Tainted steroid may lead to delayed or misdiagnosis in patients

According to the CDC, nearly 14,000 people have been potentially exposed to contaminated steroids since May 2012. The tainted steroids were shipped to various hospitals throughout the U.S. from a Massachusetts pharmacy. Public health authorities are unsure how many of those exposed will become ill but the CDC recorded 308 fungal infections in 17 states and at least 23 deaths were attributed to the contaminated steroids. A large percentage of the contaminated steroids were injectable.

New Jersey residents who received an injectable drug since May 21, 2012 should have already been contacted by their doctor. However, if anyone who received an injectable is experiencing headaches, fevers, chills, a stiff neck, nausea and other symptoms they should contact their doctor. The black mold implicated in the contaminated steroid is common in the environment and is not known to cause disease in humans.

Unfortunately, the adverse health effects when introduced into the human body are not well studied or known. Thus, doctors and healthcare providers are in a dilemma of over-diagnosing and over-treating those who were exposed to but not necessarily at risk.

A case in point is that of the mayor of a New Hampshire city, who received a spinal injection for his chronic back pain. After the injection he was not feeling well and, although he may have the fungal infection, there is no proof that he actually does. Nevertheless, the doctors, as a precautionary measure, are treating him as if he was infected. The antifungal drugs can damage the liver and kidneys and patients have to undergo a painful spinal tap to rule out the fungal infection. Further, this fungal infection can suppress itself for weeks and months before manifesting itself as meningitis or causing a massive stroke.

Presently, doctors are struggling to identify at-risk patients and determine when and if to start treatment and if they should perform invasion procedures such as a spinal tap. Given these challenges, a delay in diagnosis or misdiagnosis of symptoms is foreseeable.

Doctors have an on-going duty to provide a reasonable standard of care and may be negligent if, despite all the information out there, they did not take reasonable steps to rule out an infection and give reasonable treatment. This particular case is uncharted medical territory but, nevertheless, healthcare providers should work with the best available information on the contaminated steroid to prevent an adverse health effect.

Source: WBUR, “Meningitis From Tainted Drugs Puts Patients, Doctors In Quandary,” Richard Knox, Oct. 24, 2012