I have not the slightest practical experience, but from the photos and text on the ismp safety alert (http://www.ismp.org/newsletters/acutecare/articles/20100812.asp) you would have to defeat the spring loaded safety mechanism, which pushes a safety shield over the needle after use (or prior to use in the case of the defective Sandoz syringes). Seems inconceivable (as you suggest) a hospital would do that. If that were your inclination, why buy the prefilled syringe in the first place?