Patients Were Not Told of Misuse of Syringe

State health officials notified 628 patients this week that they should be tested for hepatitis and H.I.V. infection because they were treated years ago by an anesthesiologist in Nassau County who used improper procedures for preventing the spread of blood-borne diseases.

The anesthesiologist, Dr. Harvey Finkelstein, of Plainview, first became the focus of a state health investigation in 2005 after two of his patients contracted hepatitis C. His name was reported by Newsday.

Yesterday, county and state officials traded blame over the 34-month delay in notifying the patients. At the same time, the incident led state health officials to seek a meeting with the Centers for Disease Control and Prevention to address an issue of drug packaging that was apparently at the heart of the problem.

In 2005, investigators found that, in violation of widely accepted practices recommended by the C.D.C., Dr. Finkelstein, 52, who specializes in pain management, was reusing syringes when drawing doses of medicine from vials that hold more than one dose.

He would use a new syringe for each patient. But when giving one patient more than one type of drug by injection, his practice of using the same syringe to draw medicine from more than one vial led to the potential contamination of the vials. The blood of a patient who was infected with hepatitis C could, by backing up through the syringe and entering the vials, infect another patient when the same vial of medicine was used again. This is what happened in at least one case, health officials said.

State health officials said yesterday they hoped to get the C.D.C.’s support in seeking the elimination of such multidose vials.

Any fix would come too late for Raymond Bookstaver, 49, a Hicksville mechanic who was one of two patients initially identified as having been infected by Dr. Finkelstein’s improper use of syringes.