San Francisco Chronicle (SF) - THURSDAY October 17, 1991
Sabin Russell, Chronicle Staff Writer

Unions representing doctors, nurses and orderlies at the city-run hospital are upset that the hospital is providing the safer but more costly needle to staff members in its emergency room and to ambulance crews but has refused to make it available throughout the medical center.

The drive for safer needles was prompted by a frightening accident in March, when a University of California at Davis medical student was accidentally stuck in the palm of his hand with a catheter needle that had just been withdrawn from a patient infected with human immunodeficiency virus, which causes AIDS.

Hospital nurse Janet Christensen, who was pulling out the needle when the medical student moved his hand into its path, said she was devastated by the accident. "I don't want this to ever happen again to anyone," she said. "I'd rather it had stuck me than someone else."

Since the accident, the medical student has been taking the AIDS drug AZT and has yet to show evidence that he was infected by HIV. Christensen helped launch a campaign for safer needles when she learned that one, known as a Critikon angiocath, was being used in the emergency room. It is not available to her unit, a pre-operation holding room, where she sets 10 to 20 intravenous catheters per day.

The Critikon device features a plastic shield that slips over the needle when it is withdrawn. The needles cost $1.50 apiece, compared with 50 cents for the standard catheters used outside the emergency room.

"I feel very strongly that it would have prevented what happened," she said. "It is unfathomable why we would provide this safety equipment to one part of the hospital and not another."

Dr. Peter Lurie, co-chairman of the union representing interns and residents, said he objects to what he called the "double standard." The emergency room accounts for only 7 percent of the roughly 30 needle-sticks reported each month.

He said the cost of switching to universal use of the safer needle would be $175,000 a year.

Gloria Rodriguez, spokeswoman for San Francisco General, said the hospital is studying the issue. "There is an ongoing debate as to whether this product is better than the existing one," she said. "The matter is being carefully studied by our product evaluation and infection control committees."

Despite the impassioned national debate over the risk of an HIV-infected doctor infecting a patient, medical experts say health care workers actually have a greater risk of being infected by their patients. Nationwide, about 40 health care workers -- including two nurses at San Francisco General -- have been accidentally infected with HIV from needle-stick injuries.

Always watch for outdated information. This article first appeared in 1991. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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