OSHA Inspection: CITYWIDE AMBULANCE SERVICE

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Penalty

Initial $1,750 · Current $500 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:
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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 including but not limited to emergency medical
technicians were exposed to the hazards of being infected
with tuberculosis through contact with clients from long
term care facilities for the elderly who were or may be
infected with tuberculosis in that;
(a)On 7/1/93, worksite
A client with suspect or active TB was transported by
ambulance from Concourse Nursing Home to Mt. Sinai
Hospital.  During transport, the emergency medical
technician performed patient care activities, such as but
not limited to, the taking of vital signs and the
administration of oxygen.
(b)On 7/10/93
A client with suspect or active TB was transported by
ambulance from Dry Harbor Nursing Home to St. Johns
Hospital.  During the transport, the emergency medical
technician performed patient care activity, such as but
not limited to, the taking of vital signs and the
administration of oxygen.
(c)On 7/23/93
A client with suspect or active TB was transported by
ambulance from Fairview Nursing Home to Parkway Hospital.
During the transport, the emergency medical technician
performed patient care activity, such as but not limited
to, the taking of vital signs.
ABATEMENT NOTE:    Feasible and useful abatement methods for
reducing this hazard, include:
1 Protocol for early identification of individuals with active
tuberculosis.
2 Medical surveillance (at no cost to employees) including
preplacement evaluation, administration and interpretation of
TB Mantoux skin tests, and periodic evaluations shall be
offered to employees as follows:  an initial baseline
screening at the time of employment for all employees in
covered facilities; annually for all employees in the covered
facilities; retesting every six months for workers with
exposure as defined above (see MMWR pp.1819).  Attachment A.
3 Evaluation and management (at no cost to employees) of workers
with a positive skin test, or with skin test conversion onrepeat testing,
or who are exhibiting symptoms of TB,
including work restrictions for infectious employees.  Workers
who experience a TB exposure incident (exposure to a
patient/client with infectious TB for whom infection control
precautions have not been taken)  shall also be managed
according to CDC recommendations (see MMWR p.19).
4 Training and information to ensure employee knowledge of such
issues as the hazard of TB transmissions, its signs and
symptoms, medical surveillance and therapy, and sitespecific
protocols including the purpose and proper use of

Issued

Jan 19, 1994

Abate by

Apr 30, 1994

Penalty

Initial $1,750 · Current $500 Reduced

Issued

Jan 19, 1994

Abate by

Jan 24, 1994

Penalty

Initial $875 · Current $500 Reduced

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Penalty

Initial $875 · Current $500 Reduced

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Penalty

Initial $525 · Current $300 Reduced

Issued

Jan 19, 1994

Abate by

Jan 24, 1994

Penalty

Initial $350 · Current $100 Reduced

Issued

Jan 19, 1994

Abate by

Mar 31, 1994

Penalty

Initial $350 · Current $100 Reduced

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Issued

Jan 19, 1994

Abate by

Feb 24, 1994

Issued

Jan 19, 1994

Abate by

Jan 24, 1994

Issued

Jan 19, 1994

Abate by

Feb 24, 1994