OSHA Inspection: HOSPITAL SAN CARLOS INCORPORADO

Issued

Nov 8, 1999

Abate by

Dec 11, 1999

Penalty

Initial $5,000 · Current $2,500 Reduced

General-duty citation text

Section 6(a) of the Puerto Rico Occupational Safety and Health Act:  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 physical harm to employees
in that employees
were exposed to:
Seccion 6(a) de la Ley de Seguridad y Salud en el Trabajo de Puerto Rico:
El patrono no
proveyo empleo y un sitio de empleo libre de riesgos reconocidos que esten
causando o que
puedan causar muerte o dano fisico a los empleados, por cuanto empleados
estaban expuestos
a:
a)Workplace - Employees exposed to the hazard of being infected with
Mycobacterium tuberculosis through unprotected contact with patients who
were infectious or suspected to be infectious with tuberculosis in that:
1.Isolation rooms number 101, 102, 218, 221, 236 and 201 were not acid
- fast bacilli (AFB) isolation rooms (negative pressure rooms).
2.The employer did not have a written and implemented protocol for the
early identification of individuals with active TB.
3.The employer did not have a worker education and training program
regarding exposure to tuberculosis.
Feasible and useful abatement methods for reducing this hazard, as
recommended by the CDC, include, but are not limit to:
1.Individuals with suspected or confirmed infectious TB disease must be
placed in a respiratory acid - fast bacilli (AFB) isolation room. AFB
isolation refers to a negative pressure room that exhausts room air
directly outside.
2.The employer shall develop and implement a protocol (TB infection
control policies) for the early identification of individuals with active
TB. This protocol must include a group of professionals with the
authority to implement and enforce TB infection control policies.
Communication must exist between this persons regarding making
decisions for the correct handling of suspected or confirmed TB cases
(CDC 1994 guidelines, pages 15 thru 30, could be used for this
purpose).
3.Training and information to ensure employee knowledge of such issues
as the mode of TB transmission, its signs and symptoms, medical
surveillance and therapy, and site specific protocols including the
purpose and proper use of controls shall be provided to all current
employees at risk and to new workers upon hiring (CDC 1994guidelines,
pages 43 thru 44, should be used for this purpose). Training
should be repeated as needed.
a)Lugar de trabajo - Empleados expuestos al riesgo de infeccion con
Mycobacterium tuberculosis a traves de contacto sin proteccion con
pacientes
que estuvieron infectados o con sospecha de infeccion de tuberculosis en
que:
1.Cuartos de aislamiento numero 101, 102, 218, 221, 236 and 201 no
eran cuartos de aislamiento del tipo "acid - fast bacilli (AFB)" (cuartos
de presion negativa).
2.El patrono no tenia un protocolo escrito e implementado para la
identificacion temprana de individuos con TB activa.
3.El patrono no tenia un programa de educacion y entrenamiento
relacionado con exposicion a tuberculosis.
Metodos de correccion utiles y factibles para reducir este riesgo, segun
recomendado por el CDC, incluyen, pero no se limitan a:
1.Individuos con tuberculosis confirmada o sospechada tienen que
colocarse en cuartos de aislamiento del tipo "acid - fast bacilli (AFB)".
Aislacion tipo AFB se refiere a cuartos de presion negativa que extraen
el aire del cuarto directamente hacia el exterior.
2.El patrono tiene que desarrollar e implementar un protocolo (politica
para el control de infecciones por TB) para la identificacion temprana
de individuos con TB activa o sospechada. Este protocolo tiene que
envolver un grupo de profesionales con la autoridad de implementar y
hacer cumplir las politicas para el control de infeccion de TB. Tiene
que existir comunicacion entre estas personas en relacion a la toma de
decisiones para el manejo correcto de casos de TB sospechados o
confirmados (las guias del CDC 1994, paginas 15 a la 30, pueden
seguirse para este proposito).
3.Informacion y adiestramiento para asegurar conocimiento del empleado
de asuntos tales como el modo de trasmision de TB, sus signos y
sintomas, vigilancia medica y terapia, y los protocolos de la institucion
incluyendo el proposito y uso apropiado de controles tiene que ser
provisto a todos los empleados en riesgo y empleados nuevos al
momento de ser reclutados (las guias del CDC 1994, paginas 43 a la
44, deben usarse para este proposito). El adiestramiento debe repetirse
segun necesario."nto

Issued

Nov 8, 1999

Abate by

Nov 21, 1999

Penalty

Initial $1,125 · Current $563 Reduced

Issued

Nov 8, 1999

Abate by

Nov 26, 1999

Penalty

Initial $1,125 · Current $563 Reduced

Issued

Nov 8, 1999

Abate by

Nov 26, 1999

Penalty

Initial $1,125 · Current $563 Reduced

Issued

Nov 8, 1999

Abate by

Nov 16, 1999