Needle Safety Remains a Sticking Point in Medical Offices
By LAURENCE DARMIENTO
Staff Reporter
Workplace safety inspectors are continuing to turn up serious violations of the state’s landmark needle safety law at California medical offices, although the number of violations has declined over the past two years.
State inspectors found 15 violations they determined could cause serious injury or death last year, down from 22 the year earlier, after visits to 30 doctors’ offices. Seven of the citations were in L.A. County, and nearly all came as the result of employee complaints.
“It has been a slow process of getting all the facilities in compliance,” conceded Dean Fryer, a spokesman for the California Occupational Safety and Health Program, commonly known as Cal-OSHA.
The 1999 state law, which was passed following an outcry over nurses and other health care workers becoming unintentionally infected with HIV and other illnesses, requires hospitals, doctors and other medical providers offices to take a variety of steps to lessen the risk of infection. It formed the model for a national law that went into effect in 2001.
It is believed that several hundred thousand health care workers nationwide are exposed to illnesses each year through needlesticks and other sources, such as being splashed with blood, though hard statistics are not available.
The law requires doctors, with some exceptions, to purchase a new generation of needles with tips that can be retracted like a pen or automatically blunted after each use. Doctors also must develop safety plans and educate workers on how to handle needles and other sharp devices.
Janine Jagger, a professor at the University of Virginia School of Medicine and a leading expert on health worker safety, said data from medical device manufacturers indicates nearly all hospitals are buying safer blood drawing and injection devices, but perhaps a quarter of doctors are not. “(It’s) a substantial number,” she said.
Adapting to change
The California Medical Association maintains that while the number of doctors being cited by Cal-OSHA is still unacceptably high, doctors appear to be getting better at following the law.
Statistics compiled by Cal-OSHA show that 48 physician offices were inspected in 2002, turning up 169 workplace safety violations laws, 22 of which were “serious” violations of regulations governing needle and blood safety.
“Serious” violations are defined as those that have the potential to cause serious illness or death. That could mean exposing workers to HIV and other diseases through sloppy needle handling or the use of needles that do not meet safety standards.
Hans Lee, a CMA attorney, said he believed the association’s on-going education efforts, which include sending out materials to doctors about the law, was making a difference.
“It took time to adapt to this change and actually implement it,” he said. “But if they are not already aware of it by now, they really need to be. There is really no excuse.”
However, Bill Borwegen, director of occupational health and safety for the Service Employees International Union, a driving force behind the 1998 California law, said he was not impressed by the reduction.
He noted that Cal-OSHA, like its counterparts in other states, is under-funded and can only catch a fraction of safety violations in workplaces with fewer than 10 employees, such as doctors offices, where inspections generally only take place after complaints.
“The chance of getting a Cal-OSHA inspection is pretty slim,” he said. “If that was your chance of getting a ticket for going through a red light, I think a lot more people would go through red lights.”
Of the 30 inspections conducted by Cal-OSHA last year, all but two were prompted by complaints. Fryer said the department has 196 inspectors covering the state’s 1 million employers, leaving little time for random audits.
The inspections conducted last year found serious violations of the law at 11 medical offices statewide, including four in Los Angeles County.
The Imperial Family Medical Group in Downey received four citations, the most statewide, while the offices of Dr. Philip Lim in Bellflower, a medical practice called Grow With Us in Arcadia and Dr. William Isacoff at UCLA Medical Plaza received one each.
The details of the citations were not available, and the offices did not return telephone calls. Fines ranged from $900 to $2,360, including some that were reduced after settlement talks. Some of the fines may still be on appeal, Fryer said.
Dr. Marcy Zwelling-Aamot, president of the Los Angeles County Medical Association, said she believes most doctors want to comply with the law, but clearly not all do, partly because they may not feel they are endangering anyone. “I think there is perhaps a casualness,” she said.
