Schneider still storing waste outdoors in unsafe conditions, despite looming deadline for final inspection by DPNR
Published: October 14, 2013
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ST. THOMAS - Schneider Hospital continues to pack open boxes of "red bag" waste outside on a loading dock, in violation of its permit to store and generate medical waste, with a deadline of Tuesday looming for a final follow-up inspection tied to a notice of non-compliance issued by the Department of Planning and Natural Resources on Oct. 1.
A follow-up inspection of Schneider Hospital has revealed that DPNR officials cannot be certain that the indoor freezer that, according to the hospital, was filled with boxes since early September dating to an unspecified time has been maintained at the temperature that safety regulations require.
Further, the hospital was similarly cited in 2006, when DPNR inspectors concluded the hospital had possibly failed for seven years to get a medical waste permit and threatened to assess penalties related to the improper and dangerous storage practices, according to DPNR documents.
Following an unannounced inspection of Schneider Hospital on Sept. 27, DPNR noted several permit violations related to the piling of 144 boxes, some of them crumpled and stacked haphazardly three boxes high, on a loading dock at the rear of the hospital. Also, six boxes, which were still being packed, were open on the loading dock.
The dock was unmarked by warning signs, and the area was insecure, with no personnel continuously monitoring it, a section of wire fencing missing and the electronic gate to restrict vehicle traffic to the area not functioning.
At least five 20-foot trailers full of red bag waste have left the hospital since Sept. 27, according to DPNR officials, Virgin Islands Regulated Waste Management - the hospital's medical waste hauler - and hospital documents supplied to DPNR.
Red bag waste and sharps are two forms of medical waste that contain contaminated feces and urine; discarded body tissues and blood; equipment, such as used needles and vials; and lab specimens used in the diagnosis of infectious disease. Safety regulations require red bag waste to be stored not more than 30 days, that it be kept below freezing and in containers impervious to bacteria.
Schneider Hospital has, since a resolution plan created in 2002, when the Environmental Protection Agency ordered the hospital's incinerator closed, collected and stored for transport medical waste from various offices and clinics on St. Thomas in addition to the waste its own units produce.
However, to date hospital staff have no idea how much waste its unit are producing and have only created internal tracking logs in response to its most recent non-compliance order, according to Leslie Leonard, Environmental Program Manager at DPNR.
Hospital officials have admitted that, also since 2002, they have engaged in the dangerous practice of outside storage whenever the volume of waste exceeds storage capacity and shipping containers are not readily available.
From at least 2002 to 2006, they stored medical waste without a permit from DPNR, according to DPNR documents.
Leonard said she went to the hospital Friday and found that, though a sizable portion of waste had been evacuated from the freezer, loose red bags were sitting in inches of liquid that hospital staff told her was "condensate" from an air conditioning unit.
For that reason, Leonard was reluctant to enter the freezer.
"We weren't able to ascertain that," Leonard said of the freezer's temperature. "They assured me it was condensate from the A/C unit, but it wasn't something I was going to go step into. It's up to your ankles, you know, along the heel of your shoe, and it could get into your shoe."
The hospital also has reported having trouble since May with five air-conditioning compressors. Schneider executives have said that contractual issues with a vendor have delayed the replacement of what Sen. Clarence Payne III, chairman of the Senate's Health and Hospitals Committee, has described as "old, ancient" climatic control equipment at the hospital.
Leonard and Payne both said they did not know whether any of the downed compressors would have affected the freezer.
Operation Red Bag
Since the disclosure of the recent medical waste overflow at Schneider Hospital, officials at DPNR and the V.I. Waste Management Authority have initiated enforcement actions and campaigns directed at the producers and collectors of medical waste on St. Thomas and St. Croix, with the Waste Management Authority ticketing two facilities on St. Croix, according to the authority's general counsel, Kelvin Vidale.
Leonard said that reports trickled in last year from Waste Management Authority's enforcement officers of red bags appearing disguised in regular trash bags in dumpsters on St. Thomas and St. Croix.
"People get frustrated, and they throw the red bags in the dumpster, and they don't care because there's no way to track it back to them," Leonard said.
Vidale said a search at Waste Management Authority had not yielded any documentation or evidence of these reports.
"We have a special investigation called Operation Red Bag that we started," Vidale said. "We have been reminding individuals that they have to get the permits for the medical waste generation and storage, but they also have to have proof of their disposal, and they have to have it stored in accordance with the permit conditions."
Schneider's submittal to DPNR includes a letter from Marcia Richard O'Neale, general manager of Virgin Islands Regulated Waste Management, to Karen Hodge, Schneider's vice-president of Facilities Management.
O'Neale states: "Recently on St. Croix, Customs closed the port for two days and inspected all containers. They found a container of illegally packed and placarded medical waste that did not belong to VIRWM."
Schneider's Chief Executive Officer Bernard Wheatley has not complied with a public records request from The Daily News for documents related to the shipping and storage of the waste.
Also, requests for comment on any assessment or mitigation of the public health risk from V.I. Health Commissioner Darice Plaskett have been ignored.
DPNR's Director of Environment Protection, David Simon, said an officer from the Environmental Health Division had contacted them about the situation recently, but so far the Health Department has not offered to conduct tests that would be outside the purview of DPNR, which primarily targets the large-scale physical contamination of ground, air or water.
"Let's be honest. It's kind of awkward contacting the Department of Health about the Department of Health," Simon said.
At a Sept. 25 meeting, Hodge informed the Schneider governing board that the waste was being kept in intemperate conditions. She blamed the situation on the lack of unrefrigerated temporary trailers because of an order from the Environmental Protection Agency directed at the hauler, but that order later was proven not to exist. Hodge also failed to tell the board that the facility was in violation of its DPNR permit.
In its response to DPNR's notice, the hospital supplied a plan of corrective action, which includes purchase orders for four additional 20-foot trailers quoted at a total of $33,600; the construction of an air-conditioned enclosure on the loading dock specifically for the packing of waste boxes quoted at $19,879; and the purchase of a supplemental refrigerated container to hold waste on-site quoted at $10,950.
While dodging further interview and information requests, hospital staff have tightened security and obscured the packing of waste outside by placing pallets along the interior of the fence since the dangerous practice was discovered and publicized.
Wheatley, Hodge and Director of Engineering Julian Magras downplayed any public risk involved in the outdoor storage in an interview immediately after DPNR's unannounced inspection Sept. 27.
They said the waste was "actually safer," as it was being packed outside, because by the time it had reached the loading dock it was being double bagged before being dropped in the lined cardboard boxes.
DPNR officials disagree with these statements now, as they did in August 2006, when the department wrote a notice of non-compliance because of the unpermitted storage of medical waste.
The 2006 notice follows an inspection by Dr. Clanicia Pelle from DPNR and an EPA employee Nov. 4, 2004, during which they found that a refrigerated storage area on a concrete foundation at Schneider was "three-fourths full" and gave Darryl Smalls, then Schneider's Director of Engineering, permit applications to fill out.
"DPNR has reached a conclusion that the respondent's violation of the V.I. Code and of the V.I. Rules and Regulations has unreasonably subjected the public health, welfare, and environment to serious and unreasonable risk," the notice of non-compliance written two years later states.
According to Simon, the two most serious violations of the hospital's current permit with DPNR are that boxes of waste in the freezer dated to before Aug. 23, when the last trailer picked up waste. That means that waste had been stored for more than 30 days, and that boxes were stored outside of a freezer, where, ideally, temperatures below 32 degrees Fahrenheit could control the growth of dangerous microbial agents.
Simon said he was "optimistic, but cautiously so" about the hospital's corrective action plan. It will take long-term monitoring of waste volume and shipments to see whether the hospital's new equipment would circumvent the issues that led to the waste overflow, he said.
The hospital's submittal contains letters from Hodge and O'Neale stating that expediting of the decontamination and reshipment of trailers from Miami had reduced the seven- to eight-week return time to four weeks, but the letters also contain caveats about Customs processing, weather conditions and damage to trailers that could impact the cycle.
With all of the hospital's fleet gone, a two- to three-week lead time on newly purchased trailers and a federal shutdown limiting manpower of agencies such as Customs and the U.S. Transportation Department, it remains to be seen whether the hospital has solved the root causes of the problem or merely rushed to get the waste off-site before its next inspection.
O'Neale said that all the trailers have been turned over the Crowley Shipping Company, but calls to Crowley to verify that they had custody of the containers were not returned. O'Neale also said that Customs and Border Protection had not issued any warnings that the shutdown would create delays at the port.
- Contact Amanda Norris at 714-9104 or email firstname.lastname@example.org.