In March, the state said five of Dr. Parvez Dara's patients were found to have hepatitis B and that nearly 2,800 patients should get tested for it. There are now 29 positive cases, plus 68 others who tested positive for antibodies but cannot be definitely linked to the outbreak, according to the state Health Department.
The state is aware of nearly 1,400 patients who have been tested so far.
On Aug. 12, state epidemiologist Dr. Christina Tan sent a letter to 2,000 more patients and to patients in the first group who had yet to get tested urging them to do so.
In July, the department responded to an Associated Press open records request by declining to release any information about the test results, citing the ongoing investigation. The department quietly released the test results on its Web site Sept. 1, nearly three weeks after sending out the letter to patients.
Health Department spokeswoman Donna Leusner said the investigation is ongoing, but a report was prepared at the request of the Board of Medical Examiners, which suspended Dara's license in April.
A spokesman for Dara criticized the health department for releasing the test results while the investigation is still open, saying it was a "rush to judgment."
"There are a number of possible medical reasons that explain why hepatitis B may have developed among patients - particularly those being treated for cancer with chemotherapy," said Dara spokesman Tim White.
Health inspectors visited Dara's office in March and described conditions there as unsanitary. The inspectors said they found blood on the floor of a room where chemotherapy was administered, blood in a bin where blood vials were stored, unsterile saline and gauze, and open medication vials.
Inspectors also cited problems with cross-contamination of pens, refrigerators and countertops; use of contaminated gloves; and misuse of antiseptics, among other health code violations.
Following the inspection, county health officials sent a March 28 letter to Dara's patients warning them of the risk and suggesting they be tested for the liver diseases hepatitis B and hepatitis C and for HIV, the virus that causes AIDS.
"Evidence gathered at this time suggests that since 2002, some clinic staff provided care in a manner that put patients at risk for infection caused by bloodborne viruses, including hepatitis B," the Aug. 12 letter told patients. "The investigation to date suggests that the hepatitis B infections identified may be associated with the method by which medications were administered and procedures performed at the practice."
Dara, originally from Pakistan, has been practicing at his Toms River office for 23 years and has been a licensed oncologist in New Jersey since 1980. He estimated that he saw 45 to 60 patients a day, with about a dozen receiving chemotherapy each day.