A Nevada doctor is facing more than 20 felony charges for what prosecutors say he did inside an outpatient surgery center. Prosecutors say he encouraged employees to reuse vials of a medicine to save money.
An investigation revealed the staff used clean needles, but the syringes and vials that contained the medicine were used more than once. The result: A hepatitis outbreak in which 6 or 7 people were allegedly directly infected, and more than 100 people were allegedly indirectly infected.
A new study by the Centers for Disease Control and Prevention finds similar cost-cutting measures and safety lapses at outpatient ambulatory surgical centers across the country.
Researchers at the CDC surveyed a random sample of outpatient surgical centers and found that 67.6 percent of the centers studied had at least one lapse in infection control.
Infection control refers to things like hand hygiene, injection safety and medication handling, equipment reprocessing, environmental cleaning and handling of blood sugar monitoring equipment.
Ambulatory surgical centers, like the one in Nevada, are increasingly popular settings for operations that don't require a patient to be hospitalized, surgeries like eye, dental or foot surgery.
Doctors perform 6 million procedures each year at ambulatory surgical centers. Some of these centers are part of a hospital system, but others operate independently.
"They are not being regulated with anywhere near the thoroughness and completeness and frequency that large hospitals are," said Dr. William Schaffner from the Vanderbilt University Medical Center in Nashville, Tenn. "They have fallen between the regulatory cracks."
Nearly half of the centers inspected, 46 percent, were handling blood sugar testing equipment improperly.
More than a quarter, 28.4 percent, failed basic reprocessing procedures, meaning they didn't sterilize and disinfect instruments correctly.
Astonishingly, 28 percent were using those single medication vials for more than one patient. This is the exact same offense that set off the hepatitis outbreak in Nevada.
So how do you know if a surgery center near you is safe or even clean?
"If the self-standing surgical center is associated with a large medical center or a large community hospital, I think there is greater assurance that their infection control procedures are indeed at a very high level. Beyond that, it's kind of difficult," Schaffner said.
Surprisingly, in most states, outpatient surgical centers don't have to be inspected or accredited. Some lawmakers want to change that, arguing that if they're going to operate, doctors should operate with some kind of oversight.