Reporter follows epidemiological investigation of dental practice Date: 10/23/13
By Mary Otto
When genetic testing concluded that a former patient of W. Scott Harrington contracted hepatitis C at the Tulsa oral surgeon’s office, Tulsa World reporter Shannon Muchmore was there to file the latest installment in an unfolding story she has been covering since the spring.
The case turned out to be the first documented report of patient-to-patient transmission of the hepatitis C virus associated with a dental setting in the United States, according to Oklahoma state and local health officials. In March, officials started testing thousands of Harrington’s former patients for hepatitis and HIV after an office inspection turned up lax sanitation practices and other violations of the state’s Dental Act. Since then, more than 4,200 people have been tested at free clinics.
Muchmore took some time out from her work on this story to offer AHCJ members an update on what she has found.
You wrote that genetic testing has confirmed that a former patient of Tulsa oral surgeon W. Scott Harrington contracted hepatitis C at his office. The case is the first documented report of patient-to-patient transmission of the hepatitis C virus associated with a dental setting in the United States, according to Oklahoma state and local health officials.
Can you tell us a little more about the epidemiological detective work that went into this conclusion?
The epidemiologists looked at patient records, which only dated back a year, to find clusters of patients who tested positive and went to Harrington's office at about the same time. They did testing to determine whether it was the same type of hepatitis C and then sent away for more comprehensive quasispecies testing at the Centers for Disease Control, which can determine that the patients shared the exact same type of the virus. This leads them to conclude there was patient-to-patient transmission.
Has there been a strong reaction to the release of the test results so far? Are the test outcomes expected to have a bearing on the civil cases against Dr. Harrington?
Mostly in talking to people I've found few who are surprised at the findings. Based on what investigators found at Harrington's office – rusty equipment and a lack of infection-control procedures – many people believed patient-to-patient transmission would be discovered. It remains to be seen exactly how the results will affect the civil cases, but lawyers I've talked to who have had similar lawsuits in other parts of the country say linking infected patients together was key to proving their case.
How has it been working with local, state, and national health authorities while covering this story? Any advice for getting the information you’ve needed?
Most have been helpful in coming forward with information and explaining various parts of the story. I would advise, of course, being in frequent contact with key sources in the various departments so you know when they are releasing important information and can make sure you set up the interviews you will need. The agencies are constantly talking to one another so if somebody isn't giving me a certain piece of information I'll ask another source even if that information wouldn't typically come from his or her agency. It may seem elementary but it has also helped me with this story to be sure and write out every question I have and go through that list every time I talk to a source so I don't miss anything.
Has it been challenging to continue to follow the many tracks of this story, the public health investigation, together with the criminal, civil and dental board pieces of it? Have you collaborated with colleagues at your paper on any angles of it?
It's been a bit tricky to keep track of everything. The civil cases are piling up and we have to make judgments on which ones should be reported. Sources with the health departments and the dental board have been helpful in letting me know what's coming and keeping me on top of everything. I've done a little work with other reporters. The projects team at the Tulsa World has helped when we wanted to look at the bigger picture of regulation among dentists and other doctors in Oklahoma.
Officials have not yet released the results on the HIV testing. One of the patients you interviewed in an early story said he was certain he contracted the virus at Dr. Harrington’s office. Have you been in touch with him?
I did try to get in touch with him but haven't succeeded so far. He had gone to Harrington more than a year prior to the allegations surfacing, so the patient records being examined wouldn't include his.