Six Port Alberni residents are being monitored for bloodborn diseases after unsterilized medical equipment was used on two of them during medical treatment at West Coast General Hospital.
The Vancouver Island Health Authority has confirmed that the incident happened on Sept. 15, spokesperson Anya Nimmon said.
The incident occurred during a night shift when a registered nurse in the emergency department wanted extra incision trays for the following day’s medical procedures.
The equipment is used for minor procedures requiring incisions.
The RN accessed the hospital’s sterilization room where she retrieved medical equipment trays that were cleaned but not sterilized.
She took them back to the emergency department, where the following day six procedures were performed.
Hospital officials retrieved the unsterilized equipment when they realized what happened, but two patients had already been operated on, Nimmon said.
Hospital officials don’t know which two of the six patients had procedures done with the unsterilized equipment, she added.
All six patients have been contacted through their personal physicians, and all will undergo medical monitoring for the next six months. “The risk for exposure to bloodborne pathogens is very small because the instruments were already clean,”Nimmon said. “We are taking the precaution of ensuring that the six patients who had procedures done all have follow-up blood testing.”
Hospital and infection prevention and control officials have reviewed the incident and the processes for accessing sterile equipment.
Access to the sterilization area is now limited. The area has also been re-keyed, and extra keys are only available except to staff who work in the sterilization area. As well, extra supplies will be kept in the emergency department.
Equipment packaging contains a sticker or plastic tab that changes colour if it has been sterilized, and staff have reminded of how to identify this.
Nimmon would not, however, disclose if the RN responsible was reprimanded or dismissed. “We do not discuss discipline or confidential personnel issues publicly,” she said. “We feel we have responded to this error appropriately and that the best approach in moving forward is to ensure it doesn’t happen again.”
A procedural review is well and fine but it should have been done regularly and a long time ago, NDP deputy health critic Sue Hammell said.
“Maybe a review should have been done well before,” Hammell said. “When this can happen there is something wrong.”
The incident isn’t the first of its kind in the province. In2010, 9,000 patients in the Kamloops region were monitored after possibly being exposed to contamination at Royal Inland Hospital.
And in 2007, 57 patients underwent monitoring after possible contamination exposure at Mills Memorial Hospital in Terrace, B.C.
“There’s a a big warning bell ringing about quality assurance, and yours is an example of it,” Hammell said.