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Legal warning for GPs over sterilising vaginal speculae

Medical defence experts are warning GPs to ensure they are up to date with the latest guidance on sterilising vaginal speculae or face legal action for breaching health and safety rules.

The alert came after a GP in West Lothian, Scotland, mixed up sterilised and unsterilised speculae, putting up to 100 women at risk of sexually transmitted infections.

Dr Carol Stewart contacted West Lothian Health Trust after discovering the mix-up, which involved 98 women treated between March 2002 and November 3 this year.

Research into four previous incidents of 'inadequate decontamination' of vaginal instruments in primary care, presented at a Health Protection Agency conference earlier this month, also concluded many more cases were likely to have occurred.

New guidance was issued in July by the Medical Devices Agency, giving specific instructions on how to clean and decontaminate stainless steel spec- ulae using steam sterilisation.

Dr Karen Dalby, risk manager at the Medical Defence Union, said practices 'must be aware of the guidance and if they are not following it they must be able to justify it'. She added: 'From a medical negligence point of view, it would be in breach of duty of care as well as health and safety law.'

All surgeries should have clear protocols relating to infection control, she added.

Author of the HPA research into previous incidents, Dr Fiona Neely, said GPs should either use disposable speculae or follow the MDA guidance.

West Lothian NHS Trust said it was working to 'ensure procedures for medical equipment sterilisation were understood by all practices'.

Lothian LMC secretary Dr Dean Marshall said the case was an isolated incident. He added if the trust had a central sterilisation policy and provided water disinfectors for practices such incidents would be less likely.

Julietta Patnick, head of the cervical screening programme in England and Wales, said the incident should not dent confidence in the programme.

She added: 'GPs might want to reassure women they are using a sterilised or a disposable instrument.'

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