The autopsy report, which would be used to confirm a Creutzfeldt-Jakob disease diagnosis, will take several weeks, Dr. Joseph Pepe, president and CEO of Catholic Medical Center, wrote in a separate letter posted Sept. 5 to the hospital's website. Pepe said the at-risk patients were identified by the hospital and the health department after they reviewed their medical records.
Creutzfeldt-Jakob disease is a fatal brain disorder caused by a rare type of protein called a prion, which resists standard sterilization processes used by hospitals.
About 200 people a year are diagnosed with the disease in the U.S. However, there are only four confirmed cases of patients contracting the disease from surgical instruments, and none occurred in the U.S., the New Hampshire health department said. The use of surgical instruments in brain, eye and spinal cord procedures are the most risky.
The health department said Catholic Medical Center tracks the use of surgical medical equipment in patients as required by the Joint Commission and adheres to sterilization guidelines established by the Association for the Advancement of Medical Instrumentation.
Lisa Waldowski, an infection control specialist for the Joint Commission, which accredits the quality and safety of healthcare providers, said the commission expects hospitals to track the use of medical equipment in patients and expects hospitals that offer surgical services to have a prion processing protocol in place.
In 2001, the Joint Commission issued a sentinel alert (PDF) recommending that hospitals establish a policy for disinfecting or disposing of neurosurgery instruments when Creutzfeldt-Jakob disease is suspected or confirmed. The recommendation came after two hospitals in Denver and New Orleans notified patients that they could have been exposed to Creutzfeldt-Jakob disease during surgical procedures. About the same time and over the next several years, hospitals in Atlanta and Pittsburgh notified patients of similar concerns.
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