Bulletin urges health care providers not to reuse single-use devices

Nevada's chief health care officer has issued a technical bulletin to all health care providers, reminding them that the reuse of single-use only endocavity needle guides during prostate biopsies "places the health, safety and welfare of the public at risk for blood-borne pathogens such as hepatitis B, hepatitis C and HIV."

The unusual action this week by Dr. Tracy Green came on the heels of the second major "breach of infection control" by a Southern Nevada physician who was reusing devices intended to be used on only one patient.

"I've never heard of anything like this (bulletin) before," said Dr. Joseph Thornton, an associate professor of surgery at the University of Nevada School of Medicine. "You're just restating the obvious to people who should know better. But maybe when you've had happen what's happened in this state, you have to."

On Monday, the Nevada State Medical Board suspended Dr. Michael Kaplan's license, saying the physician only stopped reusing single-use only needle guides for prostate/rectal biopsies when they became "too bloody."

Southern Nevada Health District officials have announced that the time frame when patients of Kaplan were at risk for contracting blood-borne diseases was between Dec. 20, 2010, and March 11, 2011. Patients with concerns should talk with their personal physicians, district officials said.

Three years ago, more than 40,000 patients at Dr. Dipak Desai's endoscopy clinics were notified that they had to be tested for hepatitis C and HIV after authorities saw his staffers reusing syringes and single-dose vials of anesthetics.

Green's bulletin tells all hospitals and other health care facilities to "review their policies and educate their staff regarding the use of single use only medical devices."

It goes on to say: "The thorough cleaning of single use medical devices with the use of hot water, scrubbing off blood and tissue matter or soaked in Cidex" -- a sterilizing solution -- "is not acceptable in any circumstance or situation."

According to the suspension order brought against Kaplan, the needle guides would be washed between patients, but the buildup of blood eventually was too much after use on multiple patients, and only then were they discarded.

Plastic endocavity needle guides are attached to the exterior of an imaging instrument for viewing internal organs and structures, regularly coming in contact with blood and body fluids as a needle passes through the guide to obtain a tissue sample. When the same guide is used on another patient, it is possible that any disease present could be transmitted.

Contact reporter Paul Harasim at pharasim@review
journal.com or 702-387-2908.