OSHA Fines New York Hospital

The National Alliance for the Primary Prevention of Sharps Injuries

(NAPPSI) reports in a special alert to its members that the Occupational Safety and Health Administration (OSHA) has issued a groundbreaking ruling involving needlestick-safety violations at Montefiore Medical Center, a prominent New York City

hospital associated with Albert Einstein School of Medicine.

OSHA cited the medical center for 46 instances of unsafe practices that improperly exposed interns, residents and other healthcare workers to sharps injuries.

Many of the violations involved failure to use primary prevention

technologies such as needleless access valves, and sutureless devices to

secure catheters and tubes. Failures to employ proved secondary

prevention devices -- like safety catheters and retractable scalpels --

were also cited. The citations and fines came in response to a complaint

filed by more than 20 Montefiore medical residents.

NAPPSI welcomes the OSHA ruling as an important victory for primary

prevention. As part of the group's campaign to protect interns and residents from

suture-related needlesticks, NAPPSI has issued a statement of support for

the Montefiore residents (http://www.nappsi.org). The residents recently

notified the American Hospital Association (AHA) of their intent to

file "institution-by-institution" complaints with safety regulators,

unless AHA writes its members regarding needlestick safety.

The residents and their organizational allies, The American Medical

Students Association and the Health Research Group of Public Citizen,

want AHA to alert its members to the OSHA ruling against Montefiore, as a

way of facilitating hospitals' compliance with needlestick safety

standards.

In a related earlier action, OSHA ruled in January 2003 that suture

needles used for catheter securement constitute a safety hazard. The

agency now requires healthcare employers to evaluate sutureless

securement devices and to adopt them if they are found to be appropriate

and feasible.

"The needlestick hazards identified at Montefiore exist at hundreds of

other teaching hospitals around the country," said NAPPSI president

Steve Bierman, MD. "America's interns and residents will continue to face

potentially fatal injuries until hospitals comply with OSHA regulations,

by adopting sutureless and suture-safe technologies, surgical glues, as

well as other primary prevention devices such as noninvasive monitoring

devices."

NAPPSI has created the most current and comprehensive list of

needlestick-safety devices, available at www.nappsi.org/safety.shtml.

The organization's Clinician Advisory has also been widely disseminated

by governmental and clinician organizations. NAPPSI utilizes

communications such as a monthly e-mail newsletter and a national

speaker's bureau to inform decision makers, clinicians,

and the media about the value of primary prevention. For more

information, contact info@nappsi.org.