Community disservice

March 14, 2004

THE FULL dimensions of the public health problem resulting from Maryland General Hospital's appalling use of faulty equipment and procedures to test patients for HIV and hepatitis C are not yet known. But the impact could be severe, not only on individual patients given inaccurate results, but also on the entire campaign to encourage people at risk for these infectious diseases to be tested.

Thus, it was dismaying that hospital executives have sought to minimize this tragedy and blame it on low-level workers - one of whom was the whistle-blower who alerted city and state health officials.

No doubt the scapegoating is inspired in part by a desire of the higher-ups to save their own jobs. But it also bespeaks an attitude that appears to have contributed to the faulty lab work.

The patients involved are generally at the lowest end of the clout scale: poor, homeless, drug-addicted, in no position to be careful consumers of health care services. When hospital officials discovered last August that their testing equipment was faulty, they stopped using it but didn't investigate to determine if some patients had been given false results until December, when a former employee lodged a complaint. No wonder state Health Secretary Nelson J. Sabatini is skeptical now about whether the mishandling of these particular tests is an isolated incident or a symptom of broader problems in the hospital's operations. His further inquiry is well justified.

An state initial investigation of the whistle-blower's charges found that laboratory technicians were not following the manufacturer's standards for the test equipment. They were supposed to check the accuracy of the machine on a regular basis. But if such checks indicated an error, the technicians doctored the findings so they would appear correct and sent the suspect results to patients.

The whistle-blower, a fired lab technician now suing Maryland General because she said she contracted both HIV and hepatitis C while using the malfunctioning testing machine, contends the hospital's management had been warned about problems with the equipment months before it was taken out of operation in August.

Of about 400 patients who may have received inaccurate test results, the statistical likelihood is that 20 of them were infected with AIDS but were told they tested negative, according to city Health Commissioner Peter L. Beilenson. Those people not only have lost valuable treatment time, but also may have innocently infected many others. It will be a huge challenge just to find them. An even more ambitious effort will be required to repair the damage to 20 years' worth of convincing those at risk of the value of HIV testing. Now perhaps the message should be: Get tested twice.

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