title: A proposed nationwide reporting system to satisfy the ethical obligation to prevent drug diversion-related transmission of hepatitis C in healthcare facilities.
abstract: In 2012, dozens of patients of Exeter Hospital in New Hampshire contracted new hepatitis C infections that were tracked back to a cardiac technician who ultimately confessed to drug diversion. A multistate epidemiological investigation of hepatitis C cases occurring in multiple hospitals revealed that the technician had been fired from prior institutions due to similar drug diversion activity, about which Exeter Hospital had not been notified. In this article, we highlight the institutional ethical issues raised by this outbreak, and propose a national centralized reporting system to support institutional fulfillment of the ethical obligation to protect the health of patients by preventing such nosocomial outbreaks.
authors.affiliation: Geisel School of Medicine at Dartmouth Medical School, Hanover Dartmouth-Hitchcock Medical Center, Lebanon.
authors.forename: Tim
authors.initials: T
authors.lastname: Lahey
authors.affiliation: Geisel School of Medicine at Dartmouth Medical School, Hanover The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire.
authors.forename: William A
authors.initials: WA
authors.lastname: Nelson
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000635:transmission; D030881:Disclosure / Q000941:ethics; D018563:Disease Notification; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004651:Employment / Q000941:ethics; D004991:Ethics, Institutional; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology / Q000635:transmission; D006801:Humans; D009513:New Hampshire; D015819:Substance Abuse, Intravenous
keywords: disease outbreaks; hepatitis C; institutional ethics; intravenous substance abuse; quality improvement