Schneider now in full compliance for waste handling


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ST. THOMAS - Schneider Regional Medical Center's handling of medical waste is now in compliance with all government regulations and the hospital's Chief Executive Officer has demoted the vice president of Facilities Management for allowing the problem to escalate.

In September, V.I. Department of Planning and Natural Resources officials conducted an inspection and found a number of violations, prompting the agency to issue a notice of non-compliance.

Chief Executive Officer Bernard Wheatley received the hospital's amended notice of compliance status from the DPNR on Thursday. According to the document, the hospital has taken the necessary corrective actions and is now in compliance with their permit to dispose of medical waste.

At a September board meeting, Vice President of Facilities Management Karen Hodge mentioned that the hospital's medical waste had backed up and was becoming a problem.

Subsequent investigations by The Daily News revealed the scope of the problem - 150 boxes of medical waste sitting in the hot sun on the loading dock - which led to the DPNR inspection and notice of violation.

"The practice of storing packed waste outside freezers has been discontinued," Wheatley told The Daily News last week.

Wheatley said he has taken steps to ensure the mishandling and improper storage of medical waste will no longer be a problem: Buying additional trailers; replacing a condenser for the medical waste storage freezer; and purchasing a refrigerated container for overflow from the freezer.

Wheatley said he also is working on enclosing the loading dock to make an air-conditioned staging area where medical waste is packed into boxes.

On Friday, Wheatley confirmed that Hodge has been demoted to director of facilities and he said her performance will continue to be monitored.

"I will provide the leadership as I have been doing, as this is an area of expertise. However, we have begun an aggressive search," Wheatley said.

Overflow

On Sept. 27, 150 boxes - some of them crumbling and damaged - were stacked haphazardly on a loading dock outside the hospital. The boxes contained red bag waste and sharps.

Red bag waste and sharps are two forms of medical waste that contain contaminated feces, urine, blood and bodily tissues discarded during medical procedures, as well as used needles, gauze, and tubing. The hospital also tracks and collects waste from private doctors offices and clinics on St. Thomas.

Body parts, blood and tissue are kept separately in the freezer of the pathology lab and were not included in the boxes sitting out on the dock, according to Wheatley.

Hazardous waste - waste from chemotherapy and radiation treatments - is regulated by the Nuclear Regulatory Commission and was not included in the medical waste backlog, Wheatley said.

Freezer repair

The DPNR permit mandates that the hospital package, seal and date all boxes of medical waste and have it removed from the property within 30 days. Medical waste must be stored in a freezer prior to shipment and the freezer must be kept at a temperature in the range of 32-40 degrees Fahrenheit.

In addition to the overflowing freezer, a bad condenser meant the freezer temperature hovered at 40 degrees and ankle-deep water from the condenser pooled on the floor of the freezer.

A new condenser has been purchased, which will keep the freezer at 32 degrees, Wheatley said.

All the backed-up waste has been shipped out, and the freezer has been cleaned, he said.

Shipping issues

The hospital contracts V.I. Regulated Waste Management to ship the waste to a facility in Miami, Wheatley said.

The hospital had four shipping containers for the waste, but Wheatley said they often were delayed in returning to the island, causing waste to back up in the freezer and end up sitting on the loading dock.

The hospital has purchased four additional trailers - each one costing about $6,000 - to eliminate the backlog, Wheatley said. The new trailers give the hospital a three- to four-week lead time, in contrast to the seven- to eight-week turnaround the hospital used to have, he said.

Refrigerated container

The freezer, which sits out on the loading dock, can hold 360 boxes.

Wheatley has ordered a refrigerated container that will stay at the dock to be used for overflow, if needed. The container cost about $8,000 and has a capacity of 160 boxes, he said.

Wheatley said he is in the process of obtaining a permit to build a $70,000 concrete slab for the container as well as to enclose the loading dock area.

The hospital also is considering an onsite medical waste treatment facility as a long-term solution to the problem, Wheatley said.

Such an investment would cost about $300,000 to $400,000, but with less shipping to pay for, the investment would cut the facility's medical waste cost in half, according to Wheatley.

Wheatley, who has served as the medical center's CEO since February, said he immediately began to fix the problem as soon as he learned about it.

Could have been avoided

"With forward thinking, we could have avoided this, because it didn't happen overnight," Wheatley said. "It could have been avoided, it should have been avoided and it shouldn't have happened."

He blamed the facilities management department for letting the medical waste pile up.

The cash-strapped hospital has spent - or intends to spend - about $100,000 fixing the medical waste problem.

"When you have a crisis like this that arose, you have to handle it immediately, and it shouldn't happen again," Wheatley said.

- Contact reporter Aldeth Lewin at 714-9111 or email alewin@dailynews.vi.

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