Sterile Processing Error Leads To HIV Outbreak at Indiana Hospital

22 Nov

On November 25th 2019 a prominent hospital in Indiana issued a press release. More than 1,000 of their patients between April and September of 2019 had been exposed to HIV, hepatitis C and hepatitis B due to an error in sterile processing.  A technician had missed a key step, in a multi-step processing procedure, for an instrument that left it contaminated with the blood of other patients. The hospital identified 1,182 people who were effected by this mistake and offered them free testing services to check them for the diseases.

Almost immediately a class action lawsuit was filed by the patients who claimed that even if they were not infected, they were still entitled to compensation from the emotional distress and trauma that the event caused them. The hospital’s reputation also took a nose dive and it is likely that it will lose millions of dollars in lost revenue, legal expenses, and settlements. All over one small mistake, for one instrument, by one person, in the basement of the hospital.

CaseTrak360 greatly reduces the risk of these events by providing step-by-step processing instructions for sterile processing technicians. The instructions can either come from IFUs that a facility already has or though CaseTrak360’s OneSource integration. Pictures of all sets/items are also available for reference and CaseTrak360 offers a built-in quality check so managers can verify that processing steps were completed properly.

CaseTrak360 also aids with infection response through its detailed reporting feature that tracks the procedures in which a set/item has been used, how it was processed, how it was stored, and all of the people that were involved in those processes. CaseTrak360 also tracks sets/items in real time, so they can be instantly pulled for scrutiny at any moment. With CaseTrak360, not only can infections be greatly reduced but a clear history and chain of accountability is established to stop it when it occurs.

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