A patient of a dental clinic at the Veterans Affairs Medical Center in Butler filed a legal claim yesterday after learning that some clinic instruments were not sterilized between uses.

The medical center shut down the clinic between March and May, and in June, sent letters to 2,000 patients who had visited it from 1999 to March, advising of the sterilization problems and offering them an opportunity to visit a physician at VA expense.

Free blood tests were offered to anyone who called a special phone number established for clinic patients and staffed by VA registered nurses.

Clinic staff members "raised questions" about the clinic's sterilization techniques to administrators, said Richard Cotter, associate director for operations at the Butler VA hospital.

The clinic's operations were suspended immediately while a review was conducted by a panel that included an infectious control expert from a Pittsburgh VA Medical Center, a dentist from the U.S. Department of Defense and a representative of the state Department of Health. All were in consultation with the federal Centers for Disease Control and Prevention.

Butler VA Medical Center Chief of Staff Dr. Varsha Mehta said the breaches of sterile technique dealt with instruments that did not have direct contact with patients' mouths, like the handle of a slow-speed drill. She said a panel of experts and representatives of the CDC said the risk of any blood-transmitted diseases resulting from the sterilization problems was minimal.

Nevertheless, the lapses posed a chance that a patient could contract HIV, hepatitis B or C, or other blood-transmitted diseases.

Two clinic patients have notified Cotter they will file tort claims against the VA hospital.

John Cyprian, veterans affairs director for Butler County, confirmed he filed one claim yesterday with the U.S. Department of Veterans Affairs. It alleges negligent medical treatment. He said he is prepared to help anyone else who comes forward.

"It's really a shame that something like this happened," he said.

He said he learned of the dental clinic problems during a meeting with VA hospital representatives this month. Also participating were representatives of several service organizations, including the American Legion and the Veterans of Foreign Wars.

Cyprian said a claim against the VA hospital would protect a veteran's benefits.

"It's a claim that the VA made an error and, if that error is proven, then the veteran can receive service-connected benefits out of it," he said. Free, lifelong medical treatment and possibly a financial settlement can follow, he said.

Cotter said only a fraction of those who were contacted asked for blood tests, all of which proved negative.

He said 107 people called the special clinic hot line in response to the 2,000 letters, 70 of which were returned to the hospital as undeliverable. Of the 107, 56 asked to see a physician and, of that number, half requested the blood testing for HIV and hepatitis B and C.

The dental clinic is staffed by two dentists, two technicians and one lab person. Cotter would not identify the name or position of the person alleged to have breached sterile technique policy.

No one in the clinic was fired or demoted.

Cotter said changes were made immediately "and we are confident things are fine in the clinic now."

Cotter said the VA decided to send letters to all patients of the clinic from 1999 forward because "we wanted to be as comprehensive and inclusive as possible."

The dental clinic had been reviewed that year by a joint commission on hospital accreditation and no issues were identified at that time.

The Butler VA dental clinic serves veterans in Butler, Lawrence, Beaver, Armstrong, Clarion and Mercer counties and part of Venango County.