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The human face of needlesticks

The human face of needlesticks

In petitioning the Food and Drug Administration to recall conventional needle devices from the market, health care worker safety advocates cited the following documented cases of seroconversion following a needlestick:

ñ Lynda Arnold was a 23-year-old nurse working in the intensive care unit (ICU) at Community Hospital in Lancaster, PA, in September 1992 at the time of her injury. She had recently graduated from nursing school and was beginning her career. Following standard ICU procedure, Arnold started an IV line on a newly admitted patient. After starting the line using an 18-gauge catheter, she withdrew the stylet from the patient. At that moment, the patient jerked his arm, forcing the stylet into the palm of Arnold’s left hand. Later, she found out that the patient had AIDS. Six months later, Arnold tested HIV seropositive.1

ñ Ellen Dayton was stuck by a blood-drawing syringe. After drawing blood from a patient, Dayton was about to dispose of the used device when three glass blood-collection tubes started to roll off the counter top. Instinctively, she reached over to catch the glass tubes. In the process, she sustained a needlestick from the contaminated needle that she was carrying in her other hand. Dayton subsequently tested seropositive for HIV and hepatitis C virus.2

ñ Peggy Ferro was a nurse’s aide at a Kaiser Hospital in San Francisco at the time of her needlestick in the winter of 1990. Ms. Ferro was cleaning up a patient’s bedside table when she was stuck with a blood-filled needle that was hidden from view by a piece of gauze. Several weeks later, she tested HIV-positive. Ms. Ferro died on Nov. 4, 1998 at the age of 49, as a result of her needlestick.3

ñ Hacib Aoun was a second-year medical resident in internal medicine when a glass capillary tube lacerated his index finger when he was attempting to seal the tube with clay. He later died of AIDS. His case was one of the first to draw attention to occupational HIV exposure when he described the injury and its devastating personal and social impact in the New England Journal of Medicine.4

ñ Lisa Black was a registered nurse in her late 20s when she was stuck with a syringe while working the night shift on a medical-surgical unit in a small hospital in Nevada. On the night of her injury, Black was taking care of eight acutely ill patients, including one in the terminal stage of AIDS. When she checked this patient, she saw that his IV line tubing had become blocked and blood had backed up in the line. Although the hospital had made needleless IV access systems available, Black’s patient did not have such a system and instead used a system that required a needle for gaining access to the IV line. She tried to unclog the line by inserting a syringe into the rubber port of the IV line and aspirating. During this procedure, the patient startled and jerked his arm, causing the needle to dislodge from the rubber stopper on the IV line and puncture Black’s palm. Although immediately after the injury she started a drug regimen to prevent HIV infection, nine months after the injury she was diagnosed with HIV. Shortly thereafter, she also tested seropositive for hepatitis C virus.5

References

1. Arnold L. My needlestick. Nursing 1997; September:48-50.

2. Holding R. Nurse’s life changed in a moment. San Francisco Chronicle, April 13, 1998:A6.

3. Carlsen W. Peggy Ferro (obituary). San Francisco Chronicle, Nov. 12, 1998:C7.

4. Aoun H. When a house officer gets AIDS. N Engl J Med 1989; 321:693-696.

5. Black LM. One unnecessary needle = HIV + HCV. Advances In Exposure Prevention 1999; 4:25-29.