San Francisco Chronicle - Tuesday, May 25, 1999
Sabin Russell, Chronicle Staff Writer

State investigators identified yesterday 25 different sites where the 52-year-old technician had worked since she was trained as a blood- drawing specialist -- known as a phlebotomist -- in 1994.

Giorgi worked with other phlebotomists at most locations, but included in the list are five sites where she worked alone, briefly, almost five years ago. A total of 612 patients had their blood drawn by her at those locations, but state health officials stressed that the chances are exceedingly slim that anyone was infected at any of the newly disclosed sites.

The two-month probe found no evidence that Giorgi had reused needles at any sites other than the SmithKline Beecham blood drawing station at 1101 Welch Road in Palo Alto, where she worked, typically alone, from June 1997 until March 22.

About 3,600 patients who had blood drawn by Giorgi at the site were previously advised to take precautionary blood tests after she admitted occasionally using washed- out disposable butterfly needles on difficult-to-pierce veins.

"This particular phlebotomist was so far in violation of accepted medical practices, . . . that it warranted us taking her to court," said state health officer Dr. James Stratton. Giorgi is barred by a temporary court order from working as a phlebotomist. "We think this is a very, very unusual circumstance."

Now an additional 11,687 patients have been identified who had blood drawn at 18 different SmithKline Beecham locations where Giorgi was employed as a temporary worker. The Philadelphia pharmaceutical company is offering all of them free blood tests, despite a state finding that the screens are not recommended for most of them.

"We think it's the right thing to do," said Dr. Edward Kaufman, SmithKline's national medical director. "Some people may have concerns, and we are doing this for them."

Although state officials are reassured that in most cases Giorgi worked at stations with other phlebotomists who would have spotted improper procedures, it was not always the case. At four sites, for brief periods in 1994 and 1995, Giorgi worked alone. The 612 patients who had blood drawn by Giorgi at these sites will be the first to get letters from SmithKline. The notices will be sent by registered mail this week.

The remaining 11,075 patients will also be notified, by registered mail, over a two-month period.

Dr. Jon Rosenberg, the epidemiologist leading the state Department of Health Services probe of the Giorgi case, told reporters yesterday that taking the blood test is a personal decision. "If I had my blood tested at these sites, I wouldn't worry about it and I wouldn't be tested," he said.

Because Giorgi worked with other phlebotomists at the remaining 14 SmithKline Beecham sites, but no records exist as to which person drew a patient's blood, Giorgi probably did not do the drawing. "A majority of persons being notified will in fact have had their blood drawn by another phlebotomist," said Rosenberg.

State officials said it will be six months before an analysis of the results of any tests are released. It can take six months for the antibodies that signal HIV infection to turn up in a test, so some of Giorgi's most recent patients have a long wait for their results.

SmithKline's Kaufman said yesterday that so far the test results show fewer cases of hepatitis than would be expected among the group tested. Epidemiologists estimate that as much as 1.8 percent of the American population is infected with hepatitis C, and that at least half of them do not know it.

In addition to the 18 SmithKline sites identified, state officials also reported yesterday that Giorgi had worked briefly and part time at six locations currently owned by Unilab, a clinical laboratory that at the time did business under the name PathLabs. However, because laboratories are required to keep records for only two years, Unilab has none for patients who may have had their blood tested by Giorgi from May 31, 1994, through June 13, 1995, at any of the six sites: 1828 El Camino Real in Burlingame; 133 Arch St. and 77 Birch St., Suite 3, in Redwood City; 1100 Laurel St., San Carlos; and 136 N. San Mateo and 119 S. San Mateo Dr. in San Mateo.

Although there is no evidence that Giorgi performed any unsafe procedures at the former PathLab sites, Unilab will provide free blood tests to patients who present evidence they were treated during the times Giorgi worked there.
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