Other Quebec hospitals check instrument sterilization procedures

Quebec's health ministry says four hospitals which use the same medical device as the Hôtel Dieu in Lévis have checked their procedures, and all are properly sterilizing their equipment.

The concern comes after authorities at Hôtel Dieu revealed yesterday that a specialized instrument used to look for cancer or malformations during echo-endoscopic procedures was found to have been improperly sterilized since it was brought into service in 2005.

Quebec Health Minister Réjean Hébert says the sterilization procedures for the same type of echo-endoscope are correct at Notre-Dame, Saint-Luc and the Jewish General Hospital in Montreal, as well as the Sherbrooke General Hospital in the Eastern Townships.

"There was a misunderstanding between the manufacturer of the echo-endoscope and the Hôtel Dieu on the cleaning procedure," said Hébert.

He said that problem came to light when the sterilization procedure was reviewed after the machine malfunctioned in April.

The cleaning procedure has been corrected, and the hospital is in the process of notifying the 1,000 patients who came in contact with the device over the past eight years.

Infection risk extremely low

Hébert reiterated that the risk for any of the patients affected is extremely low, however the hospital is advising all of those it contacts to return to be screened for HIV and Hepatitis B and C.

Officials at Hôtel Dieu explained Monday that worldwide, there have never been any cases of HIV transmission associated with the use of improperly sterilized endoscopes. However, there have been three cases of Hepatitis B transmission and a few cases of Hepatitis C transmission recorded.

Hundreds of thousands of endoscopies are performed in Quebec every year. However, the highly specialized tool in this case is used infrequently, where cancer or other malformations are suspected.

"The population at large should not be concerned," said Dr. Josée Parent, president of the Association of Quebec Gastroenterologists. "[This instrument] is bathed in all kinds of enzyme cleaners that are very powerful, and the viruses are sensitive to it. So it would be unlikely that someone would be [infected], but the hospital is being very prudent and careful as they should be."

Unanswered questions

Jean-Pierre Ménard, a lawyer who specializes in medical malpractice, says the question as to why the manufacturer's recommended sterilization procedures weren't followed at the Lévis hospital still needs to be answered.

He said he has seen other cases of medical equipment that wasn't properly disinfected.

"Usually it was involving equipment that was supposed to be used only once, but people decided to re-use them without a proper disinfection process," said Ménard.

He said the next few months will be stressful for patients, as it may take more than one test to prove they were never infected. 

Patients' rights advocate Paul Brunet commends the hospital for acting quickly, however, he said the patients involved should have been contacted before the hospital went public with its revelation.

"That's a bit incoherent, because you have to speak to patients first," Brunet said.