Oklahoma health officials on Saturday begin testing dental patients in the Tulsa area for a variety of blood-borne viruses that cause hepatitis and AIDS, a precautionary measure to deal with what officials call the largest such incident in the state’s history.
More than 7,000 patients of Dr. W. Scott Harrington will be receiving letters urging them to seek free blood tests for hepatitis B, hepatitis C and HIV, the virus that causes AIDS. State officials have alleged a variety of unsafe practices, including using dirty equipment and allowing unlicensed workers to perform blood-related procedures, such as sedation, at clinics the dentist operated.
“We’re going to doing testing for weeks,” Leslea Bennett-Webb, a spokeswoman for the state Health Department told the Los Angeles Times on Friday.
The number of those needing tests could also grow, officials said. The 7,000 names were of patients in the records since 2007. Harrington, who has suspended his practice pending the resolution of the charges, has been working as a dentist for 36 years.
So far, there has been only one confirmed transmission of a blood-borne infection to a patient and that was hepatitis C. The case was reported to state officials, who found no other risk factors. Eventually it was turned over to state dental authorities, who began their own investigation of Harrington’s activities at his offices in Tulsa and in suburban Owasso. Originally, that patient also tested positive for the human immunodeficiency virus, which causes AIDS, but later testing showed the initial finding to be a false-positive, Bennet-Webb said.
According to the national Centers for Disease Control and Prevention, the most famous case of dental worker-to-patient transmission of HIV involved patients of a Florida dentist, David Acer, in the late 1980s and early 1990s. Eventually, the CDC found six patients who were HIV-positive and whose infection was linked to the dentist. That case led to an upgrade in healthcare practices, known as the Universal Precautions -- which includes protective clothing such as gloves and face shields -- designed to shelter patients from infections carried by bodily fluids like blood.
The call for testing is the largest in Oklahoma’s history, Susan Rogers, executive director of the Oklahoma Board of Dentistry, said in a telephone interview. It was prompted by a variety of factors surrounding Harrington’s practice.
“This situation is a perfect storm,” she said. “It is the first kind of complaint like this that we have ever had.”
The first factor was that Harrington performed oral surgery, pulling teeth and the like, which includes blood being spilled and touched in the invasive procedures, she said.
The second factor was that Harrington’s practice included a high proportion of those who could have been exposed to blood-borne illnesses like hepatitis and HIV infection.
Harrington is also charged with allowing assistants to perform direct intravenous procedures, which is contrary to state regulations. Assistants also were allowed to oversee sterilization procedures.
In her inspection, the state found rusty instruments being used and unsafe practices such as using bleach to clean some instruments. The bleach actually corroded some instruments, she said.
“We looked at the autoclave,” a device to sterilize equipment, Rogers said. “The nurse and I doing the investigation were horrified. Things were rusted and in terrible condition.”
In all, the board charged Harrington with 17 counts of being a “menace to the public health by reasons of practicing dentistry in an unsafe or unsanitary manner.”
Harrington has been cooperating with authorities through his lawyer, who did not return a telephone call. A hearing on the charges is scheduled for April 19 and officials could permanently pull his dental license.
In addition, there is the possibility of criminal charges, though whether to seek any has yet to be determined. In Oklahoma, it is a felony to practice dental procedures without a license, as the assistants are charged with doing. It is also a felony to allow unauthorized people to practice dentistry, Rogers said. Those charges carry a sentence of up to four years in prison and a fine of $5,000 on each count.
According to Abbigail Tumpey, a spokeswoman for the Atlanta-based CDC, a Colorado oral surgeon was accused last year of reusing needles and syringes, prompting letters advising testing to 8,000 patients.
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