http://www.nytimes.com/2009/07/10/us/10denver.html?_r=1

Ex-Medical Technician Is Held Without Bail in Hepatitis C Outbreak in Colorado
By KIRK JOHNSON
Published: July 9, 2009

DENVER — A former surgical technician who the authorities say stole drugs from
patients, injected herself with them and then allowed the dirty needles to be
reused — exposing hospital patients to the hepatitis C virus she carried in her
blood — was ordered held without bail on Thursday by a federal magistrate who
called her a danger to the community.

Ten former patients at Rose Medical Center in Denver, where the former
technician, Kristen Diane Parker, 26, was employed, have tested positive for
hepatitis C, which affects liver function and can have lifelong consequences.
About 4,700 patients who had surgery at Rose during the time Ms. Parker worked
there, from October 2008 to April 2009 — and an additional 1,200 people who were
treated at Audubon Surgery Center in Colorado Springs, where she worked after
that, from May through June — have been asked by state and hospital officials to
be tested.
So far, none of the confirmed hepatitis cases have been definitively tied to Ms.
Parker. And health officials stressed that relatively few people might, in the
end, have been put at risk but that having every possible exposure checked out
is the only way to know for sure.
The case, which became public here last week with Ms. Parker’s arrest, presents
what health and crime experts say is a rare conjunction of epidemiology and
crime. Most instances of exposure to blood-borne diseases come through sharing
of dirty needles by drug users, or through sloppy medical practice, like the
case last year in a Las Vegas endoscopy clinic where more than 80 hepatitis C
cases were traced by federal investigators to poor hygiene and procedures.
Here, a deliberate criminal action in stealing drugs, law enforcement officials
said — though apparently never intended to spread disease — became the agent of
transmission. Solving the medical mystery is therefore intertwined with the
criminal investigation.
“This is a first for us — new territory,” said Dr. Ned Calonge, the chief
medical officer for the Colorado Department of Public Health and Environment.
Dr. Calonge said that his public health inquiry was focused on how the infected
patients became sick. The criminal case, by contrast, hinges on establishing a
link to Ms. Parker, who said in a videotaped statement to the police that she
now believed she probably contracted hepatitis by sharing needles in injecting
heroin, but only found out for sure she was sick last month after the
investigation began.
Samples of her blood and blood from the infected patients, Dr. Calonge said,
have been sent to the Federal Centers for Disease Control and Prevention for a
specific genetic match, but no results are back yet.
Ms. Parker could face up to life in prison under federal consumer product
tampering laws if serious injury resulted from her actions, which, according to
court documents and her own statements to the police, included removing syringes
full of the painkiller fentanyl from surgical trays and replacing them with
syringes — sometimes previously used by her, sometimes not — full of saline
solution. Ms. Parker has not yet entered a plea in the case, but in her
videotaped statement she expressed tearful remorse that anyone might have been
hurt.
The federal magistrate, Craig B. Shaffer, in rejecting an appeal for home
release to her parents, said he was not convinced that Ms. Parker could have
been ignorant that she carried the virus because the blood test she had when
hired at Rose seemed “unequivocal” in saying that reactive antibodies were
present in her system.
An epidemiologist at the Centers for Disease Control who is working on the
Colorado investigation, Dr. Arjun Srinivasan, said the inquiry was focusing on
everything from Ms. Parker’s work schedule to the genetic fingerprint of her
hepatitis strain.
Dr. Srinivasan, the medical officer for the Division of Healthcare Quality
Promotion, said one thing was clear: no evidence of poor procedures in allowing
inappropriate reuse of syringes had been found at either facility that could
explain the outbreak.