CHAMBERSBURG, Pa. — Urology Associates of Chambersburg recently sent letters to patients who underwent prostate biopsies informing them of needles being reused in the procedure.
According to a copy of the letter obtained by The Herald-Mail, patients were advised to have their blood tested for conditions. Accompanying the letter was a laboratory outpatient form for tests for Hepatitis Bs Ag, Hepatitis C and HIV.
A Greencastle, Pa., resident who received the letter said Urology Associates paid for his blood test, which did not indicate he had infectious diseases.
The man, who had his biopsy last fall, said the letter arrived about three weeks ago.
"I was a little disturbed by it," said the man, who asked that his name not be used in this story.
Despite the needle issue, the man said he plans to keep an appointment for an upcoming office visit.
The letter was signed by Drs. Louis L. Glass and Christopher J. Klinko.
A Urology Associates receptionist said the doctors would not make any comment about the matter. When asked to be referred to the practice's attorney, the receptionist disconnected the call.
On a second call, a different receptionist said the office would not comment on anything, including whether doctors feel all the affected patients have been notified.
Pennsylvania Department of Health spokeswoman Brandi Hunter-Davenport said the agency was aware of the situation at Urology Associates of Chambersburg, but did not confirm the department was investigating.
"We cannot provide any comment on possible, pending or ongoing investigations," she said.
Urology Associates of Chambersburg is not owned or operated by the Summit Health system, which does own Waynesboro and Chambersburg hospitals, according to Summit Health spokeswoman Jessica Walter.
Doctors from Urology Associates did perform procedures in the hospitals, but the practice of reusing needles was limited to procedures in their offices, Walter said.
"We launched an internal investigation of our physician practices. ... We're absolutely compliant," Walter said, saying all single-use needles are properly discarded.
Dr. Jay Raman from Penn State Hershey Surgical Specialties said two of his patients showed him the letter from Chambersburg. While he said he believes the risk of infection is "very, very low," he would personally get tested if he received the letter.
"What I said to my patients is this (risk) is not zero," Raman said.
In prostate biopsies, an ultrasound device is inserted into the rectum, followed by a needle biopsy gun. An 18-gauge needle goes through the rectum into the prostate for about 12 pricks for collecting samples.
Raman said some tools are heated for sterilization, while the heat-sensitive ones are sterilized with a solution, often CyDex.
"Basically all that stuff is washed in soap and water, then soaked in CyDex," Raman said, saying the product kills bacteria and viruses.
Most, if not all, doctors in the United States use disposable needles for the practice, Raman said.
According to Raman, there are two problems with reusing disposable needles. One, they could become duller on the point and be less effective. Two, they could transfer infection from one patient to another.
The letter from Urology Associates of Chambersburg says the disposable needles were reprocessed with a detergent scrub, he said.
"What we just don't know is whether soaking it in that (sterilization) stuff is sufficient to kill what it's supposed to," Raman said of trying to clean disposable needles.
The needles are typically purchased in bulk and come individually wrapped. Raman said he disposes of his using biohazard containers.
When using a needle that has not been sterilized, the risk of contracting Hepatitis C is one in 500,000 and HIV is one in one million, according to Raman.
The Urology Associates of Chambersburg letter states "instrument reprocessing has been terminated. ... To the best of our knowledge, there has not been a single known case of a blood-borne infection, such as HIV or Hepatitis, related to a prostate biopsy in the history of our practice."
The letter states that "The Pennsylvania State Board of Medicine, Summit Health and our local medical community, including your local physician, have all been advised regarding this issue. We truly regret this occurrence and we understand that you may have questions or concerns, which will be addressed individually. Patient safety and excellent clinical care remain out utmost priority."