California Issues First Citations for Aerosol Transmission Violations

A respiratory therapist and a police office were infected with bacterial meningitis after being exposed to a patient Dec. 3, but the Oakland hospital where he was treated did not report it to the local health department as quickly as the standard requires, according to Cal/OSHA.

Cal/OSHA issued two willful citations on Monday against an Oakland hospital, Alta Bates Summit Medical Center, and additional citations against the Oakland Police Department and the Oakland Fire Department in connection with a 36-year-old man transported by ambulance to the hospital on Dec. 3, 2009, and lab results the following day that indicated this was a suspected meningitis case. The citations allege all three organizations violated the Aerosol Transmissible Disease Standard. The medical center should have reported the case to the Alameda County Health Department on Dec. 4 but did not report it until Dec. 7, according to the California Department of Public Health's Occupational Health Branch.

Proposed penalties against Alta Bates Summit Medical Center for the citations total $101,485. The police department's proposed penalties are $31,520, the first department's $2,710. According to the Occupational Health Branch, a 47-year-old male respiratory therapist working for Alta Bates and a 30-year-old male police officer were infected with the meningitis bacterial strain from the original patient; the therapist was present when the patient was intubated and performed suctioning of his airway, while the officer moved the patient in the field before the patient was transported to the hospital. Both wore gloves but not respiratory protection, and both were hospitalized for more than 24 hours, making their cases "serious" according to the California Labor Code.

The two workers' infections could have been prevented had the employers complied with the standard and had post-exposure prophylaxis been offered in a timely manner, the occupational health branch concluded. Other hospital employers were notified and treated about seven days after the original patient was determined to be a suspect case.

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