By STEPHANIE McFEETERS
@mcfeeters
Daily Hampshire Gazette
WESTFIELD — Kathy Pitoniak wasn’t too keen on the idea of a colonoscopy but, as a screening doctors recommend to everyone above 50, she figured it was a necessary step and “rite of passage.” Her 2012 procedure showed no cause for concern.
Three years later, the Westfield woman is waiting for the results of another test, an unexpected follow-up exam that has stoked a whole new set of anxieties.
Pitoniak, 54, was one of 293 patients who received a letter last week from Baystate Noble Hospital in Westfield informing her that she may have been exposed to blood-borne pathogens that could put her at risk of HIV, hepatitis B and hepatitis C. Due to a lapse in disinfection procedure, the medical devices used in some colonoscopies between June 2012 and April 2013 were inadequately cleaned.
“I was shocked. I was angry,” Pitoniak said. “I just went in for a routine exam with no risk involved, and next thing you know I’m getting a letter like that in the mail.”
Hospital officials have stressed that the risk is low, and are offering free screening to patients. Pitoniak went to Noble on Saturday and was given a blood test; she expects her results Thursday.
As someone who frequently donates blood to the Red Cross, Pitoniak said she isn’t too worried about the screening results coming back positive, because she believes the organization would have detected an illness in her donated blood.
What’s particularly frustrating, Pitoniak said, is that the hospital did not notify patients in April 2013 when it changed its cleaning procedure.
“It just pisses me off,” she said. “They knew about it and they swept it under the rug.”
It remains unclear how the medical devices were initiated into the hospital’s procedures in June 2012, and what, if any, training staff was given at the time. It is also unclear what hospital officials knew in April 2013, when they received new equipment and training, and why they did not notify patients then. Noble joined Baystate Health in July 2015.
So far, Baystate officials have apologized and explained that the disinfection lapse resulted from a missing adapter that meant one part of its colonoscopes was not sufficiently sterilized.
A state inspection in December 2015 uncovered the lapse and potential risks. It was an employee complaint that prompted the Massachusetts Department of Public Health visit, DPH spokesman Scott Zoback said.
He wrote in an email Wednesday that “this is an open investigation, and we continue to actively monitor the situation.”
‘People are scared’
As screenings continue and patients process the news, some are considering suing the hospital.
“People are scared,” said Springfield attorney Ryan Alekman, who said his firm Alekman DiTusa has been meeting with clients since Sunday about the Noble incident. He estimated he and his partner will have advised 20 patients by the end of the week.
“They’re not only concerned about their health but concerned about their loved ones’ health because for the last three years they may have been carrying a disease,” he said.
HIV, hepatitis B and hepatitis C are communicable diseases that can be spread through infected body fluids, including sexual contact and sharing needles.
If screening results return positive, Baystate Health spokesman Ben Craft said the hospital will work with a patient to provide any additional notifications to other people who may be at risk.
“We believe it is quite unlikely that any illness was transmitted from the colonoscopes,” he added.
Alekman said he is fairly confident patients can make a case against the hospital, whether or not their screening results come back positive.
“You have a medical device that’s going into a very sensitive and unfortunately contaminated area of the body — you better be real sure that you know how to use that device,” he said, questioning where the hospital went wrong. “You buy a toaster oven, you get a manual.”
Similarly, John McQuade, an attorney with the Springfield law offices of Mark E. Salomone, said his firm has received about a dozen inquires from patients interested in bringing some sort of legal action against Baystate Noble.
The firm is advising all its callers to get screened. Based on his interpretation of state law, emotional distress would not be enough to make the case that the hospital was negligent, McQuade said, explaining that there must be “consequential physical harm.”
Craft said Baystate Noble is not aware of any pending legal action.
For now, Pitoniak is focused on the results, which typically take five days. She said she hasn’t decided whether to pursue legal action. But, as someone who is healthy and has no family history of colon cancer, she is adamant that the 2012 colonoscopy will be her last.
“You put all your trust in the medical community,” she said. “Maybe stupidly.”
‘A safe procedure’
At Baystate Noble, officials are working to answer patients’ questions and assure them that they have corrected the problem. “Colonoscopy screening is an important preventive measure and we will continue to recommend it for patients for whom it is appropriate because of their age and other factors,” Craft wrote in an email.
He could not say how many of the 293 patients have been screened, but said more are getting tested every day and the hospital is “confident” its notification and screening process is working. Baystate Noble has said it will pay for screenings done at other locations so long as it can access the results, and is providing transportation to patients who need it. The hospital does not plan to publicly announce screening results, Craft said, citing patient privacy.
Health officials recommend that all men and women get colonoscopies beginning at age 50, and barring any issues, get tested every 10 years. They say those with a family history of colorectal cancer should begin sooner. It’s a procedure that requires patients to prepare their bowels by taking laxatives. In the exam, thin tubes with cameras at the tip are inserted through the anus to look for growths in the colon called polyps.
Baystate Noble conducts an average of 150 colonoscopies a month, Craft said.
Now, the disinfection lapse has Pitoniak and others scared of colonoscopies, a process that already tends to make some squeamish. But health experts want to quell this anxiety, and caution people from forgoing what is widely considered an effective and low-risk procedure, one that has been shown to prevent the second leading cause of cancer-related death among men and women in the United States.
“I understand their fears,” said Neil Maniar, vice president for health systems with the American Cancer Society, who works with hospitals throughout New England. “But this is by and large a safe procedure, and importantly, it is a very effective procedure and screening test to prevent a various serious form of cancer.”
Colorectal cancer is the third most common cancer among men and women in the U.S., a disease from which about 50,000 people die a year. This number has been declining over the last two decades, a shift that is often attributed to increased screening.
A colonoscopy is the “gold standard” in colon cancer screening, Maniar said, calling the procedure the best and most effective way to screen for colon cancer and to identify pre-cancerous polyps early, thus preventing the disease.
The American Society for Gastrointestinal Endoscopy echoed Maniar in saying colonoscopies remain an important tool.
“Endoscopy units are highly aware of the need for thorough and meticulous reprocessing protocols for their scopes. As the local experts have noted, the risk of infection from this incident is very low,” Douglas Faigel, president of the American Society for Gastrointestinal Endoscopy, said in a statement. “We are confident that the issues identified at Baystate will be easily corrected. Colonoscopy is a very safe test and a very good one.”
While colonoscopies are the preferred method, Maniar stressed what’s important is that people get screened, encouraging individuals to discuss the issue with their physicians and determine what procedure works best for them. A fecal immunochemical test, an annual exam that detects blood in the stool, is one alternative.
“If detected early, colon cancer is highly treatable,” Maniar said. “If caught late it can be one of the most lethal kinds of cancer.”
Stephanie McFeeters can be reached at [email protected].
