures to prevent future drug diversion incidents. Several other states have similar legislation. New Hampshire is not one of them – yet.
The largest hepatitis C outbreak in U.S. history occurred in 2008 at a medical center in Nevada. More than 100 people were infected with the disease and at least one died. Victims successfully sued the medical center and drug companies for more than $500 million dollars in damages. It was the largest settlement of its kind.
The source of that infection was traced to medical staff reusing syringes to treat patients. A doctor in the case is currently facing a trial on a host of criminal charges, including fraud.
Two class-action lawsuits against Exeter Hospital are already in the works.
One lawsuit is for the patients who have contracted hepatitis C. The other lawsuit is for the hundreds of patients who need to be tested for the disease. The lawsuits are being prepared by the Concord-based McGrath Law Firm.
Law firm founder Peter McGrath, a former federal prosecutor, said the hospital committed a colossal lack of oversight. He said the people who were treated at the cath lab but didn't contract hepatitis C are still victims because they weren't given the proper amount of medication because of the drug diversion tactic.
McGrath said his clients want to make sure this type of outbreak "never happens again." He said children of some of the victims have been "in tears" about their parent's diagnosis.
Exeter Hospital officials did not respond to a request for comment on whether they are prepared to deal with the coming lawsuits.
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