|
1843 -1987
History of
Syringes |
Syringe reuse a
widespread
problem: U.S.
expert-
...larger
problem than
once thought,
even though the
practice is
inexcusable...hepatitis
outbreaks linked
to dirty
syringes
|
|
1920-87 Global
Disaster
Prediction |
DEADLY NEEDLES
Fast Track to
Global Disaster-
For decades,
researchers
warned...syringes
could transmit
... efforts to
defuse the
crisis were
failed, and
today...become
an insidious
global epidemic,
destroying
millions of
lives every
year.
|
|
1970 Jetgun
Nursing
Instructions |
How to use the
jetgun,
detailing how
the device got
contaminated.
|
|
1988 A
microbiological
study |
Unsafe
injections in
the developing
world and
transmission of
bloodborne
pathogens: a
review-...Five
studies
attributed
20-80% of all
new infections
to unsafe
injections...major
mode of
transmission of
hepatitis C...
occur routinely
|
|
1996 CDC Jetgun
Advisory
Committee |
Faulty
Design...Various
routes of
transmission
...documented,
including
...blood
products, use of
jet gun
injectors with a
design fault
that allowed
blood to remain
inside the
equipment,
re-use of
contaminated
needles and
syringes, and
indirect
transfer from
contaminated
environmental
surfaces in
haemodialysis
units....
|
|
1996 WHO Jetgun
Warning |
When tested on
animal models
the metal cap
was found to be
contaminated
after 1 in 7
injections
|
|
1997 DoD Jetgun
Report |
Vaccines in the
Military- Wide
review of
Vaccine Policies
and Procedures
... says, ...jet
injector nozzles
were frequently
contaminated
with blood, yet
sterilization
practices were
frequently
inadequate or
not followed."
|
|
1997 WHO Jetgun
Statement |
Safety of
Injections-...-Needle-free
injectors
designed for use
with multi-dose
vials...should
not be used for
immunization.
These injectors
have an inherent
risk of
bloodborne
disease
transmission...
|
|
1999 Federal
Safety Needle
Legislation |
Federal Safety
Needle
Legislation-"...accidental
needlesticks...76%,
the highest rate
of any device
...million per
year...result in
the
transmission...
|
|
1999 Global
Injections |
Unsafe
injections in
the developing
world and
transmission of
bloodborne
pathogens: a
review-...Five
studies
attributed
20-80% of all
new infections
to unsafe
injections...major
mode of
transmission of
hepatitis C...
occur routinely
|
|
2000 CIA Warning |
The Global
Infectious
Disease Threat
and Its
Implications for
the United
States-John C.
Gannon Chairman,
National
Intelligence
Council
|
|
2000 Origins of
HCV Epidemic |
"Why does the
world's medical
community
continue to
ignore these
figures...stop
the practice of
allowing
multi-use
syringes...
world over.
mandatory in all
mass vaccination
programs...contribute
significantly to
the scourge of
disease..."
|
|
2001 CIA Report |
Table
|
|
2001 Policy
Change Surgery |
Women contract
hepatitis C in
surgery-
National
infection
control
guidelines are
to be toughened
after two women
contracted
hepatitis C
during routine
surgery in
Victorian hospitals
|
|
2002 Small Pox
Needles & Jet
Injectors |
THE SMALLPOX
VACCINE... Is
the use of a jet
injector gun the
best way to
administer the
vaccination?
|
|
2003 Aids Crisis
& Dirty Needles |
Aids crisis: Are
dirty needles to
blame?-The
spread of HIV
infections in
Africa may be
more closely
linked...estimates
that
two-thirds...
infected through
contaminated
needles rather
than sexual
contact.
|
|
2003 Global
Burden Italy |
Poorly cleaned
glass syringes
used to
administer the
polio vaccine in
the 1950s and
60s could have
spread the
hepatitis C
virus
|
|
2005 DoD List
Vaccines Given
to All Troops |
Discriptions:
Immunization to
Protect the U.S.
Armed Forces:
Heritage,
Current
Practice,
Prospects from
DoD, Office of
the Surgeon
General, U. S.
Army..
|
|
2005 Global
Burden Egypt |
Researchers at
the University
of Maryland
School of
Medicine... high
prevalence of
hepatitis C
...traced to
mass treatment
... fight a
common illness
...decades ago.
|
|
2005 Gloves
Transmits HCV
Disease |
Industry surveys
show glove
failure rates
vary from 11
percent to 51
percent...A
healthcare
professional's
risk of exposure
and the
subsequent
potential for
seroconversion
can be
significant
|
|
2005 Needleless
Connectors
Relationship |
Needleless
Connectors and
Bacteremia: Is
There a
Relationship?
...integral
components of an
infusion
system...healthcare
worker safety
...as part of
the continuing
development of
infusion
technology
|
|
2008 CDC
Infection
Control
Requirements |
To avoid
contamination
and potential
spread of
infection...
medications and
solutions must
be handled using
proper infection
control
precautions as
described in CDC
guidelines and
now mandated
through the new
CMS
|
|
2008 Jet
injectors &
Bifurcated
Needles |
The Unintended
Consequences of
Vaccine Delivery
Devices Used to
Eradicate
Smallpox:
Lessons for
Evaluating
Future
Vaccination
Methods B. G.
Weniger..
|
|
2008 Legal
Advice for
Patients |
PUBLIC HEALTH
CRISIS: Queries
irk hepatitis
patients-
Attorneys
telling clients
not to reveal
past drug,
sexual activity-
Southern Nevada
Health
District's
intent to
embarrass...when
it determined
what questions
to ask former
patients of two
Las Vegas
gastroenterology
clinics
regarding their
past risk
factors for
hepatitis...
|
|
2008 Multi-Risk
Transmission
Factors |
Frequency
distribution of
hepatitis C
virus genotypes
in different
geographical
regions of
Pakistan and
their possible
routes of
transmission-
Infectious
Diseases 2008,
8:69...More than
70% of the cases
were acquired in
hospitals
through reuse of
needles/syringes
and major/minor
surgery...
|
|
2008 NV State
Investigation
UPDATE |
So Nevada
Hepatitis C
Investigation
UPDATE:"Patients
were put at
risk, health
officials say,
when a syringe
would be reused
on an infected
patient and then
used to draw
anesthesia from
vials intended
for just one
patient. The
vials would then
be used on other
patients,
potentially
spreading
disease."
|
|
2008 USP Policy
Change-Multiuse
Vials |
Recommended
Practices for
Multiuse Vials
Status and
Update to
General Chapter
797
Pharmaceutical
Compounding –
Sterile
Preparations
|
|
2008 VA Nevada
Exposures
|
VA Office of
Inspector
General,inspectionefurbished
scopes were
purchased and a
scope broke...
GI providers
reused
syringes...contaminated
medication from
vials...contracts
were awarded to
the GI provider
group or that
senior managers
received
kickbacks.
|
|
2009 2 Veterans
Affairs hospital |
FDA Alert issued March 19, 2009. The information was released after reports
that 2 Veterans Affairs hospitals, at undisclosed locations, were changing
needles, but using the same cartridge
|
|
2009 CDC Report-
Hemodialysis
Unit |
Hepatitis C
Virus
Transmission at
an Outpatient
Hemodialysis
Unit --- New
York, 2001--2008
-... negative
to anti-HCV
positive in a
New York City
hemodialysis
unit Supervisory
staff members
failed to
address these
breaches. Many
of the direct
care staff
members were
unaware of
...unit's
written
infection
control
policies,
including those
pertaining to
cleaning and
disinfection.
Investigators
also noted the
lack of a
separate clean
area for... has
8% risk factor
|
|
2010 Lawsuit
Nevada |
...Health
officials have
blamed reuse of
vials ...
jury...ordered
Teva ... to pay
$356 million in
punitive
damages..Baxter...$144
million..
|
|
2011- CDC
Vaccine
Guidelines |
CDC guidleines
for appropriate
vaccine
administration.
the following
guidelines for
standard
practices during
injections of
vaccines were
not followed by
the military
during the
height of the
hepatitis
epidemic.
Needles,
syringes and
vials were
commonly reused.
|
|
2011- CDC
Vaccine
Guidleines |
CDC guidleines
for appropriate
vaccine
administration
|
|
Dangers of EMG
Needles |
|
|
Dried Hepatitis
C Blood Exposure |
The Hepatitis C
virus
transmitted for
63 days after
the virus dried
and the contents
of syringes and
surfaces were
analyzed
|
|
Exeter Hospital
Statement |
All healthcare
providers...
access to the
treatment area
...The Centers
for Medicare and
Medicaid
Services (CMS)
conducted an
unscheduled
survey on June
6, 2012
following the
public
announcement of
hepatitis C
infections at
Exeter Hospital
|
|
Preventing
infection from
the misuse of
vials |
Since 2001, at
least 49
outbreaks due to
the mishandling
of injectable
medical
products...150,000
patients
required
notification ..
potential
exposure to
unsafe
injections.
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