Officials with Covenant Health issued a warning to more than one thousand diabetes patients, that they may have been exposed to Hepatitis B and C.
Covenant Health said 1,307 patients may have been exposed during insulin pen training – at the Grey Nuns Hospital between March 2013 and February 2016, or Misericordia Hospital between May 2014 and February 2016.
The breach is connected to saline-filled demonstration pens and pillows used for practice – officials said the needle in the demonstration pens was changed each time, and needles were never shared, but the pen’s saline reservoir may not have been changed with each patient, and the pillows used may have been used by a number of patients who were using their own pens.
“Our nurses, our staff, if they would have known there were risks, they wouldn’t have done this,” Dr. Owen Heisler, Chief Medical Officer of Health for Covenant Health said.
Officials said 355 patients trained at the Misericordia, and 952 trained at the Grey Nuns.
The incorrect training practice was stopped after it was identified in February, 2016. The health authority asked for help from the Alberta Health Services Risk Assessment Panel to review the issue.
The panel advised officials to notify patients who participated in insulin pen training at the two hospitals at those certain times.
The time between the training practice being stop and patient notification was 16 months; officials said that is because of the complexity of the case, and the time it took to come up with a list of impacted patients.
Associate Health Minister Brandy Payne issued a statement in response:
“Covenant has taken steps to make sure this never happens again, but the amount of time it took to investigate this breach and then notify patients is concerning. We expect AHS and Covenant to do a thorough review of their processes and make any changes they can to be more responsive.”
Dr. Heisler said the organization would look into it.
“I am concerned and that’s why we want to look at this process and find out why it took so long,” Dr. Heisler said.
“We’re apologetic that we’re creating anxiety.”
Officials said risk associated with this incident isn’t ongoing, and the risk to those being notified is low.
New guidelines for demonstration pens have been implemented at all diabetes education centres in Alberta.
In addition, some of the training sessions were for patients with gestational diabetes, and officials said their children do not need to be tested.
Affected patients will receive a letter from Covenant Health, informing them of what happened, and advising them to get a blood test.
With files from Angela Jung
