The surgeon had admitted to applying hemostatic material to sternal incisions without the use of sponges, which is not recommended due to the possibility of glove tears and percutaneous contact. Therefore, there is atleast some evidence for 'inadequate infection control'. However, it must be added that the rare percutaneous exposure does not account for the high rate of infection as identified in this study. Since it is well-known that HB infections tend to be asymptomatic in almost 70% of the cases, it increases the risk factor of the physician transmitting the virus unknowingly. [3] Health care workers (HCW) who perform invasive procedures are obligated to know their serological status for HIV, HB and other chronic infectious conditions. Medical practice of HBeAg-positive health care worker should be carefully monitored and restricted as the health Canada panel recommended recently. [4] Blatant or negligent violations in this respect, on the part of the surgeon, may in fact be regarded as a biocrime. The article under study and some other studies [5.] have shown that even with adherence to the recommended infection control procedures, the transmission of HBV from surgeon to patient continues to be a problem. Though the study discussed here suffers from vagueness relating to the mode of transmission, it has clearly exposed the source of the infection. The study also suggests that patients undergoing immunosuppressive therapy maybe at a greater risk for catching HBV infections. There is enough justification to limit the practice of HB infected...

As the study under review concludes, HBV vaccination would have saved the doctor all the trouble that he caused inadvertently to his patients and to himself. It may not be far fetched to make HBV vaccination an essential for obtaining operating room privileges.
Bibliography

1) Gerlich WH, 'Hepatitis B and C. Risk of transmission from infected health care workers to patients' Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz., 2004 Apr;47(4):369-78

2) Rafael Harpaz MD & Lorenz Von Seidlein et.al, 'TRANSMISSION OF

HEPATITIS B VIRUS TO MULTIPLE PATIENTS FROM A SURGEON

WITHOUT EVIDENCE OF INADEQUATE INFECTION CONTROL',

NEJM, 1996, Vol 334, no 9.

3) American College of Surgeons, 'Statement on the surgeon and hepatitis', Bulletin of the American College of Surgeons, Vol.89, No. 4, April 2004

Available From, http://www.facs.org/fellows_info/statements/st-22.html

4) Shirley Paton, RN, MN; Shimian Zou, MD, PhD; Antonio

Giulivi, MD, FRCPC, 'More Should Be Done to Protect Surgical Patients From Intraoperative Hepatitis B Infection', Infection Control and Hospital Epidemiology, Vol. 23 No. 6, 303- 305, Available From, http://www.journals.uchicago.edu/doi/pdf/10.1086/502055?cookieSet=1

5) Spijkerman IJB, van Doorn L-J, Janssen MHW, et al. Transmission of hepatitis B virus from a surgeon to his patients during high-risk and low risk surgical procedures during…