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Hepatitis outbreak lessons shared at Exeter forum

Union Leader Correspondent

June 24. 2013 8:31PM

EXETER — The hepatitis C outbreak at Exeter Hospital and the investigation that followed was “unlike anything we’ve ever seen before,” Nick Toumpas, the state’s health commissioner, told about a dozen people who attended a community meeting Monday night.

Toumpas was one of several state health officials and others involved in the investigation who attended the meeting at Exeter High School to share the state’s final report on the probe with the public and answer questions.

The meeting was called after the state Department of Health and Human Services released the report last Friday on the outbreak allegedly linked to former Exeter Hospital medical technician David Kwiatkowski.

The agency’s Division of Public Health Services launched an investigation in May of 2012 after 32 hospital patients were infected with Kwiatkowski’s strain of hepatitis C.

Authorities say Kwiatkowski, who is in jail awaiting trial on federal charges connected to the outbreak, allegedly infected the patients with the virus by stealing the painkiller fentanyl, using the drug on himself, and then filling the syringes with saline and replacing them to be used on unsuspecting patients.

Kwiatkowski worked at as many as 18 hospitals as a traveling medical technician before he was hired at Exeter Hospital. He was fired from a hospital in Pennsylvania in 2008 after he was found in an area where he wasn’t assigned and again in 2010 while working at an Arizona hospital where he was reportedly found unresponsive in a locker room with syringes and needles on him.

The hepatitis C report detailed the action taken by the Division of Public Health Services and its investigators and others at the federal and state levels. It also recommended steps that other health-care facilities should take to stop a similar outbreak in the future.

“This was a con artist and he lied his way through life,” said Dr. Sharon Alroy-Preis, the state epidemiologist.

The report also explains the testing process and details the investigations into procedures at Exeter Hospital, employee interviews, operations of clinics, the state lab work and other work performed during the probe.

“We all know that drug diversion is a constant threat in health-care facilities,” she said, adding that steps need to be taken to “close the gaps” to stop the problem.

“The most important thing is to really develop a strategy with a clear plan and dedicated staff being proactive about drug diversion and not reactive,” Alroy-Preis said.

Among the recommendations, the state suggested increasing regulation and improving the sharing of information on traveling health-care workers; ensuring monitored and limited access to controlled drugs in health-care settings; closer monitoring of employee access to restricted areas during procedures; ensuring real-time accountability for controlled substances before, during and after procedures, including any medication that isn’t used; and developing a clear and concise plan for prevention and early detection of drug diversion.

The report has drawn criticism from Exeter Hospital CEO Kevin Callahan, who wrote a letter to Dr. Jose Montero, the state’s public health director, expressing his disappointment with the report, which he claimed did not “fairly represent Exeter Hospital, its staff, or the facts as we know them.”

Callahan wrote that many of the statements and conclusions in the report are “demonstrably false.” He also pointed out several examples of how the hospital took steps to uncover the alleged acts of a “single healthcare worker with criminal intent.” Since the outbreak, Callahan said the hospital has implemented several new policies to “further secure medication.”

Callahan’s criticisms concerned Paul Kleinman, an attorney from Exeter who represented clients involved in the outbreak.

Kleinman said he’s concerned because it appears the hospital, which he believed was working with the state, is contesting the findings of a report aimed at making improvements in the healthcare industry.

Exeter state Rep. Steven Briden said he hopes the outbreak leads to positive steps that the state and health-care facilities can take to improve “best practices.” He said he would like to see the industry make the necessary changes to avoid the need for legislative action.

Health Exeter

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