OSHA Inspection: MARIA E. ARROYAVE, M.D.,P.A.

Issued

Jan 31, 1991

Abate by

Feb 16, 1991

Penalty

Initial $280 · Current $140 Reduced

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:
A) ON OR ABOUT NOVEMBER 20, 1990, PHYSICIANS, MEDICAL ASSISTANTS
AND OTHER OFFICE PERSONNEL WERE EXPOSED TO THE HAZARD OF BEING
INFECTED BY HBV AND OR HIV THROUGH POSSIBLE DIRECT CONTACT WITH
BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS WHILE TREATING
WOUNDS; GIVING INJECTIONS, DRAWING BLOOD, PASSING INSTRUMENTS IN
MINOR SURGERY, AND OTHER PROCEDURES AT THE FACILITY.
FEASIBLE ABATEMENT METHODS FOR REDUCING THIS HAZARD INCLUDE:
1) ESTABLISHMENT OF A HEPATITIS B VACCINATION POLICY AND PROGRAM WHICH
ADDRESSES ALL CIRCUMSTANCES WARRANTING SUCH VACCINATIONS AND
IDENTIFIES ALL EMPLOYEES AT SUBSTANTIAL RISK OF DIRECTLY CONTACTING
BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS, AND OFFERS ALL SUCH
EMPLOYEES HEPATITIS B VACINATIONS IN AMOUNTS AND AT TIMES PRESCRIBED
BY STANDARD MEDICAL PRACTICE.
REFERENCE: CENTERS FOR DISEASE CONTROL IMMUNIZATION PRACTICES ADVISORY
COMMITTEE: RECOMMENDATIONS FOR PROTECTION AGAINST VIRAL HEPATITIS. MMWR
1985;35:313-24, 329-35.
2) ESTABLISHMENT OF A TRAINING POLICY AND PROGRAM FOR EMPLOYEES (AS
ABOVE) WHICH INCLUDES:
A) EDUCATION ON EPIDEMIOLOGY, MODES OF TRANSMISSION, AND PREVENTION
OF HIV/HBV,
B) COUNSELING REGARDING POTENTIAL RISKS TO THE FETUS FROM HIV/HBV AND
OTHER ASSOCIATED INFECTIOUS AGENTS.
C) TRAINING REGARDING CENTERS FOR DISEASE CONTROL GUIDELINES CONCERNING
"UNIVERSAL PRECAUTIONS" AS IT APPLIES TO THEIR WORKPRACTICES, AND
SPECIFIES PROCEDURES FOR WORK PRACTICES E.G., (CLEANING AND
DISINFECTION OF EQUIPMENT, USE OF PERSONAL PROTECTIVE EQUIPMENT,
ETC.).
D) TRAINING ABOUT HEPATITIS B VACCINATION PROGRAM AND PROCEDURES
TO BE FOLLOWED AND PROVIDED IF THEY ARE EXPOSED TO A NEEDLE STICK
OR OTHER CONTACT WITH BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIAL
(SEE ITEM 1 ABOVE).
3) ESTABLISHMENT OF POLICIES AND PROCEDURES TO ASSURE THAT EMPLOYEES
EXPOSED TO DIRECT CONTACT WITH BLOOD OR OTHER POTENTIALLY INFECTIOUS
MATERIALS RECEIVE A CONFIDENTIAL MEDICAL EXAMINATION AND FOLLOW-UP
INCLUDING THE FOLLOWING:
A) DOCUMENTATION OF THE HBV AND HIV INFECTION STATUS OF THE SOURCE
PATIENT (IF KNOWN) AND,
B) FOLLOW-UP OF THE EXPOSED EMPLOYEE INCLUDING ANTIGEN AND/OR
ANTIBODY TESTING (HBV/HIV), COUNSELING, ILLNESS REPORTING AND
SAFE AND EFFECTIVE POST-EXPOSURE PHROPHYLAXIS AS INDICATED ACCORDING
TO STANDARD RECOMMENDATIONS FOR MEDICAL PRACTICE.
REFERENCE: CENTERS FOR DISEASE CONTROL. RECOMMENDATIONS FOR PREVENTION
OF HIV TRANSMISSION IN HEALTH-CARE SETTINGS, MMWR 1987;36 (SUPPL. 25)
CENTERS FOR DISEASE CONTROL, IMMUNIZATION PRACTICES ADVISORY COMMITTEE,
RECOMMENDATIONS FOR PROTECTION AGAINST VIRAL HEPATITIS, MMWR 1990;39
(NO.S-2)
NOTE: IT IS RECOMMENDED THAT THE FACILITY ALSO DEVELOP POLICIES FOR
DOCUMENTATION AND TRACKING OF POST-EXPOSURE EVALUATIONS AND FOLLOW-UP
PROCEDURES (RE: HBV/HIV) WHICH ADDRESS OR SPECIFY REQUIREMENTS FOR:
1) DOCUMENTATION OF SOURCE PATIENT IDENTIFICATION AND CIRCUMSTANCES
UNDER WHICH EXPOSURE OCCURRED.
2) TESTING (HIV) OF SOURCE PATIENTS IN SITUATIONS IN WHICH CONSENT
CANNOT BE OBTAINED (E.G., AN UNCONSCIOUS PATIENT).
3) DOCUMENTATION OF SERONEGATIVE SOURCE PATIENTS "RISK-FACTORS"
EVALUATION.
4) DEVELOPMENT OF CHRONOLOGICAL TRACKING SYSTEM TO ASSURE TIMELY
ADMINISTRATION OF VACCINES AND PROCEDURES (E.G., HB VACCINE, SERIAL
HIV TESTING) AND NOTIFICATION TO EXPOSED EMPLOYEES OF RESULTS OF
TESTS AND EVALUATIONS, AND DATES OF FUTURE VACCINATIONS/
INNOCULATIONS, TESTS OR PROCEDURES THAT MAY BE REQUIRED.

Issued

Jan 31, 1991

Abate by

Feb 3, 1991

Issued

Jan 31, 1991

Abate by

Feb 5, 1991

Issued

Jan 31, 1991

Abate by

Mar 5, 1991

Issued

Jan 31, 1991

Abate by

Mar 5, 1991

Issued

Jan 31, 1991

Abate by

Mar 5, 1991