Patients given insulin at a New York hospital have been warned they could have been infected with HIV and hepatitis B and C.
It has sent out more than 4,000 letters explaining the risk of possible blood contamination and is urging them to get tested for the viruses as a precaution.
The health scare centres on insulin pens for diabetics which are pre-filled syringes used by the hospital to dispense the hormone in a single patient.
Its reservoir part - where the hormone is held before it is injected into a patient - may have been used on more than one person.
The pens each contain multiple insulin doses with disposable needles, and while nurses used new needles for each patient, they may not have used a fresh pen.
Blood could have back-flowed into the chamber contaminating the insulin, the South Nassau Communities Hospital warned.
One visitor Peter Vetro said: "It's just shocking to hear something like that. I just can't believe that."
Another, Andra Vetro, said: "It's actually very scary because you come to the hospital when you're sick, and you don't hope to get even worse while you're inside the hospital."
Hospital spokesman Damian Becker said no-one was seen re-using the insulin pen reservoir on more than one patient, but a nurse was heard saying it was all right to do so.
Since the scare, it has banned the use of insulin pens and now only permits single-patient-use vials to administer insulin treatments.
The hospital, which has said the risk of infection is extremely low, will be offering the patients free and confidential blood testing services.
And it has asked patients to schedule a blood test within 60 days of receiving the letter.
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