BBC News - Tuesday, 7 September, 2004

The Royal National Orthopaedic Hospital NHS Trust has written to 551 patients outlining a "very low" risk of cross infection from a shoulder joint check.

Staff had raised concerns that probes used in the procedure were being re-used on different patients.

People who were examined between 1995 and 2002 have been contacted.

The shoulder investigations took place at the hospital's Bolsover Street outpatient clinic in central London.

In the procedure, a probe was inserted into a tube in the shoulder joint. The patient was then asked to move their shoulder while the probe measured the pressure.

The probe was cleaned with alcohol between patients, but the trust said this was not 100% effective against all viruses.

'Right to know'

In a statement, the hospital said the investigations were initially undertaken as part of a research programme involving both NHS and private patients.

It said it had taken more than two years to tell patients because it had taken time to conduct the detailed risk assessment with external experts including the Health Protection Agency.

In the majority of cases, it said there was no likelihood of the probe coming into contact with the patient's blood, the trust said.

But it said that, if it had, and the previous patient treated with the same probe had a blood-borne disease, such as Hepatitis B or C or HIV, there was a risk of cross-infection.

After the safety concerns were raised, the procedure was suspended. It was then restarted ensuring probes were only used once before being finally halted last year.

Andrew Woodhead, chief executive of the Royal National Orthopaedic Hospital, said: "We have taken the advice of the Health Protection Agency on the level of risk of cross infection and their advice is that the risk is very low.

"However, our board was firmly of the view that our patients had the right to know that this procedure was not carried out correctly, so we have written to every patient for whom we have records telling them about this.

"For those who are concerned we are offering a blood test to detect blood-borne viruses and we have set up a number of clinic sessions to undertake this work."

He added: "We believe we let our patients down by not following the usual high standards that we expect and for that reason they have the right to know about this failure.

"However, we do not believe on the evidence that there is a real likelihood of anyone having become infected.

'Surprise'

Details of the incident have been passed to the General Medical Council. The orthopaedic surgeon involved in the procedure, Simon Moyes, who no longer works at the trust, said he was confident that any inquiry would exonerate him and other medical staff.

But he said he was "puzzled" by the trust's motives for writing to patients more than 27 months after initial concerns about the procedure were raised.

Mr Moyes, who now works with a private practice at London's Wellington Hospital, said: "Naturally I agree with the trust that the well-being of patients is paramount.

"Bearing this in mind, I am surprised the trust has not also contacted the dozens of volunteers involved in the research before 1995, who underwent exactly the same procedure."

It is not the first time the RNOH has faced controversy in recent months.

In July an independent inquiry into waiting list "irregularities" at the hospital was launched after the discovery that around 300 patients had been taken off the waiting list last year.

The hospital said most of these were due to "valid reasons". The local strategic health authority has launched an inquiry into the apparent irregularities.

Patients concerned they may have been affected can contacted NHS Direct on 020 8867 1426.

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