We’ve all heard the saying, “Out of sight, out of mind.” And let’s face it, no one wants to think about what could happen in a worst-case scenario. However, it’s important to be educated about the inherent risks in handling medical waste. If you know about the risks involved, you can safeguard against them. You can protect your employees and patients, and yourself. Since personal liability comes into play with regulated medical waste, we’re going to look at some worst-case scenarios and tell you what to do in order to make sure they don’t happen to you or your practice.
Scenario #1 – OSHA conducts an audit at your facility and discovers improper record keeping, resulting in penalties.
With all of the state and federal regulations, it can be difficult to navigate your way through the required processes, procedures, and paperwork. However, the consequences for non-compliance can be severe and ignorance is not an acceptable defense. Mishandled paperwork and procedural errors can result in costly fines. For example, a podiatry clinic in Missouri was cited in 2017 for improper handling of medical waste, including failing to review the exposure control plan annually and not updating safety data sheets or having a list of hazardous chemicals used. Those violations, along with others, resulted in proposed penalties totaling $93,074.
If your waste services company is not knowledgeable and reliable, they may not know that you need the proper paperwork to keep in your records. Or, even if they do know that you should document each medical waste disposal transaction, they may not provide either the bill of lading or a copy of the hazardous waste manifest — due to a lack of organization or experience.
What you can do: Educate yourself so that you know exactly what you need for OSHA compliance. Provide routine training (your waste disposal services company should be able to provide training) and hire a trusted company that can partner with you and provide the documentation you need.
Scenario #2 – An employee routinely disposed of trash that he or she did not know was medical waste, in a regular trash can.
Even if you have processes and procedures in place for handling your medical waste, they are only as effective as the employees who execute them. Ignorance is not a defense in this case; it doesn’t matter that the employee unwittingly committed a violation.
RCRA fines for a medical waste violation as simple as improper waste segregation or a single error in labeling can cost over $70,000 a day. In 2016, the Environmental Protection Agency (EPA) raised the maximum civil penalties for certain violations of EPA regulations to discourage noncompliance. Prior to the increase, the maximum penalty for a RCRA violation was $37,500 (per violation, per day). Now, it’s $70,117 per violation, per day.
In 2016, a hospital system serving Western Pennsylvania was assessed a $451,000 fine for disposing untreated medical waste in a landfill. The investigation found no evidence that they were intentionally disposing of medical waste illegally; the problem was attributed to improper employee training.
When you sign the medical waste manifest form, you become accountable for that waste and are certifying that it has been properly classified, packaged, and labeled. Basically, you could be held personally liable for errors and omissions on the manifest or in the shipment, itself. It is more typical for the company you represent to be the subject of any enforcement action (unless there was blatant negligence or a criminal violation); however, there is still personal responsibility and accountability.
What you can do: Make sure your employees are properly trained and display easy-to-read and understand guidelines for them to follow for medical waste disposal. Also, routinely check all of your waste containers (medical waste and regular trash bins) to make sure they are being used properly.
Scenario #3 – You do everything correctly on your end (collect, segregate, prepare, label), but the medical waste services company you hired to transport your waste disposes of it incorrectly.
The Resource Conservation and Recovery Act (RCRA) gives EPA the authority to control hazardous waste from cradle-to-grave — including the generation, transportation, treatment, storage, and disposal of medical waste. As the waste generator, you are legally responsible for the waste your practice generates until it is treated (rendered harmless) and properly disposed. A hospital in New Mexico was fined $21,400 for improperly disposing of infectious waste that was discovered in a landfill.
What you can do: Make sure you hire an experienced, trusted waste services provider. Know exactly where you waste goes when it leaves your facility, tour the plant where your waste provider treats your waste, and make sure you receive a signed certificate of destruction.
Scenario #4 – Your paper medical records are improperly disposed, resulting in a HIPAA violation.
The Health Insurance Portability and Accountability Act (HIPAA) safeguards patient’s medical records and other personal health information. Keeping medical records secure and private is a real challenge for medical practices. Part of compliance is ensuring that any subcontractors meet the HIPAA compliance checklist. A company in Illinois was investigated in 2015 for improperly disposing of paper medical records of a healthcare provider client in a dumpster.
What you can do: Make sure that your HIPAA program is compliant. If possible, hire a waste disposal services company that can also offer secure document destruction.
Scenario #5 – Your waste disposal company makes a procedural mistake that results in a fine.
A hospital group in South Carolina was ordered in 2017 to pay $28,000 to resolve allegations that it unknowingly violated EPA and state regulations regarding storage and identification of hazardous waste. The hospital hired a service provider that improperly labeled many non-hazardous wastes as hazardous. The improper labeling resulted in the hospital, which had been classified as a low producer of hazardous waste, being reclassified as a greater producer. The regulations and reporting requirements for larger generators were not met, so the fines were levied against the hospital. Needless to say, the hospital hired a new waste disposal services company.
What you can do: This example reinforces the need to use an experienced, reliable waste disposal company that is knowledgeable about all state and federal regulations and trained to adhere to them.
Mishandled medical waste can endanger your employees and patients, the community-at-large, and the environment. Diligence on your part in selecting the right partner for your waste disposal needs, maintaining compliance, and in making sure that your staff is properly educated and trained can help ensure that a worst-case scenario never happens. Use the button below to request a free consultation now to learn more about protecting your practice and yourself.