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Duke University Health System mailed 3,800 letters yesterday
to maintain open communication with patients and to update them
on additional steps being taken after surgical instruments were
accidentally rinsed in hydraulic fluid before being sterilized.
Duke reported the incident to patients and to the media shortly
after it was discovered last winter.

Yesterday's letters were from Michael Cuffe, M.D., a
long-time Duke cardiologist who has been appointed to a newly
created position of vice president for Medical Affairs. Cuffe's
primary responsibility is to advocate for the needs of Duke's
health care providers and patients, and to ensure the delivery
of high-quality care across the health system.

"I wanted to assure our patients of our ongoing commitment
to provide information and resources," Cuffe said of the
letter. In the letter, he informs the patients that Duke is
establishing a long-term program to monitor the health of the
affected patients. The program, which is based on an
established method used by the FDA to track potential side
effects of drugs, will include:

•  
• The gathering of information from many sources, including
  Duke University Health System records, hotline calls, reports
  from patient's physicians, and other sources. All patient
  information will be held in strict confidence in accordance
  with Duke's policies and state and federal regulations.
• Medical problems such as complications that arise after
  surgery, new illnesses, and unusual complaints will be
  analyzed and compared against expected rates of these
  problems.
• Infection surveillance, which will continue to one year
  for patients with implanted materials such as artificial
  joints.

In the letter, patients were invited to call the hotline
and/or their physician to report any changes in their health.
These will be recorded for a period of time, and monitored and
analyzed.

"I want you to know that we take the concerns raised by our
patients very seriously," Cuffe wrote in the letter. The letter
also outlines many resources Duke has made available to
affected patients, including a hotline for questions about the
incident, a clinic where patients can meet with a physician who
is knowledgeable about the incident, and a web site where
patients can obtain detailed information including reports from
outside experts.