EXETER, N.H. — The U. S. attorney’s office has joined the investigation into the hepatitis C outbreak at Exeter Hospital’s cardiac catheterization lab.
State public health officials have said they suspect a lab employee’s misuse of drugs led to the outbreak. A hospital worker and 19 of the lab’s patients have tested positive for the liver-destroying disease since the investigation began last month.
U. S. Attorney John Kacavas said Tuesday his office has brought in personnel from the Food and Drug Administration and FBI to determine whether the outbreak is a criminal or civil matter.
Doing so isn’t uncommon in such situations, he said.
“This case presents a matter of public health and safety, and we have statutory authority at the federal level that fit these precise circumstances,” he said.
The state attorney general’s office also is investigating the outbreak, and a Concord lawyer is preparing a class-action lawsuit against the hospital. Attorney Peter McGrath said Tuesday that 23 people have joined his suit, which accuses the hospital of negligence in supervising its staff.
The suit seeks damages for patients who were infected with hepatitis C as well as those who paid for medication they did not receive.
At least three other lawsuits related to the viral outbreak have been filed in Rockingham Superior Court.
Two were filed by medical malpractice attorney Mark Abramson, of the Manchester law firm Abramson Brown & Dugan, who is representing several patients who have tested positive in the outbreak.
A 61-year-old Newmarket woman represented by Portsmouth attorney Michael Rainboth, of Coughlin, Rainboth, Murphy & Lown, also brought litigation against the hospital this month.
The hospital has declined to comment on the lawsuits or the criminal investigation.
In the meantime, the Department of Health and Human Services announced Tuesday it will open new testing sites for the scores of patients being asked to get screened for hepatitis C.
All patients treated at Exeter Hospital’s cardiac catheterization laboratory between Oct. 1, 2010, and May 25, 2012, are being asked to get tested.
“We have set up these additional locations in response to the public meeting on Friday night,” said NH Public Health Director Dr. Jose Montero, “where a number of people were asking if there was another option (besides Exeter Hospital) available for blood draws.”
At a meeting held Friday, June 18, Montero divulged for the first time that several blood samples collected this month as part of the hepatitis C investigation had to be thrown out because they reached the state lab too late to be tested.
Blood samples must be screened for the virus within 72 hours after they’re collected to ensure the results are accurate.
Patients affected by the error are now being asked to have a second blood sample drawn.
At last week’s public meeting, some of those patients told Montero they no longer trust Exeter Hospital to collect blood samples competently.
In response, the state has announced patients will have the choice to have blood drawn at two alternative sites affiliated with Portsmouth Regional Hospital.
One will operate at 55 High St., Suite 104, in Hampton; a second site will operate at 26 Manchester Square at Pease International Tradeport in Portsmouth.
Exeter Hospital and the state health officials continued to blame each other Tuesday for the mistake involving the blood samples, which affected 24 patients.
Those patients visited Exeter Hospital on Thursday, June 7, and Friday, June 8, to have blood drawn.
The hospital claims a courier hired by the state picked up the blood work up on Saturday, June 9, but the public health lab failed to test the specimens in time.
Public health officials dispute that claim. They say they didn’t get the specimens until the following Monday, June 11, after they had already expired.
In an interview Tuesday, State Epidemiologist Dr. Sharon Alroy-Preis said the courier did pick up a box of specimens on Saturday, but it didn’t contain the 24 specimens in question.
“Our records show that we got them on Monday,” she said. “What happened, I don’t know. We’re looking into that with the hospital.”
Alroy-Preis said one factor that might have contributed to the confusion is the fact that the hospital attempted to roll out a new specimen delivery system on Monday, June 11.
Given the volume of blood samples being delivered to the state laboratory, Alroy-Preis said both parties agreed to have the hospital take over responsibility for delivering specimens beginning that Monday.
The plan was scrapped after state health officials discovered the 24 botched blood samples, she said.
An Exeter Hospital spokesman declined to answer questions about the errors Tuesday, and referred to a statement posted on the hospital’s website.
“The hospital is committed to determining, together with the state, why these samples were not processed within the required 72-hour time frame, even though they were picked up from Exeter Hospital on Saturday by the state’s courier,” the statement reads.
To prevent any “future challenges,” the hospital has stopped collecting specimens on Fridays, according to the statement.
In total, 27 specimens have now been allowed to expire before they could undergo testing for hepatitis C, Alroy-Preis said. That figure includes three additional samples not related to the other batch of 24. Alroy-Preis said she could not recall what happened to the other three specimens that prevented them from being tested.
So far, more than 800 people have been tested for the virus. A total of nearly 1,200 patients are being sought for testing.
As the hospital prepared for a torrent of litigation this month, the organization also launched an effort to provide comprehensive treatment for patients who test positive for hepatitis C.
Regardless of whether they’re linked with the outbreak, people who are diagnosed with hepatitis C through the diagnostic tests taking place this month will be eligible for assistance from an Exeter Hospital “task force.”
The program is being spearheaded by gastroenterologists working for Core Physicians, an affiliate of the hospital.
“We want to be sure that every one of these patients has exceptional care and there are no impediments there …” said Dr. Thomas Sherman, one of the health care professionals organizing the program.
Sherman said the hospital is anticipating that patients who were infected during the hepatitis C outbreak will be older and sicker than the average person diagnosed with hepatitis C, since many were receiving treatment at the cardiac catheterization lab for other health problems.
The task force will offer patients the services of a dedicated “patient navigator,” who will provide guidance and schedule appointments with specialty physicians.
Patients won’t be charged for the assistance of the patient navigator; however, it’s unclear whether patients working with the task force will be billed for their medical care.
“We are not charging them anything until we know whether we should be,” Sherman said.
Ryan Lawrence, an Exeter Hospital spokesman, said Tuesday he is “not in a position to comment on the economics of the investigation.”
“We are working with each individual on a case-by-case basis to ensure there are no barriers in care,” he said.
The Associated Press contributed to this report.
(c)2012 Foster’s Daily Democrat (Dover, N.H.)
Distributed by MCT Information Services