Over 2,400 patients may have been exposed to HIV, hepatitis at Oregon hospitals | Hacker News Reader

Over 2,400 patients may have been exposed to HIV, hepatitis at Oregon hospitals

cbsnews.com

40 pointsgeox25 comments

In my personal experience I found the Portland healthcare system to subpar and adversarial to their patients. It was difficult to find doctors, impossible to find in-person therapists (I take on high-stress jobs and talking to others about it helps keep me focused). I’m not surprised this exposure occurred, I noticed an atmosphere of carelessness and incompetence during my entire time in Portland.

I work in healthcare in Portland - our mental health system really feels like it's on life support from all of the recent trauma and the large number of transplants to the city. I have a friend who was having serious depression and went to the ED feigning SI because they knew if they did inpatient they could meet with a psychiatrist - otherwise they were looking at months of waiting.

The physician's name hasn't been released.

Why not?

And why hasn’t he been charged with a crime?

These are deadly, incurable diseases, not just a common cold.

Generally a crime needs mens rea. Not always but generally there needs to be some sort of intent. It is unclear from the article if the violation of the safety practices were intentional or due to ignorance or potentially lack of training on the employer's part. Since the article does mention that policies and procedures have been updated to account for this there may been some deficiencies discovered in their policies.

This is usually sufficient to explain why criminal charges have not been brought. If it was just simple incompetence but they believed they were following procedures to the best of their current knowledge it is unlikely they could get a conviction.

Incompetence is punishable

Incompetence doesn't often give rise to criminal liability, though.

Single physician across two employers. Thousands of people impacted, so the problem spanned years. And he was fired. Sounds like one guy got lazy to the point of maliciousness. But I’ll concede there aren’t enough details in the article to know what happened. I just know if I got a note in my e-file that I might have HIV, I’d be furious. And if I actually had it due to either malice or incompetence, I’d be out for blood.

> Generally there needs to be some sort of intent.

Often yes, but often not.

Criminal negligence is a thing. That's a standard of mens rea that's lower than intent, or foreknowlege, or recklessness. And it's particularly a thing in the context of licensed professions.

More than 2,400 patients at hospitals around Portland, Oregon, may have been exposed to infectious diseases such as hepatitis B and C, as well as HIV, because of an anesthesiologist who may not have followed infection control practices

What did he or she do? The article is vague, there is not enough information to know if or what crime there was. What does "may not have followed" mean?

If the physician negligently failed to perform a procedure, it is still not known if anyone was actually harmed by the negligence.

While these are very serious, Hepatitis A and B are preventable via vaccine, curable in many cases, and treatable. Hepatitis C is usually curable with antiretrovirals. HIV is clearly very serious but is manageable to a chronic condition with antiretrovirals.

I don't like taking the other side of this, but it doesn't seem necessary to pull out the pitchforks and torches absent a lot more information.

Although there certainly was a period during which an HIV diagnosis was viewed as a death sentence, medical advances have transformed it into a highly manageable condition.

> As a doctor, I’d rather have HIV than diabetes

https://www.spectator.co.uk/article/as-a-doctor-i-d-rather-h...

We even have (expensive) drugs that can completely cure Hepatitis C and are seeing progress on treating Hep B.

They are still deadly, incurable diseases. If treated they become more harmless, yes, but that still makes you dependent on medication and treatment for the rest of your life.

Of course you wouldn't want to have diabetes either, which is also a serious condition. Overall the article isn't the best medical advice I heard though.

There shouldn't be any stigma around it, but any of those infections will change your life significantly.

"Don't worry, you only have to take drugs with major side-effects* that are also financially crippling for the rest of your life. You'll be fine."

Say that to somebody who was just "given" HIV by a malicious/incompenetent doctors and see how they react.

Aside from the side effects, any number of things can limit access to the meds - moving, job loss, insurance company fucking up paperwork.

* everything from anxiety, depression, liver damage, kidney damage, the list goes on and on.

Is it common practice in the US to publish the names of suspects of a crime? From what I’ve read, he hasn’t been found guilty yet, or has he?

Edit: I’m not saying it is in any way unclear that the physician acted in gross misconduct. But as long as he isn’t convicted, he should not be treated as such.

>Is it common practice in the US to publish the names of suspects of a crime?

yes. I won't defend the practice, but that's how it's done.

Depends on the state and the case

In France there was a huge scandal about contaminated blood products:

https://en.wikipedia.org/wiki/Contaminated_haemophilia_blood...

Despite abundance of evidence, journalists revealing everything, and myriads of high-ups involved, only 2 people have been sentenced, for 4 and 2 years of prison.

To give 2,000 people HIV.

What justice do you hope for?

My grandmother contracted Hep C from a contaminated blood transfusion in the 1960s. When the cure was approved within the past decade, she was one of the first given the treatment.

I don't know that this was the common practice or even intentional, and giving a new therapy to an elderly person does amount to medical QA, but despite half a century elapsing, it worked.

FTA: "may have been exposed to infectious diseases such as hepatitis B and C, as well as HIV, because of an anesthesiologist who may not have followed infection control practices"

No where in the article does it say a physician did not follow infection control practices, nor does it say any the anesthesiologist did something wrong. Rather, there is the word "may" in all those cases, and may means there is room for doubt.

Let's put this another way: should we ruin someone's reputation over something they may or may not have done? Are you willing to be held to the same standard?

We pay more because we get the best care in the world.

The USA has a very high diabetes rate, so good care would mean threating those people well.

Even after you got of the scandal of the $800 insulin, it's still 10 times more expensive than most places in the world:

https://wisevoter.com/country-rankings/cost-of-insulin-by-co...

Insulin is insulin, you can't make it "10 times better".

The comment you're replying to is clearly sarcastic. Infecting 2400 people with HIV is generally not considered good care.

You're replying to sarcasm, but I do want to point out...

> Insulin is insulin, you can't make it "10 times better"

Other details aside, this part is not true. There are multiple kinds of insulin on the market today, and they span the glucose immediacy gamut from a large rapid burst to prolonged slow conversion.

And deprive the market of research subjects that could contribute to life saving therapies for state leaders?

It's not like doctors are out there just giving people dis... Ah.

Much of the world sets a pretty low bar, unfortunately.

e.g. https://www.theguardian.com/world/2007/may/07/italy.internat...

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