OSHA Inspection: DOCTORS HOSPITAL OF HYDE PARK

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

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

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:  The
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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:
a.  On or about August 29, 1994, employees such as nurses, and janitorial
staff in the patient
care areas were exposed to the hazard of being infected with infectious
tuberculosis through
contact with patients who were or may be infected with tuberculosis in
that:
1)  The employer did not have a protocol in place to identify and remove
suspect TB patients
from the emergency room as soon as possible.
2)  Employees who had responsibility for direct patient care and who
performed high hazard
procedures, such as sputum inductions, were not provided Mantoux skin
tests in accordance
with the CDC recommendations.  Some employees had not received skin tests
in over a year.
3)  Patients with suspected and confirmed TB were not placed in AFB
isolation rooms.
High hazard procedures, such as sputum induction, were performed in
treatment rooms
which were not under negative pressure with respect to the corridors.
4)  Training and information on issues such as TB medical surveillance and
site specific
precautions and controls was not provided to employees.
Feasible and useful abatement methods for reducing these hazards include
but are not limited
to the following:
a.  Develop a protocol for emergency room employees to identify
individuals with active
tuberculosis that includes the immediate removal of the patient to AFB
isolation.
b.  Provide 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 the covered facilities:  annually for all employees in
the covered facilities;
retesting every six months for workers with exposure to the exhaled air of
the individuals
with suspected or confirmed TB or for workers with exposure to high hazard
procedures
performed on such individuals.
c.  Placement of individuals with suspected or confirmed TB disease in an
AFB (acid fast
bacilli) isolation room.  AFB isolation rooms for persons with suspected
or confirmed
infectious TB and areas in which high hazard procedures are performed on
such individuals
must be maintained under negative pressure and appropriately exhausted
(either directly to
the outside away from intake vents or through properly designed,
installed,
and maintained
HEPA filters.)
d.  Training and information to ensure employee knowledge of site specific
protocols, such
as AFB isolation, and proper use of controls, such as, negative pressure.

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $1,800 · Current $1,800

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

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

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $4,500 · Current $3,600 Reduced

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $2,250 · Current $2,250

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $2,250 · Current $2,250

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $2,250 · Current $2,250

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $2,250 · Current $2,250

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $1,800 · Current $1,800

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Penalty

Initial $1,800 · Current $1,800

Issued

Dec 28, 1994

Abate by

Jan 30, 1995

Issued

Dec 28, 1994

Abate by

Jan 30, 1995