Five Facilities Cited for Health Care Violations

Five health care facilities in San Diego--including three hospitals, a medical laboratory and a dental clinic--allegedly are breaking rules designed to protect workers from exposure to viruses that cause hepatitis B and AIDS, federal health authorities are expected to announce today.

The medical facilities have been cited as part of a nationwide project launched by OSHA early last month, Federal Occupational Safety and Health Administration officials said Thursday.

The citations, which are among the first issued in California, are the result of surprise inspections made by OSHA investigators and are aimed at employers--including hospitals, blood banks, dental offices, nursing homes and mortuaries--who have 10 or more workers and deal with victims of blood-borne diseases.

Facilities in San Diego

The five San Diego facilities include Hillside Hospital on El Cajon Boulevard, San Diego Dental Group on Alvarado Court, Navy Hospital in Balboa Park, Scripps Memorial Hospital in La Jolla and Pathology Lab Inc., which operates a laboratory at Scripps Memorial.

In all, the citations alleged 17 violations and represented $8,270 in penalties. The alleged transgressions were all described as “serious violations,” defined by OSHA as instances “where a substantial probability that death or serious physical harm could result, and that the employer knew or should have known of the hazard.”

Health authorities added, however, that the violations uncovered at Scripps were minor.

James Roberts, industrial-hygiene supervisor in OSHA’s San Diego-area office, said inspectors used guidelines provided by the Centers for Disease Control in Atlanta as the basis for their inspections. Those guidelines, he said, provide uniform methods of protecting workers from exposure to viruses causing hepatitis B and AIDS by minimizing their contact with blood and blood products.

“Those guidelines treat all items contaminated with blood as though they were infectious,” Roberts said. “You don’t know who is infected and who is not.”

With the exception of Navy Hospital, which was cited in late October, the facilities were given hand-delivered citations Thursday.

The alleged violations include the following:

- San Diego Dental Group, 6330 Alvarado Court, was cited for six violations and assessed $4,240 in penalties. The dental group was cited for allegedly having an inadequate infection control program; improperly handling used needles; improperly handling infectious waste; reusing disposable gloves; failing to provide eye protection for workers, and having improper bio-hazard warning labels.

Specifically, OSHA inspectors said that blood-soiled debris in the dental group’s oral surgery and examination rooms was left in uncovered waste containers, and needles that should have been disposed of after use were instead recapped, a practice that could potentially cause workers to infect themselves through an accidental needle prick.

Gloves Allegedly Reused

Also, the dental group allegedly reused disposable gloves by washing them between patients. The gloves, according to OSHA, aren’t made to withstand washings and thus could be damaged enough to allow a virus to travel through a hole. In addition, OSHA said workers at the facility weren’t provided with goggles or other eye protection that would prevent blood from splashing into the eyes.

San Diego Dental Group declined to comment on the citations.

- Hillside Hospital, a 133-bed facility at 1940 El Cajon Blvd., was cited for three violations and $2,070 in penalties. The hospital was cited for improper waste-disposal methods, failure to provide the right kind of protective equipment and for not having proper warning labels.

The hospital, according to the inspectors, improperly disposed of blood-soiled debris and was failed to put warning labels on trays carrying blood samples, which could be hazardous if they were accidentally dropped and someone was injured, causing the virus to spread. Also, the hospital was cited for allegedly failing to provide employees with goggles.

Carmen Saavedra, human resources director for the hospital, said Thursday she had not yet thoroughly studied the citations and that any detailed response would have to wait until the hospital’s board of directors discussed the matter. But she said it is the hospital’s intention to remedy the problems described by OSHA, and that it is likely that the hospital will then ask OSHA to reduce the penalty.

- Pathology Lab Inc., which does work for Scripps Memorial Hospital, is on the hospital grounds at 9888 Genesee Ave. The laboratory company was cited for two violations and $980 in fines, including failing to provide adequate protective equipment for its workers and for improper waste disposal methods.

Violations Detailed

Specifically, OSHA found that the laboratory failed to provide employees with goggles, and that employees were transporting blood samples in disposable baskets that lacked lids. Also, inspectors cited the facility for failing to have lids on infectious trash containers.

Dr. Phillip Gausewitz, an associate director of the laboratory firm, said the problems cited by OSHA have been remedied and that his firm will seek a conference with the federal agency to discuss the matter.

“We fixed those things,” he said. Gausewitz said his company thought that workers who wear glasses while working weren’t required to also have goggles. But Roberts, the OSHA official, said goggles or a face shield are the only equipment that can be used.

- Scripps Memorial Hospital. The hospital was cited for two violations and hit with a fine of $980 for infractions that included incomplete training of housekeeping employees and not providing adequate eye protection.

OSHA, however, went out of its way to call the violations “relatively minor.”

“The program at Scripps was commendable and the minor infractions encountered were corrected immediately,” said John Hermanson, director of the San Diego OSHA area office, in a prepared statement.

Failure to Wear Gloves

Michael Bardin, a hospital spokesman, said the incomplete training had to do with some workers who clean rooms and wards failing to wearing gloves at all times. And he also said that Scripps had the mistaken impression that eyeglasses worn by employees would suffice for protective goggles.

- Navy Hospital, the huge facility located in Balboa Park, was issued four citations dealing with housekeeping, reusing disposable gloves, failing to provide adequate eye protection and improper waste handling. Because the hospital is a federal facility, OSHA is prevented by law from levying fines against it. The hospital, though, is required to take corrective action.

Among violations found at the hospital were linen hampers containing blood-soiled material being filled beyond capacity and a lack of goggles being used in the toxicity laboratory.

Officials at the hospital were unavailable for comment.

Roberts said OSHA will continue to make surprise inspections at least until next September and will include not only medical facilities but also any facility where workers are exposed to blood or blood products.

Hepatitis B infects an estimated 18,000 health care workers annually in the United States, according to OSHA officials. Of that number, nearly 10% become long-term carriers of the virus. About 300 hepatitis B victims die each year of the infection or complications.

According to the Centers for Disease Control, California has a significantly higher number of hepatitis B cases than other states.

As of July 30, about 21% of the nation’s 14,888 cases of AIDS were in California, according to the center. OSHA officials say that up to 1.5 million people in the nation have the human immunodeficiency virus that causes AIDS.