Risk At 'All Hospitals'


Doctors at the hospital where 24 people have been exposed to infection from a deadly brain disease knew which patients were at risk three months ago but failed to inform them, it emerged today.
Health officials are now trying to trace patients who could have been exposed to sporadic Creutzfeldt-Jakob disease (CJD) through contaminated instruments used during surgery at Middlesbrough general hospital during the summer.
A woman later diagnosed with CJD underwent neurosurgery on July 19 but instruments used during her operation were used again on more than 20 other people the in following months.
Ian Holtby, director of public health for Teesside, said doctors at South Tees hospitals NHS trust knew of the woman diagnosis on August 8 but only decided they would contact those at risk last Thursday.
Dr Holtby said: "It is unfortunate it has taken such a long time but it takes time to pull the experts together and it takes quite a while to pull the information out about the degree of risk."
But he told patients not to "worry unduly" about the potential risk of exposure to the fatal condition.
"Those people affected will be contacted, so if you haven't been contacted just forget about it," he advised.
The South Tees trust has withdrawn £90,000 worth of surgical equipment following the scare.
A hospital spokeswoman said: "We have withdrawn several drills, craniotomy sets [used by surgeons to cut open skulls] and general medical sets used in the theatre as a precaution as soon as the diagnosis was confirmed."
The Department of Health (DoH) claimed the instruments should have been quarantined as soon as it became clear there was a potential risk of transmitting CJD.
The chief medical officer has asked the regional director of public health, Dr Bill Kirkup, to look into the incident at Middlesbrough and report to him shortly.
Sir Liam Donaldson said the report "will ensure that any measures necessary to improve local procedures or strengthen national policy are taken".
He said: "The immediate need is to provide support and help for those who believe they may have been affected and I am assured that the hospital is now so doing."
Dr Paul Lawler, clinical director for South Tees hospitals NHS trust, said the equipment was not quarantined after the first operation because CJD was never suspected.
Dr Lawler said: "It is a terrible incident but nevertheless it could still happen tomorrow in this hospital or indeed in any other hospital."
CJD accounts for about 85% of all cases of the illness and, although it can prove fatal, it can also have an incubation period of up to 20 years.
It is not to be confused with variant CJD, which is the human form of BSE, and is potentially linked to contaminated meat.
Government guidance on the handling of instruments exposed to CJD has been in place since 1999.
A DoH spokesman said the guidelines to NHS trusts were there to "prevent the avoidable and unnecessary exposure to this disease".
Clive Evers, a spokesman and former chairman of the CJD Support Network, said the incident showed warnings were not being taken seriously.
"This is something that should not have happened. There has been guidance in place well before the time of this incident," he said.
"Clearly what is happening is that good, solid guidance is produced and it is not being disseminated, it is not being taken seriously, it is not being publicized enough to the people who need to have access to it. That's the lesson that has to be learnt."
First Published 10-30-02 © Guardian Newspapers Limited 2002,11098,822525,00.html


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