Hard economic times have everyone looking for ways to economize, including health care providers in Pennsylvania and around the country. Soaring health care costs and medical insurance companies that want to pay as little as possible for patient care are squeezing doctors and pressuring them to find ways to cut costs.

Unfortunately, cost-cutting urges in the health care field can lead to inadequate care for patients, or to shortcuts that put patients’ health at risk and amount to medical malpractice. An example of the latter is a situation that developed recently regarding a urologist who was found to be re-using endocavity needle guides. The needle guides are used in urologic procedures, such as prostate biopsies. These guides are intended to be single-use instruments; the manufacturers instruct that after one use, the needle guides should be disposed of as infectious waste.

The urologist told his staff that the endocavity needle guides were to be re-used up to five times. Patients who had procedures performed with previously-used needle guides were put at risk of contracting blood-borne diseases such as HIV and hepatitis C.

The urologist who was reusing the devices has officially been charged with medical malpractice by the State Board of Medical Examiners. The charges are that he continually failed to use reasonable care, skill, and knowledge in the treatment of 115 of his patients.

The manufacturers did not provide any instructions on how to disinfect the needle guides, because they were clearly labeled as single-use devices. But the urologists medical assistants would attempt to clean and disinfect them by running them under water, and then trying to scrape out any remaining tissue or blood without using a brush. They would then soak the devices in a disinfecting solution and allow them to dry.

The charges before the state medical board say that bits of tissue or blood would often remain on the devices after the attempted cleaning and disinfecting. Guides were then disposed of after becoming too bloody.

The doctor has claimed that the manufacturers told him the devices could be re-used three to five times, but none of the reference guides that come with the needle guides say anything other than that they are single-use instruments.

The case raises the question of why any health care provider would ever use a medical device on a patient that had blood or tissue on it from another patient. Pennsylvania medical malpractice attorneys would say that it is just another demonstration that there really are health care providers who are careless, or arrogant, or simply incompetent when it comes to patient care. Even though these care providers are a tiny minority of the whole, there still needs to be oversight of health care workers, and there needs to be a remedy through the legal system for victims to receive compensation for medical malpractice.

Source: ktnv.com “Dr. Kaplan officially charged by Nevada Board of Medical Examiners” 3/30/2011