The Colorado Department of Public Health and Environment today advised that anyone who was a patient of Dr. Stephen Stein, a licensed dentist who practiced oral surgery in Highlands Ranch and Denver, may have been exposed to HIV, hepatitis B and/or hepatitis C if they received intravenous (IV) medications, including sedation, under Stein’s care from September 1999 through June 2011.
Patients may be at risk if they were seen by Stein during these time frames and at these locations:
September 1999 to June 2011 at Stein Oral and Facial Surgery, 8671 S. Quebec St., #230, Highlands Ranch, CO 80130
August 2010 to June 2011 at Stein Oral and Facial Surgery, 3737 E.1st Ave., Suite B, Denver, CO 80206. Patients also were seen at this location by Stein under another name, New Image Dental Implant Center.
To date, there have been no specific infections linked to these offices.
The department has been working to obtain patient records so patients can be notified directly. In conjunction with this release, notifications are being sent to patients for whom the department believes it has correct contact information. Those patients should receive the letters within the next few days.
However, records may be incomplete, so any patients who remember receiving IV medications, including sedation, at one of Stein’s offices between the dates listed above should, as a precaution, contact their health care provider to be tested for HIV, hepatitis B and hepatitis C. Patients who are uncertain if they received IV medications also should be tested. Patients who did not receive IV medications do not need to be tested. Members of the public can call CO-HELP at 1-877-462-2911 or visit http://www.cdphe.state.co.us/ for more information.
The department began its investigation following a report of unsafe injection practices. Upon investigation, it was determined syringes and needles used to inject medications through patients’ IV lines were saved and used again to inject medications through other patients’ IV lines. This practice has been shown to transmit infections.
The investigation continues. State health officials are working with health officials at Tri-County Health Department and Denver Public Health due to the locations of Stein’s practices in those counties.
Stein Oral and Facial Surgery is closed. Stein entered into an Interim Cessation of Practice Agreement with the Colorado State Board of Dental Examiners at the Department of Regulatory Agencies on June 24, 2011, and currently is not practicing.
The Highlands Ranch office was purchased by another oral surgeon in September 2011. State health officials have determined that the reuse of needles and syringes on multiple patients in Dr. Stein’s offices did not continue past June 2011.
People infected with viruses such as HIV, hepatitis B and hepatitis C may not have symptoms for many years, so it is possible patients might have been infected and not know it. Even though patients who may have been exposed may not feel ill or remember getting sick, they should get tested. Although testing cannot determine where or how someone was infected (at Stein’s offices or from another exposure), it is important to know so treatment can begin.
Health providers who test Stein’s former patients are being asked to report any tests positive for HIV, hepatitis B or hepatitis C to their county health department or the state health department and to specify the patient was tested as a result of unsafe injection practices at Stein Oral and Facial Surgery. HIV, hepatitis B and hepatitis C are reportable conditions in Colorado, meaning they must be reported to public health authorities.
Patients who may have been exposed should ask their health provider to order the following tests:
. If positive, reflex confirmatory testing with Western blot or other approved confirmatory methods should be performed.
Hepatitis C antibody
. If positive, hepatitis C RNA (quantitative or qualitative) should be performed. (Reflex testing often is available for hepatitis C RNA.)
Hepatitis B surface antigen and hepatitis B core antibody should be done. Hepatitis B surface antibody also should be considered and is useful to determine immunity to hepatitis B.
Patients can and should ask their health provider about safe injection practices. For further information on safe injection practices, please visithttp://www.cdphe.state.co.us/dc/Epidemiology/injsafety.html .
For further information on HIV, please visit http://www.cdphe.state.co.us/dc/HIVandSTD/index.html
For further information on hepatitis, please visit hepatitiscolorado.info
For more information about this incident, call CO-HELP at 1-877-462-2911or visit http://www.cdphe.state.co.us/ .