medical waste chain of custody

Medical Waste Chain of Custody Protocols

This is the second article in our three-part series on Compliance and Chain of Custody Protocols.


Medical waste chain of custody protocols are a set of procedures and documentation that track the handling, transportation, and disposal of medical waste. The tracking is from the point of generation to its final treatment and disposal. These protocols are essential to ensure the safe and compliant management of waste that often contains hazardous materials, sharps, and infectious substances. Here’s an overview of the key components of chain of custody protocols for medical waste.

Medical Waste Chain of Custody First Step: Generation and Segregation

The chain of custody process begins at the healthcare facility where medical waste is generated. Proper segregation and containerization are critical. Different types of waste such as sharps and infectious materials must be separated and labeled appropriately.

Container Labeling

Each medical waste container should be labeled correctly. This includes the date of generation, type of waste, hazard category (if applicable), and the generator’s name or facility identification. Waste will be correctly handled through its lifecycle if it is properly labeled. (*Note: As seen in the photo above, TriHaz generates and affixes the labels, tracking each container we pick up.) 

Collection and Storage

Medical waste should be collected in secure and leak-proof containers. These should be stored in designated areas within the healthcare facility that are inaccessible to unauthorized personal. The areas should also be protected from environmental elements.


A licensed and authorized medical waste transporter should be used to transport the waste from the healthcare facility to the treatment or disposal facility. During transportation, waste containers should be secured to prevent spills or leaks. Documentation, including a waste manifest, should accompany the waste shipment.

The Waste Manifest and Chain of Custody

The waste manifest* is a crucial component of the medical waste chain of custody. It is a legal document that provides a detailed record of the waste. This includes its origin, destination, type, quantity, and handling instructions. Both the generator and the transporter must sign the manifest. *TriHaz uses electronic manifests as part of our industry gold-standard tracking system.

Receipt at Treatment Facility/Disposal Facility

Upon arrival at the treatment or disposal facility, the waste is inspected. The facility’s personnel acknowledge receipt of the waste on the manifest. Any discrepancies or issues are documented at this point.

Treatment/Disposal Process

The treatment or disposal facility processes the waste according to regulatory requirements. The process varies depending on the type of waste but may include sterilization, incineration, or other appropriate methods. For regulated medical waste, autoclave treatment is used to render the waste harmless before its disposal.

Chain of Custody and the Certificate of Destruction (CoD)

After treatment or disposal, the facility issues a Certificate of Destruction (CoD) to the medical waste generator. This critical part of the chain of custody serves as proof that the waste has been properly handled and disposed of in compliance with regulations.

Record Keeping

Both the medical waste generator and the treatment/disposal facility are responsible for maintaining records related to the chain of custody. This includes the waste manifest, CoDs, and other relevant documentation. These records should be retained for the specified retention period required by regulations.

Regulatory Compliance and Audits

The entire chain of custody process must adhere to federal, state, and local regulations governing medical waste management. Regulatory agencies may conduct inspections and audits to ensure compliance at any point in the process.

Emergency Response

Medical waste chain of custody protocols should include procedures for addressing spills, accidents, or emergencies during transportation or at the treatment facility. This ensures that any incidents are handled safely and according to established protocols.


In summary, an effective chain of custody is essential for the proper management of regulated medical waste. The chain of custody in medical waste management is a comprehensive and documented process that ensures the safe and compliant handling, transportation, and disposal of medical waste. Medical waste chain of custody protocols maintain a secure and transparent record of the waste’s journey to prevent unauthorized access, contamination, or mishandling. They are a crucial component of medical waste management to protect public health, minimize environmental risks, and demonstrate regulatory compliance.

The next article in our series is on RMW treatment facilities and CoDs.

Have questions about your medical waste management process and chain of custody protocols? We can help. Contact us today to learn more.