N.Y. Surgeon ‘Likely’ Source of Hepatitis C in Three Patients

A cardiac surgeon at the Manhasset, N.Y., North Shore University Hospital "likely" infected three of his patients with hepatitis C and may be responsible for infecting four others following heart surgery, according to investigators from the New York State Department of Health, Newsday reports. Since the surgeon tested positive for hepatitis C in August, health department officials have been investigating a possible link between the surgeon and seven of his patients who have developed hepatitis C over the last nine years. According to a March 15 letter from the CDC, a sophisticated new laboratory test found "a high degree of similarity" between the surgeon's viral samples and those of three of his patients. "[W]e can say with the greatest degree of certainty that is probably ever going to be available to us that the surgeon appears to be the source of transmission," Kristine Smith, a spokesperson for the state health department, said (Rabin, Newsday, 3/27). Hospital officials said they are conducting "retrospective work and deciding exactly who should be notified." Health officials would have to notify more than 3,000 people if they decide to look for all of the surgeon's patients since the first case of hepatitis C among his patients was reported nine years ago (Lambert, New York Times, 3/28). "It is possible there are people out there who have not been diagnosed," Dr. Bruce Farber, North Shore's chief of infectious diseases, said, adding, "If there are people out there, we believe the number is negligible" (Rabin, Newsday, 3/28). Officials noted that no new cases have been found in 200 patients who have been tested since the surgeon's infection was discovered last year (New York Times, 3/28).

Cases Are 'Extremely Unusual'
Since testing positive for the virus, the surgeon, whose name has not been released to protect his confidentiality as a patient, has begun wearing a double set of gloves and informing patients prior to surgery of his hepatitis C status and their possible risks. In addition, he will begin using clamps instead of wires to close the chest cavity and may use "blunted needles" or defer closure of the chest to another surgeon. In accordance with New York law and CDC guidelines, the privileges of a health care worker are not curtailed because of a positive hepatitis C or other bloodborne disease test result, Farber said. The "cluster of doctor-to-patient infections" was "extremely unusual," health department investigators said, adding that medical literature has noted only six cases of doctor-to-patient hepatitis C infections in the United States and two other countries (Rabin, Newsday, 3/27).