Medical waste basic information DPNR orders immediate action at Schneider
Published: October 2, 2013
Font size: [A] [A] [A]
ST. THOMAS - Schneider Regional Hospital has 10 days to correct violations from the outdoor packing and storing of infectious medical waste, which has exposed the biohazardous waste to dangerously high temperatures and generated a risk to workers and the public, according to officials from the Department of Planning and Natural Resources' Environment Protection division.
DPNR inspectors made an unannounced inspection of the medical waste storage areas at Schneider on Friday, and on Tuesday, the agency issued an order of non-compliance to the hospital because of its failure to follow proper standards and guidelines for storing infectious waste.
It remains to be seen how the sizable volume of overflow of what is called "red bag waste" and "sharps" ultimately will be dealt with, and officials are concerned that shipping delays from a federal government shutdown will mean the waste will stay on St. Thomas indefinitely.
DPNR Commissioner Alicia Barnes said "it definitely merits looking into" whether the waste can get past the port on schedule, as U.S. Customs and Border Protection workers who process shipping forms may not be available to do so because of furloughs caused by the federal shutdown.
Since Schneider's vice president of facilities management disclosed that waste was being stored in intemperate conditions during a meeting of the governing board Sept. 25, hospital executives have issued multiple statements downplaying public risk and blaming the problem on temporary "shipping issues," particularly the loss of temporary trailers which, being unrefrigerated, also violated health and safety standards.
According to DPNR officials, the hospital is unable to produce records tracking the volume of waste it is producing and collecting. However, the hospital says that waste coming from some units, including the hemodialysis unit and the Charlotte Kimelman Cancer Center, has escalated to a point where the hospital has breached its storage capacity.
The hospital reported that the hemodialysis unit alone can produce up to 600 red bags per month, according to Leslie Leonard, solid waste program manager at DPNR.
"They couldn't tell us because they are not tracking it the way the permit requires," Leonard said, referring to Schneider's overall volume of medical waste. "They should have a log tracking what they are getting on a daily basis for as frequently as it is coming, but they haven't been doing that."
Leonard said reports of red bags ending up in regular dumpsters on both St. Croix and St. Thomas started filtering into the Environment Protection Division more than one year ago, suggesting that mishandling of medical waste and the concealment of such dangerous practices has been occurring for some time.
Following an unannounced inspection Friday at Schneider hospital, DPNR officials found:
- Approximately 144 boxes of medical waste were piled in stacks three boxes high in the open areas of an outdoor shed and outside the freezer because the freezer was filled to capacity.
- The storage freezer still contained medical waste from before the last shipping container left on Aug. 23, meaning the waste has been backed up for an unspecified amount of time. The permit requires the waste be on-site for no longer than 30 days.
- There were no warning signs on the shed designating it as an "infectious waste storage area."
- The storage freezer is loaded from back to front and is only completely emptied four times a year. The permit requires it be emptied on a monthly basis so that it can be properly disinfected.
According to the notice of non-compliance, the 144 boxes had been accumulating outdoors since the weekend of Sept. 9. In an interview Friday, Director of Engineering Julian Magras told The Daily News that the waste had been outdoors only since Sept. 21.
On Sept. 25, during a meeting of Schneider's governing board, Vice President of Facilities Karen Hodge blamed the overflow of waste on the removal of temporary trailers by a hauler and she cited an Environmental Protection Agency order she said was directed at a hauler - Virgin Islands Regulated Waste Management - to support this explanation.
Hodge later said the EPA order, which both the hauler and the EPA denied ever existed, was an assumption on her part.
Late Tuesday afternoon, Hodge was propping up pallets around the inside of a fenced area where the biohazardous waste had been piled haphazardly in boxes, some of them crumpled and caved in from the weight of their contents, to conceal the number of boxes still left at the open-air site.
On Friday, Schneider's Chief Executive Officer Dr. Bernard Wheatley had promised the outdoor storage area would be free of waste by "Monday, Tuesday at the latest."
After consulting with Wheatley's secretary, a hospital security officer would not grant The Daily News permission to visit administrative offices, and a request for an interview was not granted.
Barnes said that DPNR had not determined that the water, air or ground around the waste had been contaminated, but she also said that scientific testing for microbial agents is not the department's purview. Requiring the hospital to perform such tests also is not part of the corrective action items attached to the non-compliance notice.
The action items do include that the hospital "immediately cease and desist from storing boxes of waste outside of the freezer" and "arrange for the immediate and proper disposal of all hazardous waste in the storage freezer that have been stored for more than 30 days."
According to Marcia Richard O'Neale, general manager of V.I. Regulated Waste Management, one trailer already had been loaded by Tuesday afternoon, and one, which had been damaged in transit, was on its way.
However, according to Leonard, it would take at least four trailers to offload the volume of waste from the freezer alone.
O'Neale declined to say whether the hospital is current in its payments to V.I. Regulated Waste Management.
The most serious violation, according to Simon and Leonard, is the packing and storing of waste outside the freezer and in the heat, where it can "putrefy."
"Freezing will minimize the growth of bacteria," Leonard said.
David Simon, DPNR's director of environmental protection, could not say which diseases were of most concern, but he asserted that the permit conditions are designed to protect workers and the public from disease transmission.
"The Department of Health would be better able to speak to that, but, whatever it is, it would not be good because just the fact that you have any kind of medical waste that may have any kind of infections inside means that could impact others," he said. "It mutating in any form is cause for concern."
- Contact Amanda Norris at 714-9104 or email email@example.com.The term "red bag waste" is used to identify infectious or hazardous waste. According to a fact sheet from the West Virginia Department of Health and Human Services:
- Medical waste can be disposed of by various methods. These methods must meet criteria for their effectiveness at killing germs.
- Medical facilities have policies and procedures in place to ensure that wastes are properly handled, treated and disposed of. As long as these systems are functioning properly, medical waste does not affect the public.
Categories of medical waste:
Sharps: Used hypodermic and IV needles; contaminated Pasteur pipettes, scalpel blades, broken and unbroken glass, blood vials, syringes.
Sharps have to be disposed of in puncture-resistant containers. They do not get disposed of in red bags, but the sharps containers get packed into boxes with red bag waste and should be subject to the same set of safety procedures for red bag waste, including storage and packing in a freezer.
Infectious Waste (red bag waste):
- Cultures and stocks of agents infectious to humans, discarded live and attenuated vaccines, culture dishes and wastes from the production of biologicals.
- Human pathological wastes, including tissues; organs and body parts (except teeth); bodily fluids that are removed during surgeries and autopsies; specimens of bodily fluids and their containers; discarded material associated with bodily fluids other than urine. This category does not include urine or fecal materials, unless they are submitted for diagnosis of infectious diseases.
- Human blood and blood products; discarded blood components; containers with free-flowing blood or blood components; items that were saturated and/or dripping with human blood that are now caked with dried human blood.
- Animal waste, including carcasses; body parts; bodily fluids; blood or bedding originating from animals known to be contaminated with infectious agents. Schneider Regional Medical Center can accept medical waste from doctor's offices and veterinary offices outside of its own facilities.