Hepatitis C outbreak spurs closer monitoring of Utah health professionals

Saturday , July 15, 2017 - 5:00 AM1 comment

MARK SHENEFELT, Standard-Examiner Staff

The hepatitis C outbreak at two Northern Utah hospitals, attributed to a nurse accused of diverting drugs and infecting at least 7 patients, has spurred the state to increase monitoring of health care professionals.

The Utah Department of Health has begun working more closely with licensing authorities “to understand when a provider is potentially exposing patients to blood-borne pathogens due to risky behaviors,” said Dr. Angela Dunn, deputy state epidemiologist.

Elet Neilson, 50, was charged in U.S. District Court on Wednesday with 16 counts involving the alleged theft of narcotic medications and tampering with prescribed drugs. Her actions led to the infection of at least seven patients at McKay-Dee Hospital while she worked as a registered nurse in the emergency room, the grand jury indictment alleged.

Because of Neilson’s contacts with patients at McKay Dee in Ogden and earlier at Layton’s Davis Hospital, more than 7,200 patients were potentially exposed, the state said. Sixteen patients tested positive for hepatitis C. Seven of those cases were tied to the outbreak.

Opioid crisis spills into health care

Dunn, who headed the outbreak investigation, said in a phone interview Friday that society’s opioid addiction epidemic has not bypassed the health care industry, where professionals have ready access to hydromorphone, fentanyl and other controlled substances.

She said the health department has teamed with the Utah Division of Occupational and Professional Licensing to more quickly respond to trouble spots.

“We’re trying to get ahead of the opioid epidemic and prevent these risks to the general public,” Dunn said. “From a public health perspective, we see this as an opportunity to get the word out about substance abuse ... for all citizens, but also for health care providers.”

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Neilson’s charges were part of a U.S. Justice Department crackdown announced this week with indictments against at least 412 people nationwide on allegations of health care fraud, drug diversion and other offenses.

“The charges involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics,” a Justice Department statement said.

License trouble for local nurses

Meanwhile, a review of state licensing records shows at least four Northern Utah registered nurses have had their licenses revoked or suspended in the past three months for violations related to controlled substances:

  • A 43-year-old registered nurse who lives in Weber County took a doctor’s prescription pad and forged 19 prescriptions for hydromorphone. The nurse told an investigator he was taking the drugs “all the time” from November 2016 through February. He told a DOPL investigator he was “probably impaired while at work.” His license is suspended and he is on five years’ probation.

  • In April, a 39-year-old nurse who lives in Ogden took fentanyl from a hospital’s drug stock. When caught, he resigned rather than be fired. An investigator wrote that the nurse said “he was addicted to controlled substances and can’t be around them.” He surrendered his state license.

  • A Weber County nurse, 40, was charged with unlawful possession of lorazepam after a car crash. Five days later, she was hospitalized after overdosing on “a large number of drugs,” including opiates and benzodiazepines, an investigator reported. She is under licensure probation for five years.

  • After a traffic stop, a Layton nurse, 29, was charged with possession of a controlled substance. He got five years’ probation.

U.S. hospital hepatitis C outbreaks expose 26,000 in eight years

Data from the U.S. Centers of Disease Control and Prevention indicate that, including the Utah outbreak, 78 hospital patients have been infected with hepatitis C and more than 26,000 patients exposed in three cases since 2009, all due to alleged wrongdoing by health care personnel.

Forty-five patients were infected and more than 11,000 exposed in 2012 when a radiology technician diverted drugs. Patients at 16 hospitals in eight states were notified of potential exposure.

In a 2009 Colorado outbreak, 26 people were infected and 8,000 exposed when a surgery technician diverted doses of fentanyl.

The CDC says people can become infected with the hepatitis C virus during the sharing of needles and syringes, and needle stick injuries in health care settings

Hepatitis C is a contagious liver disease that can range in severity from mild illness lasting a few weeks to a serious lifelong illness, the CDC says. Chronic hepatitis C can result in long-term health problems or death. The CDC says hepatitis C is the most common chronic blood-borne infection in the United States.

McKay-Dee spokesman Chris Dallin said the hospital continues to offer free testing to patients who may have been exposed during the outbreak. Call 801 387-8580 for information, he said.

McKay-Dee sent a letter Oct. 31, 2015, to about 4,800 patients who may have been exposed. In November, Davis Hospital alerted 2,800 patients of possible exposure. McKay-Dee said its exposures occurred between June 2013 and November 2014, and Davis Hospital said its exposures were between June 2011 and April 2013.

Dunn said Friday that 3,731 of the 7,217 exposed patients have come forward for testing.

(CORRECTION: An earlier version of this story reported an incorrect total of charges against Neilson. The Standard-Examiner regrets the error.)

You can reach reporter Mark Shenefelt at mshenefelt@standard.net or 801-625-4224. Follow him on Twitter at @mshenefelt and like him on Facebook at https://www.facebook.com/SEmarkshenefelt.


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