Dr. Christiane Farazli, an Ottawa internist whose infection practices ignited a hepatitis and HIV scare, is facing a class-action lawsuit. CBC

Four former patients of a doctor accused by Ottawa Public Health of lax infection prevention practices have tested positive for hepatitis C since receiving a letter telling them to get tested, says the law firm heading a class-action suit against the doctor.

Nicholas Robinson, a lawyer for Merchant Law Group, said all four people, who are either current or former Ottawa residents, were tested after receiving one of the 6,800 letters sent out to former patients of internist Dr. Christiane Farazli.

Robinson said he can't confirm how these people came in contact with the disease. He did say the tests were not arranged by the law firm but by Ottawa Public Health (OPH).

"Obviously, we would be looking at having these people participate in the lawsuit," Robinson said. "[For] at least three of them it's shocking news."

After hearing the news, Ottawa's medical officer of health sent a memo to city council and the Ottawa Board of Health regarding the four hepatitis C cases Wednesday evening.

Ottawa Public Health expected some patients would test positive

He told CBC News hepatitis C is common in the general population and public health expected some people would test positive for one of either hepatitis B, hepatitis C or HIV, which can all come from improperly cleaned instruments.

"We are aware of approximately 3,400 patients having undergone blood testing," Dr. Isra Levy wrote.

"OPH has begun to receive results of those tests. These test results continue to arrive on a daily basis. The analysis work is complex and labour intensive from both a logistical and scientific perspective."

Public health and the Ontario College of Physicians and Surgeons both completed investigations of Farazli during the fall. In mid-October, Ottawa Public Health sent the letters to all patients who visited Farazli between April 2002 and June 2011 advising them to get checked for the concerned diseases.

Levy said some infection prevention and cleaning protocols were "not always followed" at Farazli's clinic located at 1081 Carling Ave., Suite 606.

Dr. Isra Levy said Ottawa Public Health investigated Farazli for several months because of 'lapses in infection control.' CBC

Merchant is already representing at least two of Farazli's former patients, Jean-François Farjon and Rebecca Soroka, who are suing for more than $20 million.

In the statement of claim filed in Ontario Superior Court, Farjon and Soroka said they "suffered injury and damages as a result of the defendants' acts, omissions, wrongdoings, and breaches of legal duties and obligation."

Hepatitis C a silent blood virus

The claim also goes on to accuse Farazli of failing "to consistently follow standard and statutory practices and procedures used to clean endoscopes."

The specific damages suffered by the patients are described as "worry, anxiety, and possible bodily injuries."

None of the allegations against Farazli have been proven in court.

Hepatitis C is a viral disease that leads to swelling of the liver but does not have obvious symptoms. It attacks the body aggressively and can be treated with medication that tries to remove the virus from the blood.

Treatments are aimed at reducing the risk of further disease and liver cancer that can result from long-term infection.