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Infection Prevention & Control Lapse at ParaMed Clinics

The Health Unit investigated practices at four ParaMed clinics in London after receiving a complaint on July 18, 2018 about a lack of cleanliness in clinical spaces. As part of their investigation, public health inspectors found inadequate cleaning of critical devices used in wound care services. Wound care instruments were being re-used without sterilization or hi-level disinfection between patients.

The practices which led to the infection prevention and control (IPAC) lapse have been addressed and there is no further risk of infection. However, the Health Unit is advising that anyone who received wound care at ParaMed Flex Clinics between 2008 and July 27, 2018, may be at risk of having acquired a blood-borne infection. Although the risk of such an infection is very low, the Health Unit requires that patients be notified and advised to consult their healthcare provider to discuss testing for hepatitis B, hepatitis C and HIV, as a precaution. ParaMed will be advising current and past patients of the risk by mail.

To order the correct bloodwork, healthcare providers can download the pre-populated Public Health Ontario Laboratory Test Requisition Form from the link below.

Before visiting a lab, patients requesting bloodwork as a result of wound care received at a ParaMed Flex Clinic in London must see a healthcare provider, such as a doctor or nurse practitioner. A healthcare provider must sign the Public Health Ontario Laboratory Test Requisition Form.

Public Health Ontario Laboratory Test Requisition Form (PDF)

Note: this is a lapse in protocol only, and no blood-borne infections have been diagnosed and linked to the ParaMed Flex Clinics. It may also be impossible to determine whether positive blood test results, if any, resulted from procedures performed at a particular location or if they are due to other exposures.

Questions and Answers
What is an infection prevention and control lapse (IPAC) lapse? Will ParaMed be communicating with its patients?
What is the Health Unit investigating at the ParaMed Flex Clinics in London? What will happen to my test results?
Why is the Health Unit involved in investigating ParaMed Flex Clinics? When can I expect my test results?
Where are the ParaMed Flex Clinics located in London? What happens if my test results are positive?
Who is at risk? What happens if my test results are negative?
What is the level of risk? Who can I speak to about the services I received from ParaMed?
What should I do if I received wound care from ParaMed Flex Clinics in London? If I have more questions, what can I do?
Do I need to visit a healthcare provider to request bloodwork?  

What is an infection prevention and control lapse (IPAC) lapse?

Best practices for infection prevention and control (IPAC) keep clinics safe for clients. An IPAC lapse occurs when best practices are not followed, resulting in a potential risk of infection to clients.

An example of a best practice is adequate preparation of re-usable medical instruments. Instruments used in wound care which penetrate non-intact skin are considered critical devices and must be sterile at the point of use. All other instruments used in wound care should, at a minimum, undergo high level disinfection. Preferably, they are also sterile at the point of use.


What is the Health Unit investigating at the ParaMed Flex Clinics in London?

The Health Unit only investigates medical clinics or similar agencies on a complaint basis. The Health Unit received a complaint about the ParaMed Flex Clinic at 124 Barker Street, London, ON. The investigation of ParaMed Flex Clinics in London found that wound care instruments, including forceps, scissors, and probes, were being re-used without sterilization between patients.

Patients who received wound care services at these clinics between the opening of the clinics in approximately 2008 and July 27, 2018, may be at risk of having acquired a blood-borne infection.

Download the IPAC Lapse Report (PDF)


Why is the Health Unit involved in investigating ParaMed Flex Clinics?

The Health Unit received a complaint about the ParaMed Flex Clinic at 124 Barker Street, London, ON on July 18, 2018.

Facilities in which regulated health professionals operate, such as clinics and healthcare provider offices, are accountable to their respective Colleges for IPAC practices. Public Health Inspectors do not routinely visit these locations but conduct inspections and investigations of these facilities when complaints are received from the public.

The Ontario Public Health Standards under the Health Protection and Promotion Act (HPPA) mandate health units to investigate complaints about potential infection prevention and control (IPAC) lapses.


Where are the ParaMed Flex Clinics located in London?

There are four ParaMed Flex Clinics in London, Ontario.

  1. 124 Barker Street, London, ON
  2. 785 Wonderland Road South, London, ON (Westmount Mall)
    (formerly 339 Wellington Road or Windermere on the Mount)
  3. 1340 Huron Street, London, ON (Kensington Village Long-term Care Home)
  4. 148 Fullerton Suite #200, London, ON (Talbot Centre)

Who is at risk?

Patients who received wound care services at ParaMed Flex Clinics in the London region between the opening of the clinics in approximately 2008 and July 27, 2018 may be at risk of having acquired a blood-borne infection (HIV, hepatitis B, and hepatitis C). It is important to note that this risk is however very low.

ParaMed Flex Clinics in London provide other services such as IV, PICC line and urinary catheterization. Patients who received these services are NOT at risk of blood-borne infection. Only wound care patients may be at risk of having acquired a blood-borne infection.


What is the level of risk?

The risk of acquiring a blood-borne infection as a result of wound care received between 2008 and July 27, 2018 is very low. Since July 27th, the practices that resulted in the IPAC Lapse have been rectified and there is no longer a risk associated with inadequate sterilizing and disinfecting of instruments used in treating wounds.


What should I do if I received wound care from ParaMed Flex Clinics in London?

If you received wound care at a ParaMed Flex Clinic in London, the Health Unit recommends that you visit your family physician, healthcare provider or a walk-in clinic to discuss your situation and determine whether your experience warrants blood testing. A pre-populated Public Health Ontario Laboratory Test Requisition Form is available for healthcare providers to ensure that the correct bloodwork is ordered.

NOTE: Before visiting a lab, patients requesting bloodwork as a result of wound care received at a ParaMed Flex Clinic in London must see a healthcare provider, such as a doctor or nurse practitioner. A healthcare provider must sign the Public Health Ontario Laboratory Test Requisition Form.

Public Health Ontario Laboratory Test Requisition Form (PDF) 


Do I need to visit a healthcare provider to request bloodwork?

Yes. Before visiting a lab, patients requesting bloodwork as a result of wound care received at a ParaMed Flex Clinic in London must see a healthcare provider, such as a doctor or nurse practitioner. A healthcare provider must sign the Public Health Ontario Laboratory Test Requisition Form.


Will ParaMed be communicating with its patients?

Patients who received wound care from ParaMed Flex Clinics in London will receive a letter from ParaMed. This letter will include a lab requisition for testing that includes hepatitis B, hepatitis C and HIV. Please bring the letter from ParaMed and the lab requisition when visiting your healthcare provider.

If you or your healthcare provider do not have the lab requisition, you can download it from the link below.

Public Health Ontario Laboratory Test Requisition Form (PDF)


What will happen to my test results?

The results will go to the healthcare provider who ordered the test, as well as to the Middlesex-London Health Unit. It will take at least one week (7 days) for your healthcare provider and the Middlesex-London Health Unit to receive your test results.


When can I expect my test results?

It will take at least one week (7 days) for your healthcare provider and the Middlesex-London Health Unit to receive your test results. If your test results are negative, you will not be contacted by the Middlesex-London Health Unit.


What happens if my test results are positive?

Your healthcare provider will notify you and discuss your next steps.


What happens if my test results are negative?

If your test results are negative, you will not be contacted by the Middlesex-London Health Unit.


Who can I speak to about the services I received from ParaMed?

Please call the ParaMed Phone Line at 1-888-746-5511.


If I have more questions, what can I do?

If you did not find the answer to your question on this page, please send us your message using the contact form below.

Contact Us


 
Date of creation: August 20, 2018
Last modified on: August 28, 2018