Fulminant hepatic failure (FHF) due to acute hepatitis B and delta co-infection occurred in a 74-yr-old female, who eventually died. There was no clear-cut epidemiology other than probable bloodborne transmission from a contaminated spring-loaded fingerstick device used for glucose determination, in an outpatient facility. This unusual mode of transmission reiterates the importance of using sterile cleansing and disposal procedures anytime there is a possibility of contamination with blood.