A nurse suspected of stealing injectable drugs and infecting at least two patients with hepatitis C at Puyallup’s MultiCare Good Samaritan Hospital was “surprised” to learn that she had contracted the disease herself, hospital leaders said Monday.
The linkage between the emergency department nurse and the patients, identified in late March after an internal investigation, led the hospital to announce a safety alert and a recommendation that 2,600 patients who might have interacted with the nurse seek treatment. How the disease might have been transmitted to the two patients is an open question.
The larger group of patients will receive mailed notifications from the hospital this week. Patients who do not receive the notifications are not at risk, hospital leaders said. Additional information, including testing lab locations, appears online at https://www.multicare.org/safety-alert/.
Separately, the hospital filed a report with the Puyallup Police Department regarding the nurse’s possible theft of narcotics, hospital leaders said.
Puyallup Police Chief Scott Engle said Monday afternoon that his agency was contacted Monday morning by hospital leaders, but the agency had not received a formal report regarding the alleged theft.
“That’s the first time we‘ve been contacted at any time,” he said. “We have yet to take a report.”
Hospital leaders described an investigation that began more than a month ago. They said they waited to alert the public until tests confirmed the suspected link between the infected patients and the nurse.
While the hospital has identified two patients who contracted the disease in December after interaction with the nurse, Chief Medical Officer David Bachman, M.D., said he expects more patients might have been infected.
“I hope that number is a very small number,” he said.
During a news conference Monday, Chris Bredeson, the hospital’s chief operating officer, offered an apology to the community and said new safeguards have been implemented to prevent future incidents.
“This event should not have happened at any of our facilities,” Bredeson said. “The nurse’s actions violated our organization’s values. We sincerely apologize to the two patients infected and the patients who need to be screened."
The nurse, who leaders did not identify by name or age, worked in the hospital’s emergency department from Aug. 4, 2017, through March 23 of this year. She has resigned and faces an investigation by the state’s Nursing Care Quality Assurance Commission, Bredeson said.
That inquiry began on March 29, according to a spokesman for the state Department of Health, which oversees the commission. The preliminary phase is finished.
The nurse’s license remains active, but she has told state investigators she is not practicing and is cooperating with the investigation.
She denied any illegal activity when confronted by hospital investigators, Bredeson said, but later admitted to state investigators that she had “diverted” injectable narcotics intended for patients.
How were the patients infected? Answers are still unclear, Bachman said.
Hepatitis C is a bloodborne virus that attacks the liver. Typically, it spreads through shared needles. Left untreated, it can lead to cirrhosis and liver cancer, but treatments have improved greatly in recent years.
"The disease is now considered curable," Bachman said.
The hospital linked the patients through genetic comparison, leaders said. The investigation, conducted by the national Centers for Disease Control and Prevention, found a 96 percent match between the patients and the genetic source of the virus.
Investigators could not establish a direct link between the nurse and the two infected patients because the nurse did not have enough virus present to make such a comparison. However, the nurse tested positive for the illness. She treated the two patients, and admitted taking drugs intended for patients.
“We are taking action as if she’s the common denominator,” Bredeson said.
Asked whether the nurse might have used needles on herself and then patients, hospital leaders said they don’t know yet and can’t say how the disease was transmitted.
“We know she admitted diverting medications,” Bachman said. “But we don’t know the mechanism.”
The nurse passed a drug screening before she was hired, Bredeson said. He described her as “experienced,” noting that she was licensed in three states, most recently in Oregon.
Whether the nurse engaged in similar activity at other hospitals is also unclear. The state investigation will probe that possibility.
The 2,600 patients who might have been affected represent the number of patients who went through Good Samaritan’s emergency department while the nurse was on duty. They did not necessarily receive treatment from her. Hospital leaders said the patients are included in the group that should seek testing as a measure of extra caution.
Bachman described the risk of potential exposure to hepatitis C as “low.” Bredeson said that the number of at-risk patients represents roughly 5 percent of the 54,000 patients who were treated in the emergency department during the 8-month time frame.
Symptoms of hepatitis C vary and typically take six to eight weeks to appear, Bachman said. They include loss of appetite, stomach pain, nausea and jaundice. Treatment, via an oral medication, tends to take two to three months.
Patients who seek testing will receive it at no cost, Bredeson said. Anyone found to have contracted the disease will also receive free treatment if the source of infection is linked to the hospital.
Asked whether the hospital might face future legal action as a result of the incident, Bredeson said he didn’t know.
“I can’t speak to whether we’re gonna be sued, but we are doing the right thing by being transparent and being public about this,” he said. “We want to make sure this doesn’t spread throughout the community. We want to do whatever is needed to make this right.”
Hepatitis C basics
What is it? A virus that attacks the liver and can be life-threatening.
Can it be cured? New treatments with oral medications taken over a 2-3 month period have been shown to cure the disease in many cases.
How does it spread? Hepatitis C is a bloodborne virus. Typically it's passed through shared needles or sexual activity, also through shared items such as toothbrushes or razors. The disease can also be inherited from mothers already infected. It is not spread by kissing or hugging, coughing or sneezing.
What are the symptoms? In some cases, none at all. More commonly, symptoms include stomach pain, nausea and jaundice (yellow eyes or skin).
How do I find out if I need to be tested? Patients affected by the Good Samaritan Hospital Safety Alert will receive notices by mail. If you don't receive a notice, you are not at risk. For patients who receive notices, testing is free.