Aerosol Transmissible Diseases Citations at Alta Bates Summit Medical Center

The handling of a patient with bacterial meningitis landed an Alta Bates Summit Medical Center employee and an Oakland police officer in intensive care and prompted California’s Division of Occupational Safety and Health (DOSH) to issue citations to three employers, including willful allegations against Alta Bates.

The citations, issued April 19, were the first issued under Cal/OSHA’s Aerosol Transmissible Diseases (ATD) standard, which took effect last summer. DOSH issued citations to Alta Bates, and the Oakland Police and Fire departments, and is investigating possible meningitis exposure to ambulance drivers employed by American Medical Response.

The ATD standard is designed to protect workers in healthcare and related industries from diseases that are spread by coughing and sneezing. The standard has three levels of requirements, depending on the workplace. Besides healthcare facilities, it covers law enforcement, correctional facilities, homeless shelters, laboratories and emergency responders. In announcing the citations, DOSH Chief Len Welsh called the situation a “textbook case” of why the ATD standard was developed and said it is a “wake-up call” for other medical facilities and first responders.

The case occurred on Dec. 3, 2009, when emergency responders were summoned to a patient’s Oakland home. “Employees of all three responders at [the] scene were exposed to bacterial meningitis,” the Department of Industrial Relations says. The patient was transported to Alta Bates, where a respiratory therapist who directly treated the patient developed the disease and required 11 days of hospitalization, including time in the Intensive Care Unit. An Oakland police officer also developed meningitis and spent five days in the ICU.

Alta Bates was cited for alleged willful violations for not reporting the original meningitis case to local health authorities in a timely manner and for failure to conduct an exposure analysis of employees exposed to the potentially deadly disease for a week after the exposure. Alta Bates also was cited for not implementing an ATD program, not providing post-exposure information to employees, not properly fit-testing employees for respirators and not providing medical treatment for the exposed employee. Proposed penalties are $101,485.

Oakland P.D. was cited for allegedly failing to develop and implement an ATD program, not properly notifying the Fire Department and American Medical Response of the officer’s exposure, not obtaining a medical evaluation of the exposed employee, failing to report the hospitalization to Cal/OSHA and not notifying the officer of his exposure to meningitis. Proposed penalties total $31,520.
The Fire Department was cited for not having an ATD program and lack of exposure notification.

Cal/OSHA reminds employers that all employers involved in the transportation and treatment of patients exposed to bacterial meningitis are required to provide respiratory protection, report the case to the local health authority and employees or other employers exposed, and initiate appropriate medical treatment.

CAL OSHA Reporter Flash Report

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