Colorado Dental Patients Advised to Get HIV, Hepatitis Testing

July 17, 2012— -- Patients of a former Colorado oral surgeon have been advised to get tested for HIV and hepatitis infections after a state health department investigation accused him of reusing syringes and needles on patients receiving intravenous medications for nearly 12 years.

Any patient who received an IV injection, including sedation, from licensed dentist Dr. Stephen Stein between September 1999 and June 2011 might have been exposed to HIV, hepatitis B and hepatitis C, the Colorado Department of Public Health and Environment said in a statement July 12.

Denver police are also involved in the case.

"Right now [Stein's] case is an active ongoing investigation for prescription fraud," police spokeswoman Raquel Lopez said. "We received the information on April 3 of this year."

Stein sold his practice in September 2012 to Dr. Jeremey Miner, an oral surgeon, said a woman who answered the phone at his former practice. They had not worked together previously.

Meanwhile, the state health department issued about 8,000 letters to some of Stein's former patients at both his Highlands Ranch and Denver, Colo., offices, urging them to get tested, department spokesman Mark Salley said.

Records were only available for Stein's patients from 2005 to 2011, so they will be the only ones receiving the notifications, Salley said. The former patients he treated before then will not receive a notice to seek testing.

Without the records, Salley added, there's no way to know how many patients where at risk in the earlier years.

Salley said the state health department began its investigation in April after receiving a report of alleged unsafe injection practices from the Colorado Department of Regulatory Agencies, which licenses dentists statewide.

The investigation determined that the "syringes and needles used to inject medications through patient's IV lines were saved and used again to inject medications through other patients' IV lines"

"This practice has been shown to transmit infections," according to the health department's statement.

But by the time the Department of Public Health was notified of Stein's allegedly unsafe practices, the dentist had already entered into an interim agreement with the Colorado Board of Dental Examiners to stop practicing in June 2011, Salley said.

Salley declined to provide details and Stein's lawyer, Victoria Lovato, has not returned telephone messages requesting comment.

Salley said that even if Stein's former patients test positive for any of the diseases, it does not mean they contracted it through Stein's injection practices.

The health department has asked health providers who test Stein's former patients to report any positive tests for HIV, hepatitis B and hepatitis C to their county or state health departments, according to the statement.

"We don't have any results back and we're not likely to for a couple of weeks," Salley said. "It might be that there are no positive tests to come back."

The risk to Stein's former patients' health is likely to be low and a negative result should not require additional follow up, said Dr. Joseph Perz, a health care epidemiologist at the Centers for Disease Control and Prevention in Atlanta.

"My understanding is that for the majority of patients affected, the exposure would have taken place a considerable while ago and so the issues around incubation shouldn't be a factor for the vast majority of patients," he said.

But Perz said special treatment must be given to blood- borne viruses because there is potential for chronic infection.

Perz said that while the CDC takes a firm stance that safe injection practices are every health provider's responsibility, there have been multiple incidents of doctors reusing syringes for significant time periods that led to mass patient notification.

"This is sort of the latest in a string of these events that really do leave us scratching our heads," he said.