Nevada OSHA fines Summerlin Hospital in fatal TB outbreak

Summerlin Hospital Medical Center faces almost $40,000 in state fines linked to eight violations that allege it failed to protect employees exposed to a fatal tuberculosis outbreak last year.

The Nevada Occupational Safety and Health Administration fined the hospital a total of $39,600, the agency announced Thursday. OSHA labeled six of the violations as “serious” in the May 2013 outbreak that killed a mother and her twin babies.

Summerlin Hospital disputes the citations and plans to “contest them vigorously,” facility administration said Thursday in a statement.

The hospital has 15 business days to respond to the violations. It can pay the fines or contest the citations. During that time frame the hospital can request a conference for clarification of citations, to present additional evidence related to the violations, to discuss options to correct workplace hazards or to enter into an informal settlement agreement.

The investigation to determine whether OSHA safety and health standards were violated found multiple deficiencies in the hospital’s plan to control tuberculosis exposures.

Nevada OSHA launched the investigation after learning that at least two patients with undiagnosed TB were admitted to Summerlin Hospital and were treated in the Neonatal Intensive Care Unit.

At least 20 hospital employees were exposed to and contracted TB and exhibited either contagious or latent forms of the disease, OSHA said. At least one employee who had direct contact with infected patients wasn’t given an initial TB screening until eight weeks after the exposure, a process that — according to the hospital’s plan — should be done as soon as possible after exposure to infected patients.

At least eight hospital workers who tested positive for TB in the initial screening had to wait seven or more days to have their chest X-rayed to rule out active disease, OSHA said.

The resulting citations ranged from the hospital’s failure to conduct a TB risk assessment, per its own TB exposure control plan, to its failure to initiate airborne precautions for patients who displayed signs of infection.

The OSHA inspection officer found that the most recent TB risk assessments, conducted in January, were based on data from 2012. According to OSHA, plans should be re-evaluated annually to identify and correct problems in infection control.

The officer also found that not only had the hospital’s exposure control plan not been re-evaluated since the outbreak in May, but the plan didn’t include all the significant symptoms that are indicative of a TB diagnosis.

Summerlin Hospital’s “serious” citations, with $6,300 fines, were discounted 10 percent from the maximum penalty of $7,000 because the hospital had a clean inspection history and no violations cited in two previous inspections, which were unrelated to the TB exposure, OSHA said.

A statement from Valley Health System, which runs Summerlin Hospital, said OSHA’s citations were inaccurate. When tuberculosis was diagnosed, the statement said, the hospital began working closely with the Southern Nevada Health District and federal Centers for Disease Control and began testing and notifying potentially exposed employees. It follows “nationally recognized protocols” and has TB practices in place for staff and patients.

The OSHA investigation followed the TB-related deaths of Las Vegas resident Vanessa White, 25, and her premature twins, Emma and Abigail. The mother’ssymptoms were treated at Summerlin Hospital Medical Center, but she wasn’t diagnosed with tuberculosis until after she died at a California medical facility. Lawyers for her husband, Ruben White, said in November they would sue Summerlin Hospital.

Another group of former employees and patients is suing the hospital on claims of tuberculosis exposure. Summerlin Hospital agreed in November to update visitor policies and retrain staff about wearing proper protective gear after a state investigation showed the facility didn’t take basic precautions to prevent the spread of infection.

Contact Kimber Laux at klaux@reviewjournal.com or at 702-383-0391. Find her on Twitter: @lauxkimber.