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State is investigating potential exposure to hepatitis, HIV at Coalinga State Hospital

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Questions surround an investigation into potential exposure to hepatitis C and HIV at Coalinga State Hospital, a state-run psychiatric hospital in Central California. Documents shared with KVPR suggest the exposures originated in the hospital’s pain management clinic.

FRESNO, CA. – In early May, an internal email circulated at Coalinga State Hospital informed staff that patients who used the hospital’s pain management clinic had potentially been exposed to hepatitis C and possibly HIV.

“Given that we have had several hundred patients visit the clinic, we are set to begin testing for Hepatitis and HIV for all patients who utilized those services within a specific target window,” reads the email, which was written by chief psychologist Cory Fulton and obtained and verified by KVPR.

Hepatitis C is an inflammation of the liver and HIV is a virus that attacks the immune system. Both viruses can be transmitted through contact with infected blood, shared needles, or sexual contact. If left untreated, both can lead to debilitating chronic disease.

The Department of State Hospitals confirmed an investigation into the situation is ongoing. In an email statement, Department officials wrote, “We are aware of a small number of patients who have tested positive for Hepatitis C and they are currently being treated. We are offering testing to additional patients who may be at risk for exposure.”

“At this time, it appears the event has been isolated and contained,” the statement continued.

The Department did not answer KVPR’s questions about how or when a potential exposure may have occurred, how many people are at risk, or whether any patients contracted HIV. However, a notice for hepatitis and HIV testing that was received by one patient and shared with KVPR reads, "You have been identified as possibly being exposed to contaminated needles during Pain Managment [sic] Clinic."

Patients at the hospital, a psychiatric facility run by the state, who spoke to KVPR said they feel angry that so little information is available about a situation that could affect their long-term health.

Patients are committed to the hospital by the court system, some for decades, and they have no choice but to use the healthcare options provided by the hospital.

Confusion surrounds hospital clinic

Michael St. Martin, a long-time patient at the hospital, knew something unusual was happening last month when he tore a tendon in his foot and asked his podiatrist if he could visit the pain management clinic.

“He said the pain clinic is suspended until further notice,” St. Martin said.

The clinic has been a regular part of his medical care for years as a way of managing chronic conditions. He was concerned when neither the podiatrist nor a nurse would tell him why it was closed or when he would have access to it again.

“They both clammed up and said they didn't know anything that was going on,” he said. That was in mid-April, weeks before the email would be sent revealing the potential exposures to staff.

It was after that that St. Martin learned he was one of the patients at risk.

According to him and other patients, the pain clinic provides therapies including nerve blocks, Botox injections, and a regenerative medicine treatment known as platelet-rich plasma. That treatment includes drawing a patient’s blood, running it through a centrifuge to separate platelets from other blood cells, then reinjecting concentrated platelets back into the patient.

St. Martin said not knowing when or how he could have potentially been exposed is worrisome, given that he visits the clinic every few months for dozens of injections for arthritis and other conditions.

“The opportunity for me to be exposed in the last year is a lot,” he said.

In its statement, the Department of State Hospitals did not answer questions about the status of the pain management clinic or its role in the potential exposures.

Questions remain for patients, staff

The Fresno County Department of Public Health confirmed it’s aware of the situation and is “collaborating with the California Department of Public Health (CDPH) on this investigation.”

In an email statement, the agency added it was not aware of a risk to public health.

An employee who asked to remain anonymous for fear of retaliation from hospital administrators said staff members had received little more information than patients had. The employee, who has worked at the hospital for more than 10 years, said it was unclear how far-reaching the exposure had been and whether staff could also have been exposed.

“I was like, ‘holy s--- this is bad,’” they said.

Jeff Gambord, another patient at the hospital who was also identified as potentially exposed, said he heard about the situation from other patients more than a week before doctors informed him he was at risk.

“I was quite distressed about…the time gap between my notification and the notification of patients on the other side of the hospital,” he said, raising concern for the potential for transmission during that time.

“It’s alarming, we’re all wondering how it could’ve happened,” Gambord said. “I think we’ll probably be wondering forever.”

Kerry Klein is an award-winning reporter whose coverage of public health, air pollution, drinking water access and wildfires in the San Joaquin Valley has been featured on NPR, KQED, Science Friday and Kaiser Health News. Her work has earned numerous regional Edward R. Murrow and Golden Mike Awards and has been recognized by the Association of Health Care Journalists and Society of Environmental Journalists. Her podcast Escape From Mammoth Pool was named a podcast “listeners couldn’t get enough of in 2021” by the radio aggregator NPR One.
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