Patients Unable to Prove Bloodborne Pathogens Came from Dental Clinic

  When most people visit a doctor or a dentist, they expect to receive the highest quality of care. Those who arrive with ailments expect to find relief by the end of the visit. What happens when your visit to the dentist results in exposure to one or more bloodborne pathogens, such as hepatitis? This nightmare came true for three patients in Texas, who believe they became exposed to bloodborne illnesses at a government dental office. Were those plaintiffs able to receive compensation as a result? Could employees have prevented this catastrophe with quality bloodborne pathogen training? The truth is that any patient or employee may be carrying a bloodborne pathogen at any time. Bleeding is common during even routine dental procedures. Improper training of office staff can put every single patient at risk. If you work in a medical office, you are responsible for having current training in the spread of bloodborne illnesses. Read on to learn about what can go wrong if proper precautions are not taken, and bodily fluids spread. Your knowledge might help prevent similar problems in the future.

The Case of Ledermann et al v. U.S.

Between October of 2015 and August of 2016, three patients sought dental treatment at Coastal Health and Wellness in Texas. All three patients contracted Hepatitis C. Coastal Health and Wellness is a federally funded clinic, which means that it is overseen by the government. All three patients chose to press charges against the U.S. government because of their exposure to the bloodborne pathogen. The patients all underwent an invasive extraction procedure at the office. During an extraction procedure, it is common for there to be some exposure to bodily fluids such as blood and saliva. In an office that follows proper procedures, there is no threat of exposing other patients. In February of 2018, the Joint Commission on Accreditation of Healthcare Organizations conducted a surprise inspection of the clinic. They sought to determine if the proper procedures were being followed. This was more than a year after the initial appointments that allegedly led to the infections. The inspection revealed that the office did not meet the standards for accreditation. They cited issues with both administration and infection. They felt the spread of bloodborne pathogens to patients was plausible. As a result, the inspectors contacted all previous patients. The patients underwent testing for bloodborne pathogens, including HIV, Hepatitis C, and Hepatitis B. The three positive patients chose to press charges at this time.

What Happened in Court?

The plaintiffs were Steven Ledermann, Curtis Green, and Daniel Saldana. They chose to sue the U.S. government for medical malpractice. All received a diagnosis of Hepatitis C after their extractions, and all had since recovered. Because the defendant was the United States Government, the case fell under the Federal Tort Claims Act. This means that they chose to sue for medical harm due to the negligence of a government employee. The tort claims act ensures that courts follow a uniform series of procedures. Under the federal tort law, this case fell under Texas personal injury law. Under that law, the patients had to prove a causal connection between the dental procedure and the infection. They were unable to do so in court. As a result, the judge denied the claim, and they did not receive compensation.

Why Was The Claim Denied?

The court denied their claim because there was only a temporal association between the procedure and the infection. It was not enough to definitively prove that the patients contracted the hepatitis C infection at the office. All three patients possessed certain risk factors for hepatitis C. These factors were present before they underwent the extraction procedure at Coastal Health and Wellness. In fact, the infections may have been developing for as long as fifteen years. The court believed the stage of the patients' disease was too advanced. As a result, they probably did not become infected at the time of the procedure. To reach that stage, the infection would have had to begin about a decade before any patients entered the office. The lawyers assigned to the patients' case claim that the findings don't reflect the evidence that lawyers submitted as part of the trial. This is because there is documentation that there were violations related to sterilization in the clinic. They submitted evidence of improper bloodborne pathogen procedures spanning many years. At this moment, the firm plans to appeal the decision made by the court. They will continue to fight for justice for the patients. This might help ensure that the office will follow better sterilization procedures in the future.

Could Something Have Prevented This?

Whether or not the patients are successful, The Joint Commission was able to find and document some troubling things during their inspection. While they may or may not have caused hepatitis infections, they are problems that could lead to the spread of bloodborne pathogens. If not addressed, they could create major problems in the future. Foremost, the Joint Commission found that the clinic's employees were poorly trained in handling bloodborne pathogens. They believed this was a result of poor leadership. This led to issues with the general cleanliness of the clinic. Documenting when sterilization equipment maintenance is a major part of remaining in compliance. The employees at Coastal Health and Wellness failed to document when their sterilization equipment was last maintained. As a result, no record could prove that their other medical tools were being sterilized at all. Dental instruments must also be spore tested regularly. This is to ensure that employees catch any issues with the sterilization equipment before exposure. There was no record of regular or proper spore testing at the office in question. All this meant that any of the office's patients might have had exposure to hepatitis or HIV at any time. If a patient with a bloodborne illness undergoes a procedure and the instruments are poorly sterilized, the next patient risks exposure. This is incredibly dangerous and unprofessional. Both patients and employees are at risk of contracting these bloodborne diseases. This is why bloodborne pathogen training and compliance are so important. If the employees at the office had been in compliance, this case likely would never have seen the courtroom at all.

Might the Office Still Be at Fault?

Hepatitis C is an infection of the liver caused by the HCV virus. It is spread when a healthy person comes into contact with the virus. This is often through exposure to that person's blood. A patient with chronic Hepatitis C might not experience symptoms for a long time. This is why it is possible that the patients involved already had the infection in their system before their office visits. By the time symptoms appear, it is usually because the disease has advanced far enough to cause damage to the liver. The case results suggest that the patients all had risk factors for Hepatitis C before their extraction procedures. Due to the way that it's spread, the risk factors for Hepatitis C are behavioral. Risk factors include:

• The use of needles in injecting drugs
• Sharing other drug paraphernalia
• Working with blood or needles
• Unsafe intercourse
• Receiving dialysis for another condition
• Having body piercings or tattoos
• Jail or prison time
• Receiving a blood transfusion before 1992

It is possible that the patients referenced had exposure to the pathogens responsible in another way. There is no way to determine the specific source of a Hepatitis C infection. Although the office was not in compliance, they may or may not have been the source of the infection.

Bloodborne Pathogens Training

The best way to prevent the spread of bloodborne pathogens in medical or dental settings is to ensure that all employees are in compliance. This includes learning the correct wait to document the maintenance of sterilization equipment. Well-trained staff could have completed spore testing on the dental instruments used in the office. IACET provides accreditation for bloodborne pathogens training. This training is the only way to ensure that employees will learn the skills necessary to help your practice pass every inspection. It is the simplest way to ensure that your staff or patients are safe from the spread of bloodborne illness. You can receive IACET accredited bloodborne pathogen training online through HIPAA exams. Employees achieve certification after completing the module and receiving a score of 80% or higher. The training only takes about sixty minutes to complete. If you are seeking easy and reliable bloodborne pathogens training, visit HIPAA exams to learn more about your options. It's an easy and efficient way to ensure that your office and employees will remain in compliance. It might be the thing that prevents similar cases from coming to court in the future.