Frequently Asked Questions – DermEffects IPAC Lapse Notification
Additional Information for Healthcare Providers
What is an Infection Prevention and Control (IPAC) “Lapse”?
Infection Prevention and Control refers to practices and procedures that are proven to prevent or reduce the risk of transmitting viral or bacterial infections in a health care setting.
An IPAC “lapse” means that these practices or procedures were not used consistently, or at all, putting patients at risk of contracting an infection.
Why is the MLHU alerting the community about this Infection Prevention and Control (IPAC) Lapse?
The MLHU identified a lapse in infection prevention and control (IPAC) practices at DermEffects (1560 Hyde Park Road, London) during a complaint-based inspection. As a result of this lapse, there was a potential risk of exposure to blood-borne infections such as hepatitis B, hepatitis C, and Human Immunodeficiency Virus (HIV) for individuals who underwent certain procedures at the clinic and it is our duty to inform the public of the risks they may have been exposed to.
Who is affected?
This notification applies to patients who underwent specific medical procedures at DermEffects after January 12, 2012, and on or before January 13, 2025.
The specific medical procedures involve medical instruments that require proper cleaning and sterilization prior to reusing them.
Affected procedures include:
- Punch biopsies - A punch biopsy is a diagnostic test where a small, tube-shaped piece of skin, and some additional tissue underneath, are removed using a sharp cutting tool. It can be done anywhere on the body. A punch biopsy is used to diagnose many types of cancer.
- Curettage and cautery – Curettage and cautery is a type of electrosurgery in which a skin lesion is scraped off and heat is applied to the skin surface. This procedure can be used to treat seborrheic keratoses, viral warts, squamous cell carcinoma in situ, pyogenic granuloma, actinic keratoses, basal cell carcinomas, keratoacanthoma, and skin tags.
- Excision - The removal of tissue from the body using a scalpel (a sharp knife), laser, or other cutting tool. A surgical excision is usually done to remove a lump or other suspicious growth. Some normal tissue around the lump is usually removed at the same time.
MLHU Investigators observed that some medical instruments used in these procedures may not have been properly sterilized before reuse, potentially posing a risk of exposure to blood-borne infections such as hepatitis B, hepatitis C, and HIV.
This notice does NOT apply to the following procedures where multi-use tools do not come in contact with non-intact skin or mucous membranes.
Medical Dermatology Procedures NOT included
Unless combined with one of the procedures listed above (biopsy, curettage and cautery, excision):
- Liquid nitrogen cryotherapy
- Prescription creams
- Photodynamic therapy (PDT)
- Lasers and light therapy
Medical Cosmetic Services NOT included:
- Injections (ex. Botox-type, dermal filler, double chin treatment, etc.)
- Platelet-Rich Plasma (PRP) Therapy
- Laser therapy
- Microneedling
What are the potential health risks?
While there are no known infections linked to this lapse, improper sterilization practices can lead to:
- Bacterial skin infections
- In rare cases, blood-borne infections such as hepatitis B, hepatitis C, and HIV
I had a procedure at DermEffects. What should I do?
MLHU recommends that affected patients:
- Speak with their healthcare provider to assess their risk
- Consider getting tested for hepatitis B, hepatitis C, and HIV
How do I know if the procedure I had puts me at risk?
- If your procedure only involved single-use instruments or did not involve instruments requiring sterilization, you are NOT at risk (e.g., botox, fillers, laser treatments).
- If your procedure involved reusable medical instruments requiring sterilization or high-level disinfection (e.g., biopsies, skin tag removal, wart removal, etc.), you may be at risk and should consult your healthcare provider.
How can I get tested?
Testing for hepatitis B, hepatitis C, and HIV is free for Ontario residents with a valid health card. You can:
- Visit your family doctor or nurse practitioner
- Go to a walk-in clinic if you don’t have a primary care provider
- Call 8-1-1 for health advice and testing options (including those without OHIP)
What will happen to my test results?
- Your test results will be sent to the healthcare provider who ordered the test and if positive for a reportable disease (ex. hepatitis B, hepatitis C, HIV/AIDS), the Middlesex-London Health Unit will also be notified.
- Turnaround time for testing results can vary, please follow-up with your healthcare provider or the lab where you completed the bloodwork.
What happens if my test results are positive?
- Your healthcare provider will contact you and discuss the next steps.
- If your test results are positive for a reportable disease such as hepatitis B, hepatitis C, or HIV/AIDS, a copy of your lab results will also be reported to the health unit and a Public Health Nurse will call you. You can refer to our website for more information on these diseases: www.healthunit.com/sexually-transmitted-infections.
What happens if my test results are negative?
- If your test results are negative, MLHU will not contact you.
- You may follow up with your healthcare provider for confirmation.
Why is the clinic still open?
- The Middlesex-London Health Unit works with healthcare providers to ensure they are following all of the correct procedures and processes to reduce or remove risk related to the transmission of viruses and bacteria.
- The DermEffects Clinic has updated and changed their practices so that they meet safety standards.
- There are no ongoing risks to patients currently.
Can I still go to DermEffects for treatment?
Yes. The clinic is allowed to operate after correcting the identified IPAC lapses. There are no current risks for new patients.
How can I file an IPAC complaint about a healthcare provider?
The MLHU investigates potential infection prevention and control (IPAC) lapses. If you have concerns about unsafe practices involving infection prevention at a regulated healthcare setting:
- Call: 519-663-5317
- Email: IDC@mlhu.on.ca
Where can I find more information?
- MLHU website: IPAC Lapse Reports.
- MLHU website: Body fluid exposures and testing.
- Call 8-1-1 for confidential health advice in English, French, and other languages.
Exposure Risks and Transmission Information
Blood, saliva, urine, feces, and other bodily fluids can carry infections. Exposure to these fluids poses a risk of infectious disease transmission. An exposure may include:
- A needle stick or cut from a sharp object contaminated with blood or bodily fluids.
- Blood or bodily fluids contacting broken skin (e.g., open cut, wound, dermatitis).
- Blood or bodily fluids contacting mucous membranes (e.g., eyes, nose, mouth).
Additional Resources