More than 3,000 patients treated at Griffin Hospital over the course of nearly six years will be tested for a number of diseases after hospital officials announced Friday that multi-dose insulin pens were used improperly “in a small number of cases.”
Five nurses reported observing misuse of the insulin pens or said they themselves misused the insulin pens, Dr. Patrick Charmel, the hospital’s president and CEO, announced at a press conference.
Patients will be tested for Hepatitis B, Hepatitis C, and HIV, he said.
Hospital officials say it’s “extremely unlikely” patients could have been infected, but will test patients treated with the insulin pens out of an abundance of caution.
Those treated with the pens between September 2008 and this month will receive a certified letter from the hospital with more details on the testing, which will take place in the next 30 days.
The total number of patients in that time period was 3,149, Charmel said. The hospital is also reaching out to those patients’ primary care physicians, he said.
The devices — designed to dispense multiple doses of insulin, but to only a single patient — may have been used on more than one patient in a “very small number of cases,” Charmel said.
The hospital has said it will no longer use the device in question, the Flexpen, manufactured by Novo Nordisk.
Click the play button above to see a YouTube video from the manufacturer on how the device works.
The pens deliver insulin through a safety needle cartridge disposed after each use.
Charmel said that “in at least one case we know, and it’s probably more than that,” a nurse may have taken the injector prescribed for one patient and used the same pen, with a clean needle, on another patient.
Even though a new needle would have been used, a patient’s blood or skin cells could possibly “backflow” into the insulin cartridge inside the pen when penetrated by the needle, making it possible, though unlikely, that a disease from one patient could be transmitted to another if the device is used improperly.
Hospital officials said they could not know for sure how many patients the pen could have been misused on, which is why they want to test anyone treated with the device.
“We don’t anticipate seeing any new cases,” said Dr. Harold Schwartz.
Charmel said the hospital became aware of the issue when a nurse asked an employee in the hospital’s pharmacy whether the pens could be used on more than one patient.
The pharmacist thought the question was odd, and alerted superiors, Charmel said, after which the hospital launched an investigation.
“Frankly, it shouldn’t have happened, but it did,” Charmel said.
The hospital has established dedicated phone lines that will be staffed from 7 a.m. to 10 p.m., seven days a week, for patients who might have been affected.
The hot line numbers are 203 – 732-1411 and 203 – 732-1340.
Click here to read a statement from the hospital.
“At this point, the hospital’s review has not identified any specific patient who has received an insulin injection from another patient’s insulin pen, and there is no evidence of any transmission of blood-borne infection due to insulin pen misuse,” the statement said.
Charmel said the nurses involved will face disciplinary action, and the hospital may face sanctions from the state’s Department of Health, which he said OK’d the hospital’s response plan Thursday.
“We understand that this is going to shake people’s trust,” he said. “That’s why we’re doing what we believe is the only responsible thing.”