Lawsuits against a Saddle Brook outpatient surgery center are multiplying after thousands of its former patients were instructed to undergo testing for HIV and hepatitis.

Two suits were filed in late December against the HealthPlus Surgery Center, and a third suit was expected on Jan. 2. Filed in Bergen County Superior Court, the lawsuits come after state inspectors reported major lapses in sanitation at the facility.

State inspectors found that surgical instruments at the facility had debris in the hinges, were rusty and discolored and that surgical staff failed to cover up their facial hair while operations were being conducted, according to their report.

The state Department of Health shut down HealthPlus on Sept. 7 after an inspection revealed poor drug storage methods, an outdated infection control plan and unacceptable sterilization practices. The facility was allowed to reopen on Sept. 28.

And on Dec. 17, HealthPlus sent letters to 3,778 people instructing them to have blood tests for hepatitis B, hepatitis C and HIV. Those individuals were treated at the center between Jan. 1, 2018, and Sept. 7.

Michael Maggiano of Maggiano, DiGirolamo & Lizzi in Fort Lee filed suit on Dec. 28 on behalf of a potential class of people who underwent treatment at the center, and their spouses. The plaintiffs in his suit are Lauren Marrero, a former HealthPlus patient, and her husband, Julio Marrero. The suit brings claims of negligence, and a count for loss of society, consortium, companionship and services.

Maggiano said he's hearing “devastating accounts” of the impact the potential infection is having on the lives of class members. One such person, who works in food service, told Maggiano's office that she was thinking of suicide. Maggiano said he arranged to have her evaluated by doctors. Another plaintiff said she's been shunning her husband's kisses since he received the letter instructing him to get tested.

Michael Epstein of the Epstein Law Firm in Rochelle Park filed suit on Dec. 31 on behalf of a former patient identified by her initials, C.S. His suit brings claims on behalf of four subclasses: Former patients who were treated at the facility and contracted a disease or infection, former patients who did not contract a disease or infection, a spouse or intimate partner of a former patient of the HealthPlus Surgery Center who contracted a disease or infection as a result, and a spouse or intimate partner who did not contact any disease or infection.

Brooklyn attorney Sanford Rubenstein said he expects to file suit in Bergen County Superior Court on Jan. 2 on behalf of former HealthPlus patient Kristin DeBenedictis. Rubenstein says he has other clients who underwent procedures at HealthPlus and will be filing additional suits against the facility.

HealthPlus, established in 2016, is an ambulatory surgery center that performs orthopedic, podiatry, pain management and plastic surgery, it said in a statement issued Dec. 26. During the state-ordered shutdown, HealthPlus improved its infection control and medication dispensing procedures, hired new staff to ensure compliance with high standards, including a new director of nursing and a sterile processing consultant, a quality consultant, an infection preventionist and a consultant pharmacist. The center also hired new sterile processing staff, and supervised the cleaning and repairing of all instruments by an outside vendor, HealthPlus said in its statement.

The lawyer for HealthPlus, Mark Manigan of Brach Eichler in Roseland, said in a statement that “HealthPlus is complying with the DOH's directive regarding patient testing and the test results notification process. Since reopening on September 27, 2018, HealthPlus is fully compliant. The Center will provide additional updates as appropriate.”

Manigan said in another statement, issued Dec. 29, the facility's director of nursing resigned the day before the state inspection and was later replaced. HealthPlus terminated and replaced two additional employees on Sept. 17. Manigan also said HealthPlus hired consultants to provide a procedural overhaul and to train staff.

“We are confident that the issues raised by the Department have been addressed,” Manigan said in the statement.

Manigan also said a Department of Health report showed that multidose medicines were improperly dispensed and that lapses in sterilization procedures occurred. Those lapses primarily involved orthopedic instruments and surgical trays.

A preliminary report of the first 186 patients to undergo testing for HIV and hepatitis B and C shows none of them came back positive for acute infection, but one preliminary result indicated a case of chronic hepatitis, according to Manigan's statement.

Rubenstein said the litigation against HealthPlus will still be viable, even if no patients contracted illnesses as a result of the sanitation problems at the center. Former patients of the facility are entitled to compensation for mental anguish related to uncertainty of waiting for test results, he said.

“Whether one contracts HIV or hepatitis as a result of what happened, or fears the contracting of HIV or hepatitis because of what happened, in either instance they are entitled to damages,” Rubenstein said.

Epstein said it's unclear whether those members of the potential class who get a negative test result will require follow-up testing in the future. He added that the class could be much larger than the 3,778 people who received letters from HealthPlus, because that figure does not include spouses and partners of former patients at the facility who may have contracted HIV or hepatitis through sexual contact.