OSHA Inspection: DR. KIEF'S FAMILY PRACTICE

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Penalty

Initial $140 · Current $140

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The
employer did not furnish employment and a place of employment which were
free from recognized hazards that were causing or likely to cause death
or serious physical harm to employees in that employees were exposed to
infectious blood borne diseases.
a) Health care workers such as but not limited to medical assistants and
doctors working in examining rooms, office, laboratory, and other
direct patient care areas are exposed to the hazard of being infected
by HBV and/or HIV and/or blood borne infectious agents through
possible contact with blood and other body fluids.
Center for Disease Control (CDC) Recommended Universal Precautions are
not being followed for all situations where blood and body fluids may be
encountered.
a) The hepatitis B vaccine was not offered to employees who are at a
substantial risk of contracting blood and other body fluids.
b) Appropriate follow-up procedures after a possible exposure to HIV/HBV
were not developed nor implemented.
c) Training for high risk health care workers was inadequate in that
employees had no knowledge of: all aspects of personal protective
equipment, "universal precautions", color coding, other methods used
in designating contaminated waste, precautions used in handling
contaminated articles or infectious waste, and procedures used when
exposed to a needle stick or to body fluids.
Some feasible and acceptable abatement methods among others to correct
these hazards are:
1) Provide training and education on the Universal Precaution system.
This training would be based on the fact that all patients would be
treated as infectious meaning all employees would be mandates to use
personal protective equipment for all procedures where potential
exposure to blood and/or body fluids would occur. Body Fluids include
but are not limited to: blood, semens, blood products, vaginal
secretions, cerebrospinal fluids, synovial fluid, pleural fluid,
pentoneal fluid, pencardial fluid, amniotic fluid, and concentrated
HIV or HBV Viruses. (i.e, eye protection, surgical masks, gloves,
etc.,).
2) Provide a policy that addresses all circumstances warranting
Hepatitis B vaccinations and identify employees at substantial risk
of direct contact with body fluids. Offer employees Hepatitis B
vaccinations in amounts and at times prescribed by standard medical
practice.
3) Follow CDC guidelines (appendix B) "Recommendations for Prevention
of HIV Transmission in Health Care Settings", Management of exposures
for follow-up procedures after possible exposure to HIV/HBV.
4) Provided training and education on precautionary measure,
epidemiology, modes transmission and prevention of HIV/HBV. Provide
counseling regarding possible risks of transmission to the fetus of
HIV/HBV and other infectious agents. Training and education will also
include providing information on personal protective equipment, color
coding, handling of infectious waste, and procedures after exposure.

Issued

Jul 14, 1989

Abate by

Jul 21, 1989

Penalty

Initial $100 · Current $100

Issued

Jul 14, 1989

Abate by

Jul 18, 1989

Penalty

Initial $140 · Current $140

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Penalty

Initial $100 · Current $100

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Penalty

Initial $100 · Current $100

Issued

Jul 14, 1989

Abate by

Jul 17, 1989

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Issued

Jul 14, 1989

Abate by

Aug 14, 1989

Issued

Jul 14, 1989

Abate by

Aug 14, 1989