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Here’s how it happened…
Posted by Raven on November 12th, 2005
Back in June I wrote about an intern at a Boston hospital who worked after a positive TB test…and the implications of that. Today I found an article concluding the hospitals were at fault.
Four Massachusetts hospitals failed to do enough to make sure doctors were free of infectious diseases before allowing them to practice medicine, federal investigators concluded after unraveling the case of a junior physician stricken with tuberculosis.
An investigation by the US Occupational Safety and Health Administration found that Boston Medical Center, the principal assignment of the surgical resident, didn’t follow up after suspicions emerged about her health. And OSHA concluded that three other hospitals where the doctor rotated didn’t have mechanisms for gathering detailed information on the health of trainee doctors before allowing them to begin rotations.
OSHA in August and September issued the hospitals ”letters of significant finding,” which The Boston Globe obtained through the federal Freedom of Information Act. No citations or fines were issued. The federal agency has no guidelines specifically covering tuberculosis in the workplace.
Where it all go wrong?
The doctor began her tour of duty in surgical training at Boston Medical in June 2004, undergoing a requisite medical review. As part of that, she received a skin test for tuberculosis.
The test came back positive, and the physician was ordered to report that July to a Boston Public Health Commission clinic for a follow-up chest X-ray. In the meantime, she began working as a surgical resident.
The physician ”did not show up for the appointment, and the [doctor] was allowed to work without receiving follow-up care,” the OSHA investigation reports.
”Was there a gap in the system?” said Ellen Berlin, spokeswoman for Boston Medical. ”Yes. The institution did not follow up to assure that the treatment was received.”
As part of her training, the doctor, starting in December 2004, rotated through the three other hospitals. The OSHA review found that Brockton and Cape Cod hospitals had expected that surgical residents coming from Boston Medical would have a clean bill of health.
”However, there was no mechanism to ensure that all required testing and treatment had been actually conducted and completed,” OSHA investigators wrote to administrators at Brockton and Cape Cod hospitals.
I bet they all have procedures in place now. I have never worked for a medical facility that didn’t follow up on these things. To think, these are respected medical centers. Sometimes I think these places are too big for everyone’s good.
