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County Detains Tuberculosis Patient

County of San Bernardino County Public Health Press Release

By News Staff Member
Friday, September 5, 2008

San Bernardino County, CA — An alert County Department of Public Health Employee performing above and beyond the call of duty most likely saved countless people from exposure to a tuberculosis patient who repeatedly refused orders to cease public contact.

(Photo by County of San Bernardino.)

In what was a first for San Bernardino County, the Department of Public Health on Thursday issued an Order of Detention for the patient and secured a court order allowing the patient to be taken into medical custody to be treated at Arrowhead Regional Medical Center in Colton. The patient complied with the order and on Thursday night without incident was transported to ARMC, where the patient will be treated and will not be allowed to leave until it is determined that it is safe for the patient to mingle with the public.

The Health Insurance Portability and Accountability Act, a federal privacy law, prohibits the county from disclosing any identifiable information about the patient, who came to the county's attention after being diagnosed with tuberculosis by a Las Vegas hospital.

On August 7, the county was notified by the Clark County, Nevada, Department of Public Health that a San Bernardino County resident had been treated for tuberculosis and released from Sunrise Hospital and Medical Center in Las Vegas. San Bernardino County Public Health staff immediately began searching for the patient to ensure the patient was taking proper medication and refraining from public contact, and located the patient on August 13.

Since the patient was under the care of a doctor in Needles, and because the doctor claimed that he was taking the proper steps to treat and isolate the patient, the county was under no obligation to monitor the case. However, in the interest of public safety, county Public Health staff maintained regular contact with the patient, who claimed to be taking the proper medication and refraining from public contact.

Suspecting that the patient was not being truthful, a county Public Health employee contacted the patient's place of employment and on August 26, discovered that the patient was in fact reporting to work. On August 28, the county served the patient with a formal order requiring the patient to cease all public contact. On Tuesday, the county determined the patient was ignoring the order, and on Thursday, the county secured the court order.

County of San Bernardino Public Health Director Jim Lindley and Public Health Officer Maxwell Ohikhuare, M.D., said the incident marked the first time in county history that a patient defied an order to refrain from public contact and forced the county to execute an Order of Detention requiring forced isolation - this despite the fact that 93 tuberculosis cases are currently being treated in San Bernardino County. Such incidents have occurred in other California counties, however, and San Bernardino County borrowed protocols developed by those counties for addressing the local case.

Public Health officials believe the patient contracted the illness during a recent visit to a foreign country. Public Health officials do not believe the patient's activities will lead to significant distribution of the illness. However, the Department of Public Health is using information from the case to proactively contact anyone who may have been exposed.

The department urges anyone who believes they may have been exposed or who begin suffering symptoms of tuberculosis to immediately seek a TB test from their health care provider. Initial symptoms include fever, unexplained weight loss, fatigue, coughing, and night sweats.