Hep B victims reap legacy of neglect - 2 of 2

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(continued)

Employee complaints to the health ministry and the college of physicians

first occurred in 1991, and again in 1992.

Rizwan Addetia was hired in November, 1990 to conduct ambulatory EEGs and

sleep studies and was troubled when he witnessed Kyprianou at work.

A male patient yelped in pain as the needles were stuck into his scalp, then

again as Kyprianou grabbed the bundle of electrodes and yanked them out at

once. Blood immediately began trickling down the man's right temple.

In reply to the man's shout, he recalls an annoyed Kyprianou saying, " Can't

you take some pain? "

Addetia, then a 33-year-old chemistry graduate, suspected the needles were

not being sterilized. He was in the EEG room every day cleaning his disc

electrodes in the sink and never saw a sterilizer, green sterilizing cloths

or bleach. Although and Kyprianou claimed to have 40 sets of needle

electrodes, Addetia said he only ever saw one set sitting on the counter.

And he testified he never once saw Kyprianou clean or sterilize the

electrodes.

Twice he raised his concerns with both and Kyprianou but was given

vague answers. In October, 1991, Addetia was abruptly fired.

" Mr. Kyprianou told me that I asked too many questions, " he said.

denied in testimony that Addetia ever spoke to him about

sterilization.

After leaving the clinic, Addetia complained to the health ministry, only to

be told to contact the College of Physicians and Surgeons. He did so, but

the college told him to call the health ministry.

That year, 1991, minimum technical standards for EEG labs were published in

the Canadian Medical Association Journal. The guidelines called for disc

electrodes to be used, not needles; for electrodes be cleaned and sterilized

after each patient; for gloves to be worn, and for no scarification of the

skin.

never saw or read the article that year, or for several years after.

Yet 1991 was also the first year a patient contracted hepatitis B in one of

's clinics, and the first time became aware a patient had the

disease. didn't see a connection to his office, since many of his

patients originated from Asian countries with a higher incidence of the

virus.

That year a foreign-trained doctor named Homayoun Arkia began working as a

new technician at the Bellwood clinic. Like Addetia, he was horrified by

what he alleges were unhygienic conditions and a serious lack of infection

controls.

He left after six months and immediately wrote a long letter dated March 27,

1992 to the Ministry of Health citing serious breaches in medical standards

and demanding that the province investigate what he described as a big

money-making operation.

Calling it " a crime, " he wrote that the needles Kyprianou used were never

cleaned, let alone sterilized, that people's lives were in danger.

" I'm sure if this subject comes to the public notice or public investigation

(there) will be a panic, " he wrote.

Arkia claimed every patient who came to the Bellwood office was booked for a

series of EEGs, and often at least one sleep study, regardless of their

ailments. He wrote that Kyprianou once boasted the EEG business was better

than running a Greek restaurant on the Danforth.

He hand-delivered the letter to Deegan, a medical consultant, at the

ministry's east-end office. Deegan wrote back, promised to pass it on to

OHIP and advised Arkia to also contact the college.

Arkia delivered the same letter, in person, to the college's complaints

office on April 14, 1992, with a cover letter to the registrar. He spoke

with an investigator who assured him the matter would be looked into. Arkia

never heard back from the college.

did, however, albeit briefly. Two college investigators unexpectedly

showed up one day at the Bellwood Sleep Disorders Clinic after hours and

asked to be shown around. They told they were acting on a complaint

from a former employee.

and Kyprianou were alone in the clinic. After a brief meeting in his

office, escorted the investigators to the sleep lab on the third

floor. They looked around and left, apparently without checking the EEG lab.

heard nothing more from them again.

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Three years and thousands of patients later, public health inspectors pieced

together evidence of an outbreak.

McGrath was part of the puzzle. She was standing on a chair hanging

drapes in the bedroom of her twin 4-year-old boys when a wave of nausea

almost knocked her to the floor.

" I went from being well to being very sick in a matter of minutes, " she

recalled of that day in September, 1995. McGrath and other patients agreed

to be interviewed for this story.

At first she thought it was the flu. But by Thanksgiving weekend she was

still violently ill and could barely move. Her skin was yellow. Her urine

was a dark tea colour. Even the whites of her eyes had turned yellow.

She made it to the family doctor who, after a blood test, diagnosed her with

acute hepatitis B. Her doctor, as required by law, immediately contacted the

public health department.

McGrath was highly contagious. She and her husband were told to refrain from

having sex. And her husband and sons had to get tested.

She had none of the usual risk factors - no tattoo, no recent dental work,

no acupuncture or needles that she could recall. McGrath wracked her brain

and then remembered an appointment at 's clinic.

McGrath called the public health department and described her history -

including the EEG - to Lynn , a senior health inspector with the

former city of Scarborough.

thought it strange that McGrath had none of the usual risk

factors for hepatitis. Then a second piece of the puzzle arrived.

In December, another woman called Scarborough public health to say her

husband had contracted hepatitis B and she needed a vaccination.

" I asked by chance if he'd had an EEG and she said, well, yes, he had, "

testified at 's disciplinary hearing.

Suddenly recalled that there had actually been a case some years

earlier of a woman thought to have acquired hepatitis B at 's office.

A private meeting of Scarborough health inspectors was held in early

January, 1996 and it was agreed that Colin D'Cunha, the city's medical

officer of health at the time, would set up an appointment with . He

made a call to on Jan. 19 to arrange a visit, the same day news of

another case arrived.

By Jan. 20, 1996, four days before the public health inspectors' scheduled

visit, stopped using the needle electrodes and arranged to have them

incinerated.

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Wong was suffering from dizzy spells when she went to see on

the advice of her family doctor. He booked her for an EEG at his clinic on

Dec. 22, 1995.

Wong found a packed waiting room and a steady stream of people coming and

going from Kyprianou's EEG lab. One patient testified it resembled a cattle

drive.

Wong vividly remembers when it was her turn.

" My name is Dr. Kyprianou and I'll be doing your EEG, " she recalled the man

saying as she climbed into an old black vinyl chair in a small and sparsely

furnished room.

Immediately, he picked up a clump of needles off a nearby table and began

inserting them into her scalp. He was having trouble getting them in and he

kept poking and poking so much that it hurt, she said.

" A couple of times he said it wasn't working and he literally took his thumb

and poked them into my head, " she said in a recent interview, adding he was

wearing no surgical gloves.

The test was over in 10, maybe 15 minutes, at which point Kyprianou pulled

the needles out and let her go.

She began to feel sick after Christmas. All she could do was sleep and she

was losing weight.

On Jan. 25, 1996 told her in a follow-up appointment that her EEG

test was normal, that she probably blacked out because she was tall.

" But I didn't go to him because I blacked out, I went to him because I felt

dizzy, " she said with disgust. She left his office with no explanation for

her dizzy spells. also gave her no medical reason why her palms were

orange, saying it was simply because her skin, like his, was white. Then

suddenly he decided to order blood work, tests she was shocked to read on

the requisition form were for hepatitis B.

She still hadn't received the results of 's blood test when, on March

1, while getting ready for work, she heard the radio announce that a

neurologist named was being questioned about a hepatitis B outbreak.

She immediately called Centenary hospital and was told to contact her family

doctor. Three days later she was tested for hepatitis B, C and HIV - tests

that public health officials were urging for all of 's patients.

Two days after that she got the bad news at work. Her family doctor's office

called to say she was, in fact, positive for hepatitis B.

" I lost it. I ran into one of my boss' office. I was bawling. I pulled out

an encyclopaedia. I called my mom, I called my doctor. I thought I was going

to die, " she emotionally recalled.

For months, Wong remained exhausted as her body worked laboriously to fight

off the infection. She was forced to leave work and became anorexic. She was

admitted to the eating disorder day program at Toronto General hospital in

October and wasn't discharged until the following January, 1997.

She finally went to an infectious disease specialist at Scarborough Grace

Hospital, who diagnosed her with chronic fatigue syndrome caused by the

hepatitis B virus.

Wong, now 40, works part-time at the North York public library but regrets

she must still call in sick some days because of exhaustion and neck pain.

Outside of work hours, she just sleeps.

" It's so frustrating. I have no life. It's not fair. Will I get liver cancer

down the road? Please tell me, am I ever going to be normal again? "

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and Kyprianou continue to operate a sleep disorders clinic on Neilson

Ave. in Scarborough. , who turns 65 next month, awaits a penalty

hearing to determine whether he loses his licence. He denies any wrongdoing.

Kyprianou has never faced any disciplinary action.

Repeated attempts to speak with them for this story were unsuccessful