 hepatitis c virus outbreak at a pain clinic in los angeles a hepatitis c virus hcv outbreak associated with an independent pain management clinic was identified in los angeles county prompting a public health investigation to identify the outbreak source associated hcv cases and prevent further infections while a specific source of hcv transmission was unable to be identified evidence supports the possibility that a multidose medication vial was contaminated by reuse of a needle or syringe and may have contributed to the outbreak 