Because cleaning protocols for dental equipment were not followed by workers at the John Cochran VA Medical Center in St. Louis, more than 1,800 veterans may have been exposed to HIV and hepatitis viruses.

Legion outraged at St. Louis negligence

The American Legion expressed outrage today over revelations that a VA medical center may have exposed veterans to serious infections through improperly cleaned dental equipment. Because cleaning protocols were not followed by workers at the John Cochran VA Medical Center in St. Louis, more than 1,800 veterans may have been exposed to HIV and hepatitis viruses. Those veterans recently received letters from the VA center, warning them of possible exposure to the diseases and offering screening and support.

"This is an extremely serious problem that has happened before and will happen again unless VA ensures strict adherence to proper sanitation and sterilization protocol."," American Legion National Commander Clarence Hill said. "We're talking about people who have risked their lives, who have lost arms and legs and who are suffering mentally and emotionally because they served their country honorably. They should have no misgivings about getting treatment at VA facilities, and they wouldn't if VA ensured that its staff were following the medical protocols already in place. It's management's responsibility to make sure the protocols are followed. This is a failing on the part of management that should not be excused."

Last year, veterans were notified by VA that they may have been exposed to infectious diseases via improperly cleaned endoscopic equipment at several of its medical facilities. On Sept. 18, 2009, a report from VA's Office of Inspector General indicated the problem had been eliminated.

Mark Seavey, director of new media for The American Legion, has been monitoring blogsite entries made by veterans who are angered over VA's latest failure to keep its medical instruments clean.

"Veterans are rightly angered by what they see as another failure by VA to safeguard their health," Seavey said. "Many of the veterans online are openly questioning whether it is worth the hassles and potential problems to continue using VA as their main provider of health services."

Just last month at a congressional hearing, The American Legion raised concerns about VA training standards and its high turnover in personnel. Barry Searle, The American Legion's director of Veterans Affairs and Rehabilitation, testified at a June 2 hearing before a House subcommittee on health. "VA needs to do a better job in training its people more quickly and effectively - making sure they understand the correct protocols that have already been established, such as the proper cleaning of dental equipment," Searle testified.

Each year, American Legion staff members visit VA medical centers nationwide, evaluating the quality of health care being provided for veterans and their families. They report their findings to VA and Congress.

"After all the assurances made by VA Secretary Shinseki and others to The American Legion - after past incidents like this one - we are very disappointed to see this happen once again" said Peter Gaytan, executive director of The American Legion's Washington office.

Gaytan said that VA should be commended for the care it has taken to create thorough protocols for the cleaning of medical equipment. "The failure was by the staff in not following those protocols. VA facility administrators must do a better job of enforcing proper actions by staff who are responsible for cleaning equipment. The lives of our veterans depend on their performance."

According to a fact sheet released yesterday by VA, the "failure to clean dental handpieces according to manufacturer instructions and VA standard operating procedures" was discovered at the St. Louis facility in March by inspectors from the National Infectious Diseases Program Office.

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  1. While we all know that sometimes things get done *Half Assedly*, this is a department where there should be NO H-A'd jobs done. This is really the pit of it all. I, for one, like the treatment I recieve at the VAMC that I use here in NC. I know that there are many, MANY people that take their jobs very seriously while there are those wonderous few that could care less about what, where or how they complete their tasks assigned at the VAMC. I have seen it before and when I comment upon it, I get some backwards answer like "Oh, they just come for a paycheck and we can't get rid of them..union won't allow it.." Well, to heck with that. This is why we have Patient Advocates. If you are a bit concernbed about the hygene of things..DON'T have work done. Go to the head of the Patient's Affairs and let them know why you are worried as these people are your eyes and ears at the VAMC and they WILL look into it and give you feedback when finished.
  2. While most of the medical staff seem to genuinely care about the patients, I cannot say the same about support staff. Many of these people have been employed at the VA for upwards of 20 years, they are accustomed to the "old way" of doing things, which in some cases is doing <strong>nothing at all.</strong> The VA needs to take a closer look at some of its employees and employment practices. "New Blood" needs to be brought into the system, and some of the old blood siphoned off. But, as it stands, the only way for 'outsiders' to become 'insiders' is for someone to retire or die. Sure, the VA is opening new jobs, but are the best qualified persons being placed in them? In my epxerience the answer is NO. Someone who has been stuck at a lower ranked job who wants a raise can shoot right into into the spot even if they are under-qualified. The only way to get new blood is to change how hiring is done. People who care about their jobs and those they serve need to be brought in.
  3. I understand the outrage, however lets get the facts. First off, the ultimate sterilization process, the process that kills everything is the high pressure steam process in the autoclave, not the prewashes. Second the prewash machines are used to safeguard staff from being exposed to dirty instruments. While the "specified procedures" were not followed by the staff hand washing the instruments, the fact that they were autoclaved eliminates any risk of exposure to the Veterans receiving treatment. It would be nice to know who runs the bloodborne pathegon program at the VA facility because 1812 veterans have been put on notice for no reason. While we must insure that proper procedures are followed, this incident has been improperly handled.
  4. As a Dental Hygienist and a dental professional for over 20 years not to mention a veteran, I was shocked to see this article. Proper steralization protocols are a regular part of all procedures. The breakdown in protocols had to be a lack of understanding and knowledge or laziness on the part of the staff. One comment I read said the dental assistants are preforming cleanings? Where are the dental hygienists? Who was the OSHA manager in this clinic? Personally, reading this article as a dental professional, I have found that the information sparce and misleading, clearly the people involved need to understand what is necessary for proper cleaning and sterization of instruments and correct universal precautions for patient treatment. I have often volunteered my time at my local VA clinic and was turned away. I believe that dental professionals should educate patients on what to look for in recieveing clean, sterile and professional care. Patients should be given all the informati
  5. I absolutely hate going to the Dentist. The Dental assistants are usually so rough when they clean my teeth that the electric instruments are cutting the gum line. I understand cleaning but this is just pain; now along with pain I have to worry about HIV or Hep. This should not be the case at any medical facility, let alone a VA facility. It is my opinion that any persons responsible should either be fired or required to retrain on how to sterilize equipment and then be supervised for a good time to come (micro-manage). You learn very quickly in the military not to micro-manage but in the case of failure there are not many options. Get your act together St. Louis/VA or risk loosing the patients you serve.
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