Becton Dickinson, one of the largest manufacturers of medical supplies, dominates the US market in disposable syringes and needles. In 2005, a nurse, Maryann Rockwood
(a fictional name), used a Becton Dickinson 5cc syringe and needle to draw blood from a patient known to be infected with HIV (Human immunodeficiency virus). Ms. Rockwood worked in a clinic that served AIDS patients, and she drew blood from these patients several times a day. After drawing the blood on this particular day, she transferred the
HIV-contaminated blood to a sterile test tube by sticking the needle through the rubber stopper of the test tube, which she was holding with her other hand. She accidentally pricked her finger with the contaminated needle. She is now HIV positive.
A few years earlier, in 2000, Becton Dickinson had acquired exclusive rights to a patent for a new syringe that had a moveable protective sleeve around it. The plastic tube around the syringe could slide down to safely cover the needle. The Becton Dickinson 5cc syringe used by Maryann Rockwood in 2005, however, did not yet have such a protective guard built into it. The AIDS epidemic has posed peculiarly acute dilemmas for health workers, including doctors and nurses. Doctors performing surgery on AIDS patients can easily prick their fingers with a scalpel, needle, sharp instrument, or even bone fragment and can become infected with the virus. The greatest risk is to nurses, who, after routinely removing an intravenous system, drawing blood, or delivering an injection to an AIDS patient, can easily stick themselves with the needle they were using. Needlestick injuries occur frequently in large hospitals and account for about 80 percent of reported occupational exposures to HIV among health care workers. It was conservatively estimated in 2005 that about 64 health care workers were then being infected with HIV each year as a result of needlestick injuries.
Although the fear of HIV