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A Central Texas nurse likely infected at least one patient with Hepatitis C when the nurse reused saline syringes, according to a report this month from the Centers for Disease Control and Prevention.
The 2015 incident happened in Region 7 of the Department of State Health Services, a 30-county area that includes the Austin metro area counties of Travis, Williamson, Hays and Bastrop, agency spokesman Chris Van Deusen said.
Because “communicable disease investigations are confidential,” he said, the department would not the county or hospital where the incident took place.
The nurse had been reusing pre-filled syringes for saline flushes in the IVs of multiple patients, putting the patients at risk of contracting blood-borne diseases, the report said.
The incident was reported to the health services department in October 2015.
“The nurse reported reusing syringes during the previous six months, erroneously believing that this was a safe, cost-saving measure if no fluids were withdrawn into the syringe before injection of the saline flush,” the report said.
The nurse had been working at the health unit for 18 months and had not worked at another health care facility before, the report said.
The hospital notified patients and offered screenings to patients who might have been cared for by the nurse from April 2014 to October 2015, the reports said.
As of October 2016, 67 percent of these patients had completed an initial screening, and 46 percent of them had completed all recommended tests, the report said.
Four patients with newly diagnosed blood-borne pathogen infections were identified: two with Hepatitis B and two with Hepatitis C.
One patient had been hospitalized the same day as a second patient, and they shared the same rare strain of Hepatitis C, the report says. The other patients did not share overlapping hospital days with any patient with these infections.
“Taken together, these findings indicate that at least one (Hepatitis C) infection was likely transmitted in the telemetry unit as a result of inappropriate reuse and sharing of saline flush syringes for multiple patients,” the report concludes.
“This investigation illustrates a need for ongoing education and oversight of health care providers regarding safe injection practices,” the report said.