Practice Areas - Hepatitis C Infection

You received a letter from Rose Medical Center or Audubon Surgery Center advising you to get tested for hepatitis C virus (HCV), now you need independent advice.

Our lawyers are experienced in Hepatitis C cases - we can answer your questions:

First of all, do not panic. The hospitals contacted anyone who may have been put at risk. Kristen Parker, the scrub tech now facing criminal charges, may have been assigned to your room but may not have been left alone long enough to steal your pre-filled fentanyl syringes. In the special agent’s publicly available affidavit, Ms. Parker’s thefts are detailed as crimes of opportunity.

Even if you were injected with a contaminated syringe, there is a good chance you were not exposed to the virus. HCV is not efficiently transmitted from a needlestick. Studies have shown the HCV transmission rate from a contaminated syringe is only about 6%[1].

You should, above all else, heed the advice of a doctor you trust.

Rose Medical Center and Audubon Surgery Centers are offering testing, but it is not free. They are asking you to waive certain privacy rights in exchange for the test. You are under no obligation to accept the terms they are offering. If you have private health insurance, they may pay the cost of testing, or apply it to your annual deductible. You should call your insurer to confirm whether testing is covered. If you were to pursue a civil action against the hospital, the cost of medically necessary testing, both now and in the future, would be a claimed element of damages.

What tests should I get?

Only your doctor knows the best treatment for you. There are three HCV tests commonly available, and each is appropriate in a different circumstance. Because the virus takes time to replicate to testable levels, if you are tested after a recent infection, all tests may show no sign of HCV.

The HCV-RNA test confirms a present infection. This test detects the presence of the actual virus in the bloodstream. If it comes back positive, you have been exposed to HCV[2].

When the body detects the virus, it will begin producing antibodies to fight off the infection, and in many cases suppress the virus to levels too low for the RNA test to recognize. However, the antibodies left behind after the fight will indicate a prior infection. The antibodies can be found 3 months post-infection in 90% of cases, and 6 months post-infection in nearly all cases[3]. The most common antibody test is EIA (enzyme immunoassay) which confirms the presence of HCV antibodies. However, in about 5% of cases, this test will yield a false positive. A follow up test known as a RIBA (recombinant immunoblot assay) can confirm the EIA result[4].

Your doctor may recommend repeated testing to confirm either positive or negative results.

How do I know if I have HCV?

According to the National Institute of Health, most people have no symptoms until the virus causes liver damage, which can take 10 or more years to happen. Others have one or more of the following symptoms:

• yellowish eyes and skin, called jaundice
• a longer than usual amount of time for bleeding to stop
• swollen stomach or ankles
• easy bruising
• tiredness
• upset stomach
• fever
• loss of appetite
• diarrhea
• light-colored stools
• dark yellow urine[5]

What exactly is HCV and how does the virus progress?

The hepatitis C virus (HCV) is a small enveloped RNA virus belonging to the family flaviviridae and genus hepacivirus. The HCV RNA genome is 9,600 nucleotides in length and encodes a single polyprotein that is post-translationally cleaved into 10 polypeptides including t3 structural (C, El, and E2) and multiple nonstructural proteins ([NS] NS2 to NS5).

The NS proteins include enzymes necessary for protein processing (proteases) and viral replication (RNA polymerase). The virus replicates at a high rate in the liver and has marked sequence heterogeneity. There are 6 genotypes and more than 90 subtypes of HCV, the most common in the United States being la and lb (approximately 75%), 2a and 2b (approximately 15%0), and 3 (approximately 7%). Acute hepatitis C is marked by appearance of HCV RNA in serum within 1 to 2 weeks of exposure followed by serum alanine aminotransferase (ALT) elevations, and then symptoms and jaundice. Antibody to HCV (anti-HCV) tends to arise late. In acute resolving hepatitis, HCV RNA is cleared and serum ALT levels fall to normal. However, 55% to 85% of patients do not clear virus, but develop chronic hepatitis C. Chronic hepatitis C is often asymptomatic, but is usually associated with persistent or fluctuating elevations in ALT levels. The chronic sequelae of hepatitis C include progressive hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. Extra-hepatic manifestations include sicca syndrome, cryoglobulinemia, glomerulonephritis, and porphyria cutanea tarda. Knowledge of the course and outcome of hepatitis C is important in developing approaches to management and therapy.

Jay H. Hoofnagle, Course and Outcome of Hepatitis C, 36 Hepatology S1, S21-S29 (2002).

Read the rest of this article Course and Outcome of Hepatitis C.

I have HCV. What are my legal rights and the hospital’s obligation to me?

A hospital has special duties of care it owes to its patients, to act reasonably to prevent harm. This includes the hospital’s hiring and supervision of staff and the need for safeguards to prevent drug abusers from gaining access to powerful narcotic medications. The failure of a hospital to fulfill these duties of care is legally described as “negligence.”

If you incur losses, or “damages” as a result of another person’s negligence, you are entitled to recover those losses. Damages may be either economic or non-economic. Economic damages associated with HCV infection would include the cost of blood tests, drug therapies, future medical care, and lost earnings or earning potential. Non-economic damages are for mental anguish, pain and suffering, and loss of enjoyment of life.

Even though the virus may take years to manifest, Colorado law places a two-year statute of limitations on claims of medical negligence, with certain exceptions not likely to apply to your case. If you wait for symptoms to appear, you may lose your right to make a claim.

Why Chalat Hatten & Koupal PC?

Every case arising from Ms. Parker’s fentanyl thefts is different, and requires independent consideration from an attorney experienced in medical negligence cases, and one who specifically understands your diagnosis.

Chalat Hatten & Koupal PC is currently handling cases of iatrogenic (hospital transmitted) HCV. We know the law and have done extensive research to learn the medicine. We have been consulting with top experts in the fields of hepatology and hospital medicine to present the strongest case on your behalf.

Call us at 303.861.1042

[5] http://digestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/#6

If you have concerns or questions about exposure to Hepatitis C, call us for a free consultation to discuss your matter with an experienced attorney: 303.861.1042 or toll free 800.221.5526