OSHA Inspection: VETERANS AFFAIRS: PUGET SOUND HEALTH CARE SYSTEM

Issued

Jul 16, 2013

Abate by

Aug 30, 2013

Penalty

Initial $0 · Current $0

General-duty citation text

29 CFR 1960.8(a):  The head of agency did not furnish to each employee 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 the potential hazard of being infected with Mycobacterium tuberculosis:     a.)  On or about April 15, 2013, and at times prior thereto, adequate measures were not taken when emergency surgical procedures were performed on a patient with suspected tuberculosis in a positive-pressure operating room without the benefit of a properly designed and ventilated ante-room:     Feasible and useful abatement methods to mitigate this hazard, as recommended by CDC, include, but are not limited to:     1.)  Amend the current Tuberculosis Exposure Control Plan, Appendix-A, Exposure Determination List, to include all employees in the surgical suite.     2.)  Make available tuberculin skin test (TST) or TB surveillance questionnaire, as necessary, to all employees in the surgical suite.     3.)  Amend the current Tuberculosis Exposure Control Plan to include environmental controls, such as ventilation, used at the facility to prevent spread of infectious droplet nuclei during endotracheal intubation of patient with suspected or confirmed TB disease.  Controls stated in Section 10 of the plan that required patients exhaled breath to be captured and exhausted or filtered through a HEPA filter,  were not employed and were not practical during the endotracheal intubation and extubation in the positive pressure operating room.     Note: Abatement certification and supporting documentation are required for this item

Issued

Jul 16, 2013

Abate by

Sep 20, 2013

Penalty

Initial $0 · Current $0

General-duty citation text

29 CFR 1910.134(f)(2): The employer did not ensure that an employee using a tight-fitting facepiece respirator was fit tested prior to initial use of the respirator, whenever a different respirator facepiece (size, style, model or make) was used, and at least annually thereafter:     a.) Anesthesiologists and anesthesia techs employees were last fit tested in October/December 2009.      b.) Employees in the surgical suites, who were required to use respirators when performing and/or assisting with emergency surgical procedures to a patient with suspected or confirmed tuberculosis, were not fit tested.     Note: Abatement certification and supporting documentation are required for this item

Issued

Jul 16, 2013

Abate by

Sep 20, 2013

Penalty

Initial $0 · Current $0

General-duty citation text

29 CFR 1910.134(k)(3): The employer did not provide the training prior to requiring the employee to use a respirator in the workplace:     a.) The operating room employees, who were expected to use respirators when urgent surgical procedures must be provided to patients with suspected or confirmed TB disease, were not provided with training covering the use of respirators.     Note: Abatement certification and supporting documentation are required for this item

Issued

Jul 16, 2013

Abate by

Aug 9, 2013

Penalty

Initial $0 · Current $0

General-duty citation text

29 CFR 1910.145(e)(4): Biological hazard warning signs were not used to signify the actual or potential presence of biohazard and to identify rooms which contain, or are contaminated with viable hazardous agents:     a.)  On or about April 15, 2013, warning signs stating Respiratory Isolation were not posted outside the operating room where emergency surgical procedures performed on a patient with suspected tuberculosis.     Note: Abatement certification and supporting documentation are required for this item