The New York Times - March 26, 2009
Damien Cave

More than 3,200 veterans who had the procedure at Veterans Affairs clinics in South Florida from May 2004 to March 12, 2009, may be affected.

"It's mind-boggling," said John, 58, a Vietnam veteran who asked that his full name not be used to protect his privacy. "You got to think about this: you're going to get a procedure to help you live a better life. And now it turns out I may have sped up my system of dying."

John Vara, the Miami V.A.'s chief of staff, said 11 of 41 endoscopes at the Miami hospital were not sanitized in accordance with manufacturer guidelines.

Medical experts said the risk of cross-contamination was low, "in the range of 1 in 1.8 million," said Dr. Anthony Kaloo, chief of gastroenterology and hepatology at Johns Hopkins. Dr. Kaloo said that because the gastrointestinal tract was not a sterile area, the body of a healthy patient would probably eliminate whatever virus might be carried into their system by the endoscope.

"The problem is with immune-suppressed patients, like cancer patients who are receiving chemotherapy," Dr. Kaloo said. "They may be at higher risk."

The threat, however, appears to have caused a panic among a much larger swath of the veteran population. A hot line for South Florida veterans had received more than 3,400 calls as of Wednesday afternoon.

This is not the first incident in which veterans may have been exposed to infection during colonoscopies. Last month, the Department of Veterans Affairs alerted about 6,400 patients in Tennessee that they might have been exposed to infectious body fluids during colonoscopies from 2003 to 2008. Another 1,100 veterans treated in Augusta, Ga., received a similar notification.

Katie Roberts, a spokeswoman for the department in Washington, said initial test results showed that 10 people from Tennessee and 6 from Georgia had tested positive for infection. The Georgia results were still being evaluated, but in Tennessee, six people tested positive for hepatitis C and four for hepatitis B.

Ms. Roberts emphasized that people might have gotten sick from other sources.

"There is no way to determine if the positive test results are directly related to the endoscopies at each facility," she said.

That will bring little comfort to people like Steven Senzig, 62, a Vietnam veteran who came to the Miami V.A. Wednesday. He was one of 819 people to seek testing since Tuesday.

Dr. Vara said 40 to 50 staff members had been assigned to deal with the problem, which he said was a measure of the desire to "get things right." But like two local congressmen who have called for an inquiry by the V.A.'s inspector general, many veterans said they were frustrated that the V.A. still seemed to struggle with meeting basic standards of care.

Mr. Senzig, pointing to two banners identifying the Miami hospital as an award winner for its services, said, "My question is, if it is happening here, what's happening at the rest of the hospitals?"

Carmen Gentile contributed reporting from Miami.
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