How multi-dose vials (MDVs) and insulin pens can be contaminated with HCV

Multi-dose vial contamination with HCV
Source: Web image Clarke County Health Dept./Mike Johnson

Patient-to-patient contamination with multi-dose vials

This is how I interpret the image above:

1. Syringe and needle draw fluid from a multi-dose vial (MDV). A patient with HCV is injected. Microscopic blood cells can backflow into the syringe.

2. Needle # 1 is discarded. Needle #2, a new needle, is attached to the contaminated syringe.

3. Fluid is withdrawn from a 2nd vial. Microscopic blood travels into the 2nd multi-dose vial.

4. Needle and syringe are discarded. However, the 2nd multi-dose vial is now contaminated.

5. When a new patient is injected with fluid from the 2nd vial, they are at risk for HCV infection.

A few injection safety rules from the CDC for professionals when MDVs must be used:

“If multiple-dose vials are used, restrict them to a centralized medication area or for single patient use. Never reenter a vial with a needle or syringe used on one patient if that vial will be used to withdraw medication for another patient.”

The brief video posted previously in ASKNOD about The One and Only One campaign reinforces these concepts. Also check out the CDC site: http://www.oneandonlycampaign.org/

These same safety concepts can be applied to insulin pens because blood and skin cells enter the insulin cartridges as well. This 3-minute CDC video explains:

And this is basically how jet-gun injectors with “on tool” multi-dose vials were contaminated as well.

2 Responses to How multi-dose vials (MDVs) and insulin pens can be contaminated with HCV

randy says:

January 26, 2013 at 19:55

But in all fairness (sic) this could never have occurred in the 70’s-90’s because of the top notch training and fearless leaders never made mistakes and the HCV was never clearly identified in time nor admissions made. Therefore this is not SC material folks, no sir, no way.

- Kiedove says:
  
  January 27, 2013 at 08:52
  
  Yup, it’s the elephant in the room in the professional world of public and private health. They know what a safe injection is but can’t bring themselves to state to the public that previous injections, like those administered via jet-gun injections,were risk factors for bloodborne pathogens. . They’d rather let people die than tell them to get tested. They’d rather let people in the 40-65 age cohort with HCV be stigmatized as junkie’s than come clean about unsafe vaccinations. Maybe they are imagining getting grilled in front of Congress and the media fall-out. In fairness, they didn’t know. There is no blame when you didn’t know something. There IS blame when the medical establish finally knows something but remains silent and let the slow killers like HCV take hold in the population.