Aftermath of mix-up

JANUARY 2005: Duke University Health System hospitals in Durham and Raleigh notify about 3,800 patients that they may have been operated on with surgical instruments that were mistakenly washed with used hydraulic fluid. But the hospitals assure the patients that they should be in no danger.

APRIL 2005: Bennie Holland, a Harnett County man, files a lawsuit against Automatic Elevator Co. of Durham and a medical supply company, Enhanced Coverage Linking of Dublin, Ohio, claiming that hydraulic fuel on surgical instruments entered his system. Later that month, seven women file similar lawsuits against the two companies.

JUNE 2005: An investigation by the Centers for Medicare & Medicaid Services finds that Duke officials failed to heed complaints of employees over improperly sterilized tools and therefore delayed discovery of the error and needlessly exposed patients to potential harm over a longer period of time. Meanwhile, dozens of patients report complications from surgeries.

Duke sends letters to patients offering consultations with two Duke doctors who specialize in occupational and environmental medicine.

JUNE 28, 2005: Duke releases findings from a chemical analysis that indicate patients were unlikely to be harmed by their exposure to the hydraulic fuel remaining on surgical instruments. The analysis is conducted by RTI International in Research Triangle Park.

AUGUST 2005: Duke says it will track patients exposed to tainted instruments but then agrees to outsource the work to an independent group to avoid potential bias. A Superior Court judge rules that patients in question can seek high-dollar punitive damages.

SEPTEMBER 2005: Results from an independent laboratory say heavy metals that can cause cancer and microscopic particles of carbon and machinery metal were found in the hydraulic oil waste at Duke.

NOVEMBER 2005: Duke hires an independent clinical research organization, PharmaLinkFHI in Durham, to monitor the health of patients who were exposed to tainted surgical instruments.

JULY 2007: Duke releases PharmaLinkFHI's report, which found that exposed patients did not suffer any more health problems than would be expected in the general population. But an epidemiologist said the study was flawed because it didn't didn't compare the Duke patients with a similar group not exposed to the hydraulic fluid.

JUNE 2008: Duke University Health System settles claims with 60 patients who alleged they suffered health problems after being exposed to hydraulic fluid on surgical instruments at two Duke hospitals in 2004.

JULY 2008: Eighteen patients who had operations at Duke hospitals in 2004 sue Duke University Health System charging fraud and negligence in connection with exposure to surgical instruments mistakenly washed in elevator hydraulic fluid.