Health commish grilled over syringe case

BY RIDGELY OCHS | ridgely.ochs@newsday.com

10:48 PM EST, December 6, 2007

State Health Commissioner Richard Daines conceded again Thursday that the state mishandled aspects of the Dr. Harvey Finkelstein case, and State Sen. Kemp Hannon said he would propose legislation to speed the notification of patients infected after improper practices and to disclose charges against doctors.

Hannon (R-Garden City), chairman of the State Senate's health committee, held a hearing at Farmingdale State College Thursday to address questions surrounding the transmission of hepatitis C in the Dix Hills doctor's office in 2004 after he improperly re-used syringes in multidose vials of drugs. The state says Finkelstein corrected his methods as soon as state health investigators noticed them in 2005, and he continues to practice.

The health department has come under fire because it took nearly three years to notify many of his patients that they should be tested for hepatitis C, hepatitis B and HIV. The Office of Professional Medical Conduct, which is part of the department, also has been criticized for not disciplining Finkelstein, and for not taking into account his 10 malpractice settlements in the past nine years. Of the state's 70,000 doctors, 177 have as many settlements, according to Public Citizen, a national nonprofit organization that monitors health issues.

Hannon said he plans to craft a bill to make public charges brought against doctors by the professional conduct office. New York is one of a handful of states in which findings against a doctor are made public only after he has been found to be at fault, which can take years.

Despite assurances from Daines that the department is making changes to quicken the pace of investigations, Hannon said he also will look into legislation to ensure that it happens and that people are notified as soon as possible.

In two hours of testimony before the legislators, Daines repeated his past descriptions of the department's scientific investigation as "world class." But he said "the investigation could have and should have moved along more quickly, which would have allowed the notification of patients to occur earlier."

Daines said he has established a committee to review ongoing investigations to ensure they are done as quickly as possible. He said "adverse events" in office practices such as Finkelstein's would be reported to the department's Patient Safety Center.

He said he wants that center to work with the professional conduct office to more proactively flag doctors who prompt a high number of complaints or errors. Critics have assailed the office for not reviewing doctors like Finkelstein, who are forced to get insurance from a state pool because they are involved in an unusually high number of malpractice cases.

And he said Gov. Eliot Spitzer has called for a Hepatitis C Advisory Council to help the department develop a program on hepatitis C education, detection and treatment.

But Daines balked at the suggestion from Sens. Charles Fuschillo (R-Merrick) and Carl Marcellino (R-Syosset) that patients be notified as soon as the state knows of an infection problem.

"That's a key philosophical issue," Daines said. Referring to health department officials' watching Finkelstein's practices in January 2005, Daines said: "After observing unsafe practices, was that enough to notify the public? Or do you wait to verify transmission?"

The department confirmed the transmission a year later and issued its first public statement on the matter on Nov. 10 this year.

Daines said the health department was concerned about wrongly notifying patients who weren't at risk.

But Marcellino and Fuschillo asked why the public couldn't be informed of a transmission the way parents are notified of an illness outbreak at school.

"I would want to be notified immediately. I would rather be proactive with my own life," Fuschillo said.