OSHA Inspection: BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER

Issued

Aug 13, 1990

Abate by

Mar 1, 1991

Penalty

Initial $640 · Current $225 Reduced

Issued

Aug 13, 1990

Abate by

Feb 1, 1991

Penalty

Initial $800 · Current $275 Reduced

Issued

Aug 13, 1990

Abate by

Mar 1, 1991

Penalty

Initial $350 · Current $100 Reduced

Issued

Aug 13, 1990

Abate by

Oct 1, 1991

Penalty

Initial $400 · Current $150 Reduced

Issued

Aug 13, 1990

Abate by

Jul 1, 1991

Penalty

Initial $320 · Current $100 Reduced

Issued

Aug 13, 1990

Abate by

Jul 1, 1991

Penalty

Initial $320

Issued

Aug 13, 1990

Abate by

Oct 1, 1991

Penalty

Initial $400 · Current $150 Reduced

Issued

Aug 13, 1990

Abate by

Jun 1, 1991

Penalty

Initial $7,000 · Current $2,800 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety an 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 employee(s) in that employee(s) were exposed
to the hazards of working with blood and body fluids thus causing or
likely to cause employee exposure to and contraction of Hepatitis B
Virus (HBV) and/or Human Immunodeficiency Virus (HIV):
a) Workplace; 365 East Main St., Patchogue, NY: On or about 4/5/90;
Health Care workers exposed include Physicians, Nurses, Medical
Assistants, Ward Clerks, Lab Technicians, X-Ray and Housekeeping
personnel.
Feasible abatement methods for reducing this hazard, include, but are
not limited to:
TRAINING AND EDUCATION:
Training and Education of Health Care Workers such as, but not
limited to, physicians, nurses, medical assistants, ward clerks,
laboratory technicians, x-ray and housekeeping personnel. Such
training and education shall be at the time of initial employment
and at least annually thereafter. The training materials used shall
be appropriate in content and vocabulary to educational level,
literacy and language background of the employees being trained.
The training and Education program shall contain as a minimum the
following elements:
i) A general explanation of the modes of transmission of bloodborne
pathogens;
ii) An explanation of the employer's Infection Control Program;
iii) An explanation of the appropriate methods for recognizing tasks
and other activities that may involve exposure to blood or body
fluids and other potentially infectious materials;
iv) An explanation of the use and limitations of work practices that
will prevent or reduce employee exposure, including appropriate
engineering controls, work practices and personal protective
equipment;
v) An explanation of the basis for selection of personal protective
equipment;
vi) Information on the Hepatitis B vaccination, including information
on its efficacy, safety and the benefits of being vaccinated;
vii) Information on the appropriate actions to be taken and the person
to contact in an emergency;
viii) An explanation of the procedure to follow if an exposure incident
occurs, including the method of reporting the incident and the
medical follow-up that will be made available;
iv) An explanation of the signs and labels and/or color coding used
in the workplace; and
v) A copy of the Center for Disease Control (CDC) Guidelines.
WRITTEN INFECTION CONTROL PROGRAM
The employer shall design and implement a written Infection Control
Program to minimize or eliminate employee exposure. This Infection
Control Program shall be reviewed and updated as necessary to reflect
significant changes in tasks or procedures. This program shall
contain as a minimum, the following:
i) A determination of the exposure potential of all employees;
ii) The schedule and method of implementation of all Infection
Control Program.
iii) Incorporate all the items contained in the employer's Infection
Control Training and Information Program as it relates to
identification evaluation and control of bloodborne pathogens
and exposure to blood and body fluids.
The written Infection Control Program shall be made available to all
employees during the training program.
HEPATITIS B VACCINATION
The facility's infection control policy regarding Hepatits B
vaccinations shall address all circumstances warranting such
vaccinations and shall identify employees at substantial risk of
directly contacting body fluids.All such employees shall be offered
Hepatitis B vaccinations in amounts and at times prescribed by
standard medical practice.
FOLLOW-UP PROCEDURES AFTER POSSIBLE EXPOSURE TO HIV/HBV:
i) If a health care worker has a percutaneous (needlestick or cut)
or mucous membrane (splash to eye, nasal mucosa, or mouth)
exposure to blood or body fluid or has a cutaneous exposure to
bloor or body fluids when the worker's skin is chapped, abraded or
otherwise nonintact, the source patient shall be informed of the
incident and tested for HIV and HBV infections, after consent is
obtained.
ii) If patient consent is refused or if the source patient tests
positive, the health care worker shall be evaluated clinically by
HIV antibody testing as soon as possible and advised to report
and seek medical evaluation of any acute febrile illness that
occurs within 12 weeks after exposure. HIV seronegative workers
shall be retested 6 weeks post-exposure and on a periodic basis
thereafter (12 weeks and 6 months after exposure).
iii) Follow-up procedures shall be taken for health care workers
exposed or potentially exposed to HBV. The type of procedures
depends on the immunization status of the worker (i.e., whether
HBV vaccination has been received and antibody response is
adequate) and the HBV serologic status of the source patient.
The CDC Immunization Practices Advisory Committee has published
its recommendations regarding HBV post-exposure prophylaxis in
table format in the June 5, 1985, Morbidity and Mortality Weekly
Report.
iv) If an employee refuses to submit to the procedures in (b) or (c)
above, when such procedures are medically indicated, no adverse
action can be taken on that ground alone since the procedures are
designed for the benefit of the exposed employee.
HANDLING OF LINEN
The Infection Control Program shall have identified all laundry
operations involving substantial risk of direct exposure to blood or
body fluids. Linen soiled with blood or body fluids shall be handled
as little as possible and with minimum agitation to prevent
contamination of the person handling the linen.
All soiled linen shall be bagged at the location where it was used;
it shall not be sorted or rinsed in patient-care areas. Soiled
linen shall be placed and transported in bags that prevent leakage.

Issued

Aug 13, 1990

Abate by

Oct 25, 1990

Penalty

Initial $100

Issued

Aug 13, 1990

Abate by

Jun 1, 1991

Penalty

Initial $400

Issued

Aug 13, 1990

Abate by

Apr 1, 1991

Issued

Aug 13, 1990

Abate by

May 1, 1991

Issued

Aug 13, 1990

Abate by

Apr 30, 1991