TranslateInspection Detail
Inspection Information - Office: Ca San Bernardino | ||||
|---|---|---|---|---|
| Nr: 111866034 | Report ID: 0950633 | Open Date: 11/02/1990 | ||
| St Mary Desert Hospital | ||||
| 18300 Hwy 18 Apple Valley, CA 92307 | Union Status: NonUnion | |||
| SIC: 8069/Specialty Hospitals, Except Psychiatric | ||||
| Inspection Type: | Accident | |||
| Scope: | Partial | Advanced Notice: | N | |
| Ownership: | Private | |||
| Safety/Health: | Health | Close Conference: | 03/25/1991 | |
| Emphasis: | L:Carcreg | Close Case: | 11/20/1991 | |
| Related Activity: | Type | ID | Safety | Health |
| Accident | 361055593 | |||
Violation Summary | ||||||
|---|---|---|---|---|---|---|
| Serious | Willful | Repeat | Other | Unclass | Total | |
| Initial Violations | 3 | 3 | 14 | 20 | ||
| Current Violations | 3 | 3 | 14 | 20 | ||
| Initial Penalty | $2,900 | $54,000 | $0 | $1,270 | $0 | $58,170 |
| Current Penalty | $2,900 | $54,000 | $0 | $1,270 | $0 | $58,170 |
| FTA Amount | $0 | $0 | $0 | $0 | $0 | $0 |
| Violation Items | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| # | ID | Type | Standard | Issuance | Abate | Curr$ | Init$ | Fta$ | Contest | LastEvent | |
| 1. | 01001 | Other | 3203 A02 | 03/25/1991 | 03/25/1991 | $0 | $0 | $0 | - | ||
| 2. | 01002 | Other | 5143 A05 | 03/25/1991 | 03/25/1991 | $85 | $85 | $0 | - | ||
| 3. | 01003 | Other | 5194 E01 | 03/25/1991 | 04/24/1991 | $0 | $0 | $0 | - | ||
| 4. | 01004 | Other | 5194 G08 | 03/25/1991 | 04/24/1991 | $0 | $0 | $0 | - | ||
| 5. | 01005 | Other | 5220 L03 A02 | 03/25/1991 | 03/25/1991 | $0 | $0 | $0 | - | ||
| 6. | 01006 | Other | 5220 L03 A03 | 03/25/1991 | 04/18/1991 | $85 | $85 | $0 | - | ||
| 7. | 01007 | Other | 5220 I04 | 03/25/1991 | 03/25/1991 | $0 | $0 | $0 | - | ||
| 8. | 01008 | Other | 5220 I05 A01 | 03/25/1991 | 03/25/1991 | $55 | $55 | $0 | - | ||
| 9. | 01009 | Other | 5220 I05 A02 | 03/25/1991 | 03/25/1991 | $55 | $55 | $0 | - | ||
| 10. | 01010 | Other | 5220 K02A | 03/25/1991 | 03/25/1991 | $0 | $0 | $0 | I - Informal Settlement | ||
| 11. | 01011 | Other | 5220 M02 A | 03/25/1991 | 04/24/1991 | $450 | $450 | $0 | - | ||
| 12. | 01012 | Other | 5220 M02 B | 03/25/1991 | 04/24/1991 | $450 | $450 | $0 | - | ||
| 13. | 01013 | Other | 14301 A | 03/25/1991 | 03/25/1991 | $45 | $45 | $0 | - | ||
| 14. | 01014 | Other | 14301 B | 03/25/1991 | 03/25/1991 | $45 | $45 | $0 | - | ||
| 15. | 02001 | Serious | 5162 A | 03/25/1991 | 03/25/1991 | $450 | $450 | $0 | - | ||
| 16. | 03001 | Serious | 5220 F01 A | 03/25/1991 | 03/25/1991 | $2,000 | $2,000 | $0 | - | ||
| 17. | 04001 | Serious | 5220 F02 B | 03/25/1991 | 03/25/1991 | $450 | $450 | $0 | - | ||
| 18. | 05001 | Willful | 5220 G02 B | 03/25/1991 | 03/25/1991 | $18,000 | $18,000 | $0 | - | ||
| 19. | 06001 | Willful | 5220 G03 | 03/25/1991 | 03/25/1991 | $18,000 | $18,000 | $0 | - | ||
| 20. | 07001 | Willful | 5220 H02 | 03/25/1991 | 03/25/1991 | $18,000 | $18,000 | $0 | - | ||
Accident Investigation Summary | ||||||
| Summary Nr: 170193536 | Event: 06/14/1990 | Five Employees Exposed To Ethylene Oxide | ||||
| At approximately 3:30 p.m. on June 14, 1990, Employees #3 and #4 were operating an Ansco Cryotherm ethylene oxide (EtO) medical instrument sterilizer in the surgical central supply area adjacent to, but separate from, the surgical suites at a full service hospital. Employees #1 through #5 suffered skin and respiratory exposure to ethylene oxide. Employee #2 responded to the audible alarm and donned an unapproved respirator to shut down the system. All of the employees were treated by a physician on site; none were hospitalized. The ethylene oxide sterilizer mechanical room and the mechanical ventilation system did not meet ANSI design and operational standards because of an inefficient and ineffective gas exhaust and extraction system. The inefficacy of the system was compounded by the temporary malfunction of the general HVAC in the surgical suites, which was down for repair, and the lack of a dedicated make-up air ventilation system. By depending on the general HVAC to make up for the poor system in the sterilizer room, an excessive concentration of off-gassed EtO collected and was dispersed into the ambient atmosphere. | ||||||
| Keywords: respiratory, ventilation, ethylene oxide, work rules, inhalation, gas, skin, chemical vapor, overexposure, mech malfunction | ||||||
| Inspection | Degree | Nature | Occupation | |||
|---|---|---|---|---|---|---|
| 1 | 111866034 | Non Hospitalized injury | Poisoning(Systemic) | Health aides, except nursing | ||
| 2 | 111866034 | Non Hospitalized injury | Poisoning(Systemic) | Health aides, except nursing | ||
| 3 | 111866034 | Non Hospitalized injury | Poisoning(Systemic) | Machinery maintenance occupations | ||
| 4 | 111866034 | Non Hospitalized injury | Poisoning(Systemic) | Health aides, except nursing | ||
| 5 | 111866034 | Non Hospitalized injury | Poisoning(Systemic) | Health aides, except nursing | ||