Could a national registry save hospitals from hiring problem workers?

As officials continue to investigate the hepatitis C outbreak, some outraged citizens and healthcare organizations are calling for a national registry that would require hospitals and staffing agencies to report professional misconduct by medical technicians, as well using confidential, third-party reference checks, Seacoast Online reported.

State and hospital investigations into the work history and conduct of David Kwiatkowski, a traveling lab technician and alleged infector who caused the hepatitis C outbreak at New Hampshire's Exeter Hospital, bring up questions into oversight responsibilities. The Centers for Medicare & Medicaid Services also is investigating infection control procedures at the hospital.

Thirty people have been diagnosed with the same strain of hepatitis C as Kwiatkowski, who allegedly passed the disease through infected syringes after stealing fentanyl. The state on Friday began conducting tests on an additional 3,400 patients, Foster's Daily Democrat reported.

Kwiatkowski worked in seven other states, including New York, Maryland, Michigan, Georgia, Kansas, Arizona and Pennsylvania.

In addition to a trail of infected patients, Exeter Hospital faces 19 lawsuits by infected patients, according to another Foster's Daily Democrat article. Exeter and other hospitals are facing some tough scrutiny as to who's responsible.

"It's shocking how careless it appears that Exeter Hospital was, and that maybe other hospitals were," attorney Peter McGrath, who drafted the class-action lawsuit, said in the Seacoast Online article. "It's very concerning that our hospitals don't do a better job to protect their patients."

For instance, one employer in Arizona fired Kwiatkowski after finding him with syringes and needles and had cocaine and marijuana in his system. The incident was reported to the American Registry of Radiologic Technologists, but police didn't follow up because he moved out of state, Seacoast Online noted.

The national registry, which would require federal intervention, would be a place for hospitals and staffing agencies to report problem medical technicians who move from state to state.

Among other suggestions that the ad hoc committee, led by state Rep. Lee Quandt (R-Exeter), might consider is mandatory testing for drugs and infectious diseases of healthcare professionals.

Exeter Hospital told Seacoast Online that there was no information available prior to Kwiatkowski's hiring that would have provided the hospital with a reason to not employ him. "His criminal background checks were clear, he had no restrictions placed on his professional licensure/certification, he was not included on the Health & Human Services Office of Inspector General's list of sanctioned healthcare workers, he passed a drug test, and he had very strong references from his previous employers."

Exeter said providers and lawmakers should consider a mandatory reference disclosure process for healthcare providers to report problems with former employees, establish legislative protection for hospitals to share information that relates to criminal activity or threats to patient safety, and the possibility of a national registry that tracks problems of all healthcare workers similar to reporting systems for physician and nurses.

"[Contract workers and temporary] employees undergo thorough screenings, including state and national criminal background checks, drug tests and verifications of their medical licenses and certifications," according to an editorial in Sentinel Source. "But unless state regulatory boards diligently investigate all complaints against healthcare workers and national certification agencies uphold appropriate levels of oversight, it seems standard background checks may not be enough to prevent tragedies like the outbreak at Exeter Hospital."

For more information:
- read the Seacoast Online article
- see the Foster's Daily Democrat article on patient testing and the article on the lawsuits
- read the Sentinel Source article

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