Kristen Diane Parker, the Colorado scrub tech who stole fentanyl syringes, replaced them with used, saline-filled ones and infected surgical patients with hepatitis C, will serve 20 years in prison for her actions.

The prison term is part of a plea agreement that Ms. Parker, 26, entered into with federal prosecutors on Friday, according to a news report. In pleading guilty to 5 counts each of tampering with a consumer product and obtaining a controlled substance by deceit or subterfuge, she also agreed to surrender her medical license.

Prosecutors dropped the remaining 14 counts of each charge listed on the original indictment. Ms. Parker made no statement at last week's hearing. A formal sentencing hearing has been scheduled to take place in Denver's federal court on Dec. 11.

Ms. Parker, who had originally entered a plea of not guilty, asked the court on Sept. 24 to withdraw her trial date, which had been scheduled to begin yesterday, and to arrange the plea agreement hearing.

Ms. Parker's crimes took place at the Rose Medical Center in Denver and the Audubon Surgery Center in Colorado Springs. Prosecutors say they've definitively linked at least 16 cases of hepatitis C among Rose Medical Center patients to Ms. Parker's misdeeds during her employment there.

Before last week's plea agreement, federal prosecutors had subpoenaed the Audubon Surgery Center to disclose the identity of a patient who may have been infected by Ms. Parker's actions there in order to build their case, but according to a news report, the center opposed the demand on patient privacy grounds.

While Audubon supplied prosecutors with HIPAA-compliant, identity-redacted medical records, it refused to name the patient, honoring the patient's wishes. Audubon administrator Brent Ashby declined to comment on the issue.

Colorado health officials have expressed concerns that thousands of other patients may have been exposed to hepatitis C as a result of Ms. Parker's actions, and investigations at facilities in Mount Kisco, N.Y., and Houston, Texas, that had employed her are ongoing.

David Bernard

The parents of an 18-year-old who died from malignant hyperthermia during breast surgery are suing the doctors involved in her case for negligence and are calling for a ban on general anesthesia in outpatient surgery facilities.

Arguing that their daughter Stephanie's death in March 2008 was preventable, Joanna and Thomas Kuleba are accusing Boca Raton, Fla.-based plastic surgeon Steven Schuster, MD, and anesthesiologist Peter Warheit, MD, of failing to diagnose the MH quickly enough and failing to administer enough dantrolene to save her life. The Kulebas are seeking an unspecified amount in damages from Dr. Schuster and Dr. Warheit as well as from Dr. Warheit's employer, Scott Berger, MD.

"The evidence will show that they used 1 to 2 vials of dantrolene and per Stephanie's body weight, they would have needed to administer 6 vials, quickly," attorney David Zappitell, counsel for the Kulebas, told reporters last week. The lawsuit also alleges that Dr. Schuster's office-based practice did not keep dantrolene available in the surgical suite or call 911 soon enough.

In a press conference held 3 days after the lawsuit's filing, the Kulebas demanded a ban on the use of general anesthesia in outpatient settings, arguing that such facilities can't adequately respond to such emergencies as malignant hyperthermia.

Irene Tsikitas

A second wave of surprise inspections at VA medical centers show that the facilities are making improvements to their colonoscope reprocessing practices, says the Department of Veterans Affairs Office of Inspector General.

The inspections, which were conducted in August, found that each of the 129 centers reviewed were following standard operating procedures in their scope reprocessing areas, and that all but one adequately documented their reprocessing staff's demonstrated competence, according to a report issued last week by the OIG.

Unannounced inspections were conducted in May after 3 VA facilities were forced to warn more than 10,000 patients that they may have been exposed to hepatitis B and C and HIV due to scope reprocessing errors. Those initial inspections revealed that only 42.5% of the 42 facilities reviewed followed adequate colonoscope reprocessing procedures.

"I am very encouraged that out of 129 unannounced and unscheduled site visits to VA medical facilities across the country, there was only one location with an adverse finding," writes Gerald M. Cross, MD, FAAFP, acting secretary for health at the department. "While there is still much work to be done, I am confident that endoscope reprocessing in VHA is on the right track."

Daniel Cook

A surgery's start time means different things at different facilities. At yours, is it when the patient is wheeled into the OR, when anesthesia is induced or when the first incision is made? Tell us how you define an on-time start. Go to our Web site to answer this week's InstaPoll and to see real-time results. We'll report the results in this space next week.

Slightly more than half (53%) of the 119 facility managers who took last week's poll say they offer to buy lunch for their surgeons every day. We've long heard that surgeons appreciate the convenience, and also that surgical team members enjoy breaking bread with surgeons, which lets them form bonds that wouldn't otherwise be possible.

Dan O'Connor