The Contra Costa Times
OAKLAND, Calif. — A state regulatory agency Monday issued citations to Alta Bates Medical Center in Oakland, the Oakland Police Department and the Oakland Fire Department for how the agencies handled a life-threatening exposure of bacterial meningitis in the city last December.
My Day on the Hill By Art Hsieh, EMS1 Editorial Advisor This week I had the wonderful opportunity to participate on the first annual EMS on the Hill Day. Over the course of a day, EMS providers representing 40 states reached out to more than 160 members of Congress, informing the members and their staff of the urgent need to support EMS services across the United States. A few of my thoughts through the day: 1. Although I’ve visited the US Capitol before, it’s awe inspiring. Just as impressive are the folks who work there, and in the various buildings surrounding the Capitol. The “people’s business” was buzzing with an incredible amount of energy and purpose. 2. You would be proud of the people who represented our profession. Folks from super-rural areas sat alongside deep urban EMS providers during the briefing session, held the night before. During the day, you could see uniformed personnel waiting patiently outside offices, waiting for their turn. 3. In preparing for the day, we were trained to stay unified and “on message” as we spoke to congressional members and staff. Freelancing was a detriment. We were only able to discuss our concerns for less than thirty minutes, which gave little time to really talk about anything more than the agenda topics. 4. I personally found my meetings to be pleasant. Some of the staffers were really very informed about the topics, and were encouraging in their remarks. These folks really work hard to listen to the message and bring it back to their congressional member. The take-home lesson: You can’t be heard unless you speak. In previous columns I’ve mentioned that it was critical to let your local elected officials know about what you do and what you need to perform excellent service every day. EMS on the Hill drives that message home, like a spike. I look forward to attending next year; I hope you will, as well. Art Hsieh, MA, NREMT-P, is Chief Executive Officer & Education Director of the San Francisco Paramedic Association, a published author of EMS textbooks and a national presenter on clinical and education subjects. |
The California Department of Industrial Relations’ Division of Occupational Safety and Health, better known as Cal/OSHA, said the exposure resulted in emergency hospitalizations of an Alta Bates employee and an Oakland police officer.
The agency said ambulance employees of American Medical Response are also under investigation in connection with the incident.
Cal/OSHA issued citations of $101,485 against Alta Bates, $31,520 against the Oakland Police Department and $2,710 against the Oakland Fire Department.
Department of Industrial Relations Director John Duncan said in a statement, “The new Aerosol Transmittable Disease (ATD) Standard was designed to protect workers from just this type of exposure.” He said, “Protection of medical facility staff and first responders is critical in the process of assisting the public in need of the life-saving services they offer. We cannot allow the spread of diseases caused by airborne aerosols in these critical professions when preventive measures are readily available, and have been required since August 2009.”
Cal-OSHA said that on Dec. 3 Alta Bates received a patient with bacterial meningitis who had been transported by American Medical Response with the assistance of a fire department paramedic.
According to the state agency, the ambulance service responded to the home of the patient where the Oakland police and fire departments had previously arrived. Employees of all three responders at scene were exposed to bacterial meningitis, the state said.
Cal/OSHA said it was notified on Dec. 15 by Alta Bates that a respiratory therapist, who directly treated the patient, was hospitalized at another hospital and in the intensive care unit being treated for bacterial meningitis. The respiratory therapist was hospitalized for 11 days.
The agency said Alta Bates was issued citations 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 to the exposed employee.
The medical center also received two willful citations: one for not reporting the meningitis case to the local health authorities and other employees in a timely manner, and one for failure to conduct an exposure analysis of employees exposed to bacterial meningitis for a week after the exposure.
The Oakland Police Department, which had an officer hospitalized in the intensive care unit of another hospital for five days with bacterial meningitis, was cited for nine violations that included failure to develop and implement the required ATD standard and failure to properly notify the fire department and AMR of the exposure.
The fire department, which had a paramedic who assisted in transporting the exposed patient, was cited for five violations that included failure to develop and implement an ATD standard. However, none of the responding firefighters, who all used personal respirators, developed the disease.
Cal-OSHA said all employers involved in the transportation and treatment of a patient exposed to bacterial meningitis are required to provide respiratory protection, report the case to the local health authority and to employees or other employers exposed and initiate appropriate medical treatment.
The agency said its investigation revealed a failure to comply with those requirements in the Dec. 3 case.
Alta Bates, the Police Department and the fire department have 15 business days to appeal or to accept the violations and pay the penalties.
Alta Bates said in a statement, “The medical center immediately responded to this very unfortunate and unusual occurrence.” It said, “A thorough investigation was completed and a performance improvement action plan to prevent an event like this from reoccurring was implemented. The medical center has every intention of appealing portions of the citation.”
A spokesman for the emergency medical services division of the Oakland Fire Department said he has no comment on the citations. An Oakland police spokesman didn’t immediately respond to a request for a comment.
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