Infection Prevention and Control Lapse at a Stittsville Medical Clinic

7/31/2018 News and Public Notices - Ottawa Public Health

Infection prevention and control lapse at a Stittsville medical clinic

Posted on Tuesday July 17, 2018 Like 0 Tweet

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July 17, 2018

Infection prevention and control lapse at a Stittsville medical clinic

Ottawa – An infection prevention and control lapse investigation by Ottawa Public Health (OPH) has identified that patients who had some minor surgical procedures at the Main Street Family Medical Centre, located at 1251 Stittsville Main Street, may have been exposed to improperly cleaned medical equipment.

The investigation began on April 24, 2018 following a complaint. On April 25, 2018, OPH directed the clinic to stop performing all minor surgical procedures until further notice. There is no ongoing risk to patients being treated at the clinic. At this time, OPH is not aware of any cases of infection associated with this infection prevention and control lapse.

OPH, in collaboration with Public Health Ontario (https://www.publichealthontario.ca/en/Pages/default.aspx) and the Ministry of Health and Long Term Care (http://www.health.gov.on.ca/en/), determined that an estimated 4,600 patients who underwent some minor surgical procedures at this clinic between December 2003 and April 25, 2018 may have been exposed to improperly cleaned reusable medical equipment.

Although the risk is low, as a precaution, OPH recommends that patients who received a minor surgical procedure of concern at the clinic between December 2003 and April 25, 2018 undergo testing for hepatitis B, hepatitis C and Human Immunodeficiency Virus, abbreviated as HIV. Today, the Main Street Family Medical http://www.ottawapublichealth.ca/Modules/News/index.aspx?newsId=9c072336-c413-4007-a5b4-c8e5ac436bd9 1/7 7/31/2018 News and Public Notices - Ottawa Public Health Centre is mailing letters to the estimated 4,600 affected clinic patients, which represents 5 percent of the estimated 90,000 patients seen at the clinic since 2003.

Quotes

“The protection of the public’s health is our top priority. As soon as Ottawa Public Health identified the infection prevention and control lapse at the Main Street Family Medical Centre, they acted immediately to ensure no ongoing risk to the public. OPH worked closely with Public Health Ontario and the Ministry of Health and Long Term Care to identify who was at risk from this infection prevention and control lapse and to notify those patients as soon as possible.”

Councillor Shad Qadri, Chair of the Ottawa Board of Health (full statement below)

“For some people in our community, this information may create concern. I want to assure residents that, at this time, Ottawa Public Health is not aware of any case of infection associated with this infection prevention and control lapse. Even though the risk of infection transmission is low, as a precaution, Ottawa Public Health recommends that patients who may have been exposed to improperly cleaned medical equipment at this clinic get tested for hepatitis B, hepatitis C, and HIV.”

Dr. Geneviève Cadieux, Associate Medical Officer of Health, Ottawa Public Health (full statement below)

Procedures of concern are:

Removal of a skin tag, mole, or cyst using a blade or scissors Skin biopsy Incision, drainage, or packing of an abscess or cyst Removal of an ingrown nail Sutures or staples, or their removal Foreign body removal

Procedures that are not a cause for concern include:

Injections (e.g., vaccines, vitamin B12, anti-inflammatories, steroids) Blood drawing Removal of a wart or skin lesion using liquid nitrogen (freezing) spray or swab Pap test, endometrial (uterus layer) biopsy Swabs (e.g., throat swabs, nose swabs, testing for sexually transmitted infections)

The letter being mailed to affected patients explains that the patient may have had a minor surgical procedure involving improperly cleaned medical instruments at the http://www.ottawapublichealth.ca/Modules/News/index.aspx?newsId=9c072336-c413-4007-a5b4-c8e5ac436bd9 2/7 7/31/2018 News and Public Notices - Ottawa Public Health clinic and that OPH recommends that they be tested for hepatitis B, hepatitis C and HIV. The letter also includes a laboratory requisition that the patient can take directly to any laboratory to be tested, and provides alternatives for testing. OPH recommends that patients who are uncertain about having had a procedure at this clinic should speak to their primary health care provider about their risk and possible testing.

OPH investigates clinics on a complaint basis and does not routinely inspect medical clinics’ infection prevention and control practices. Medical doctors are a self- regulated profession and are responsible for upholding infection prevention and control standards in their own practice. The College of Physicians and Surgeons of Ontario (http://www.cpso.on.ca/) (CPSO), which regulates physician practice in Ontario, was notified of OPH’s investigation.

For more information about the OPH investigation or information about hepatitis B, hepatitis C and HIV, please visit www.OttawaPublicHealth.ca/Lapse (http://www.ottawapublichealth.ca/Lapse), call the Ottawa Public Health Information Centre at 613-580-6744 or email [email protected] (mailto:[email protected]). Patients can also contact the Main Street Family Medical Centre at 613-831-7372.

For more information: Media contact 613-580-2450

()Full statement by Dr. Geneviève Cadieux

“Good morning and thank you for joining us this morning. As Jason mentioned, I am joined Councillor Shad Qadri, Chair of the Board of Health and my colleague Sherry Beadle, Manager of Public Inspections.

An infection prevention and control investigation by Ottawa Public Health has identified that some patients at the Main Street Family Medical Centre, located at 1251 Stittsville Main Street, may have been exposed to improperly cleaned medical equipment used for some minor surgical procedures.

The investigation began on April 24, 2018 following a complaint. The next day, on April 25, Ottawa Public Health required the clinic to cease performing all minor surgical procedures until further notice. At this time, Ottawa Public Health is not aware of any case of infection associated with this clinic and there is no ongoing risk to patients being treated at the clinic.

Une enquête de prévention et de contrôle des infections menée par Santé publique Ottawa a révélé que des patients de la clinique Main Street Family Medical Centre, située au 1251, rue Stittsville Main, pourraient avoir été exposés à du matériel médical insuffisamment nettoyé qui aurait été utilisé pour certaines interventions chirurgicales mineures.

L’enquête a débuté le 24 avril 2018 à la suite d’une plainte. Le jour suivant, le 25 avril, Santé publique Ottawa a exigé que la clinique cesse d’effectuer toute intervention chirurgicale mineure jusqu’à nouvel ordre. Il n’y a aucun risque pour les http://www.ottawapublichealth.ca/Modules/News/index.aspx?newsId=9c072336-c413-4007-a5b4-c8e5ac436bd9 3/7 7/31/2018 News and Public Notices - Ottawa Public Health patients ayant été traités à la clinique après le 25 avril. À l’heure actuelle, Santé publique Ottawa n’a connaissance d’aucun cas d’infection en lien avec cette clinique.

Ottawa Public Health, in collaboration with the Ministry of Health and Long-Term Care, assesses that an estimated 4,600 patients who underwent a minor surgical procedure at this clinic between its opening in December 2003 and April 25, 2018 may have been exposed to improperly cleaned reusable medical equipment.

Based on the specific deficiencies identified at the clinic, Public Health Ontario estimated a low risk of transmission of hepatitis B, hepatitis C, and, to a lesser extent, Human Immunodeficiency Virus, abbreviated as HIV.

However, although the risk is low, as a precaution, Ottawa Public Health recommends that patients who received a minor surgical procedure of concern at the clinic between December 2003 and April 25, 2018 undergo testing for hepatitis B, hepatitis C and HIV.

En vertu des manquements spécifiques notés à la clinique, Santé publique Ontario a estimé qu’il existe un faible risque de transmission de l’hépatite B, de l’hépatite C et, dans une moins grande mesure, du virus de l’immunodéficience humaine, abrégé « VIH ». Bien que le risque soit faible, par précaution, Santé publique Ottawa recommande que les patients qui ont subi une intervention chirurgicale mineure à la clinique entre son ouverture en décembre 2003 et le 25 avril 2018 effectuent un test de dépistage de l’hépatite B, de l’hépatite C et du VIH.

Earlier today, the Main Street Family Medical Centre mailed letters to the estimated 4,600 patients who may have had a procedure of concern between December 2003 and April 25, 2018. It’s important to note that this represents about 5 percent of the estimated 90,000 patients seen at the clinic since 2003.

The letter sent by the clinic explains that the patient may have had a minor surgical procedure involving improperly cleaned medical instruments at the clinic and conveys the OPH recommendation that they be tested for hepatitis B, hepatitis C and HIV. The letter also includes a laboratory requisition that the patient may take directly to any laboratory.

The procedures of concern are the following:

Procedures that are not a cause for concern include:

Injections (e.g., vaccines, vitamin B12, anti-inflammatories or steroids) http://www.ottawapublichealth.ca/Modules/News/index.aspx?newsId=9c072336-c413-4007-a5b4-c8e5ac436bd9 4/7 7/31/2018 News and Public Notices - Ottawa Public Health Blood drawing Removal of warts and other skin lesions using liquid nitrogen freezing spray or swab Pap test, endometrial biopsy Swabs such as throat swabs, nose swabs and testing for sexually transmitted infections

OPH recommends that patients who are uncertain about having had a procedure of concern at this clinic speak to their primary healthcare provider about their risk and possible testing.

Medical doctors are a self-regulated profession and are responsible for upholding infection prevention and control standards in their own practice. Ottawa Public Health investigates clinics on a complaint basis and does not routinely assess medical clinics’ infection prevention and control practices. The College of Physicians and Surgeons of Ontario, which regulates physician practice in Ontario, was notified of Ottawa Public Health’s investigation.

Je reconnais que cette information pourrait causer des préoccupations chez certains membres de notre communauté. Je tiens à vous assurer qu’à ce jour, Santé publique Ottawa n’a pas connaissance de cas d’infection en lien avec ce manquement aux pratiques de prévention et de contrôle des infections. Il est important pour les patients de la clinique qui auraient pu être exposé à du matériel médical insuffisamment nettoyé d’avoir accès à l’information nécessaire pour prendre des décisions éclairées à propos de leur santé. Santé publique Ottawa a aussi envoyé de l’information sur ce manquement aux professionnels de la santé de la région d’Ottawa, pour qu’ils soient en mesure d’aider les patients touchés.

Les patients qui recherchent de l’information au sujet de l’enquête de Santé publique Ottawa ou des renseignements au sujet de l’hépatite B, de l’hépatite C et du VIH peuvent visiter SantePubliqueOttawa.ca/Manquement ou communiquer avec la Ligne info-santé publique d’Ottawa au 613-580-6744, ou par courriel à [email protected]. Les patients peuvent aussi contacter la clinique Main Street Family Medical Centre au 613-831-7372.

I want to acknowledge that, for some people in our community, this information may create concern. I want to assure residents that, at this time, Ottawa Public Health is not aware of any case of infection associated with this infection prevention and control lapse. It is important that patients who may have been exposed to improperly cleaned medical equipment at this clinic have the information they need to make informed decisions about their health. Ottawa Public Health is also sending information about this lapse to Ottawa-area healthcare providers, so that they can assist affected patients.

Patients who are looking for information about the Ottawa Public Health investigation or about hepatitis B, hepatitis C and HIV can visit OttawaPublicHealth.ca/Lapse or call the Ottawa Public Health Information Centre at http://www.ottawapublichealth.ca/Modules/News/index.aspx?newsId=9c072336-c413-4007-a5b4-c8e5ac436bd9 5/7 7/31/2018 News and Public Notices - Ottawa Public Health 613-580-6744 to speak to a public health nurse, or email [email protected]. Patients can also contact the Main Street Family Medical Centre at 613-831-7372.

Thank you, merci.

Dr. Geneviève Cadieux, Associate Medical Officer of Health, Ottawa Public Health

()Full statement by Councillor Shad Qadri

“Good morning and thank you for joining us this morning. As Chair of the Ottawa Board of Health, I want to use this opportunity to express my support for the work of Ottawa Public Health in this investigation of the Main Street Family Health Centre. This medical clinic is located in Stittsville Ward, which I represent on City Council.

As Dr. Cadieux mentioned, OPH responded immediately to a public complaint and initiated an investigation. Based on that rapid response, all procedures that OPH assessed as being a risk to the health of clinic patients stopped immediately.

I am also reassured by the thorough work OPH has done over the last several weeks to identify and notify patients affected by this infection prevention and control lapse. This work could not have been done without the close collaboration of our health care system partners including the Ministry of Health and Long Term Care, Public Health Ontario, the Public Health Ontario Laboratory, and the College of Physicians and Surgeons of Ontario.

This close collaboration was essential in order to provide the necessary information, services and care to affected patients in the weeks to come. I also want to thank, in advance, all of our city’s primary health care providers who will be providing care and support to affected patients in the weeks and months to come.

As Dr. Cadieux said earlier, this news may cause concern for the affected patients of the Main Street Family Medical Centre. I want to assure all residents that OPH is ready to support affected patients with readily available information to address their concerns and questions in an accessible and transparent way.

Answers to many anticipated questions is available now on Ottawa Public Health dot C A slash lapse. OPH nurses are also available to answer any questions from the public.

Finally, I want to reassure the public that OPH’s work to support affected patients in this infection prevention and control lapse is at the core of Ottawa Public Health’s mandate to promote and protect the health of all Ottawa residents. Thank you, merci.”

Councillor Shad Qadri, Chair of the Ottawa Board of Health

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