SPSA contends with mishandled medical waste

Over the past eight months, state and local officials have quietly grappled with a recurring problem: mishandled medical wastes from local hospitals that could put public health and the environment at risk.

The problem got so bad earlier this year that SPSA, the regional waste authority, threatened to stop taking all trash from Sentara Norfolk General Hospital and Sentara Leigh Hospital until they took corrective actions.

While the Southeastern Public Service Authority never fully imposed the trash ban, its leaders say they made an important point - one that, so far, has reduced the number of unpermitted shipments of potentially hazardous wastes to facilities licensed only to handle basic garbage.

"We needed to get everyone to understand how serious this had become," SPSA's executive director, Rowland "Bucky" Taylor, said this week.

However, the incidents have never been disclosed to SPSA's board of directors nor to the public, and state regulators say they will not fine or punish anyone involved.

The Virginian-Pilot found out about the cases after obtaining government records through the Freedom of Information Act.

Hospital officials say they responded by tightening controls around large trash containers, including the installation of video cameras, and by re training employees on proper disposal techniques - regular trash goes in clear bags, medical waste goes in red bags.

"We are glad that the information came to our attention because we want to fix it," said Bill Hoefer, vice president of operations at Norfolk General. "We want to make sure that, moving forward, we do a much, much better job."

Improper handling of medical waste became an explosive political issue in Virginia in the 1990s. The governor at the time, Jim Gilmore, a Republican, once donned rubber gloves and went on TV to illustrate how medical waste was being hidden in trash shipments from New York.

Gilmore tried to impose limits on imported trash, but those efforts were thrown out of court as unconstitutional.

Since the most recent local incidents began in December and continued sporadically into this month, regulators say no workers were injured and no medical wastes were exposed to the public or buried in a landfill, where they could leach into groundwater or contaminate soils.

Instead, officials say, the cases illustrate the difficulty in regulating wastes such as used needles, bloody bandages and body fluids, and how human error can gum up even simple safety procedures.

"Any place you have hospitals, these issues are going to come up," said Bob Kania, divisional manager for Waste Industries, a private company that inadvertently picked up red bags of medical waste from Sentara hospitals and dropped them at SPSA facilities.

Generally, state inspectors say they hear about red bags appearing in solid waste about twice a year.

Between December and May, four local hospitals improperly discarded medical waste bags on 13 occasions, according to records from the Virginia Department of Environmental Quality. Hoefer, of Norfolk General, said another incident happened in July. State officials said they were not aware of it but are now investigating.

In January, SPSA sent its threatening letter to Waste Industries regarding Sentara trash. Still, several more cases ensued. Then, in the spring, the state met with representatives from Sentara and Bon Secours. Regulators also sent warning letters to Norfolk General, Leigh, Sentara Bayside Hospital and Bon Secours DePaul Medical Center.

"We made them address it, and they did," said Milton Johnston, waste program manager at the Department of Environmental Quality 's regional office.

In each case, workers at SPSA's transfer stations had spotted between one and four medical-waste bags amid other refuse from the hospitals. The red bags are supposed to contain only wastes that could carry infectious diseases via blood, tissue or body fluid. Such materials should be bagged separately and handled by a licensed medical waste hauler. In most instances, the wastes are incinerated in Maryland or North Carolina.

As an example, Sentara Leigh produces about 5,000 pounds of regulated medical waste in a week, enough to fill about 500 red bags each week. Norfolk General fills more than 2,300 red bags in a week. By law, SPSA cannot accept any medical waste at its facilities or its landfill. And hospitals cannot release any regulated waste to anyone but a professional contractor. Violations can lead to fines and required fixes.

Sentara officials said they were unable to determine who was responsible for the breaches. Other officials said the problems seemed to be related to newly hired hospital employees unfamiliar with daily disposal protocol.

In response to the incidents, Norfolk General and Leigh limited the number of people with access to their trash bins, improved lighting in the areas and installed surveillance cameras. They also conducted staff meetings and individual trainings to be sure that employees knew proper procedures.

Some hospital officials said the bags in question may not have actually contained medical waste. Nonetheless, workers must treat all red bags as though they do contain medical waste, no matter their contents.

DePaul's vice president of operations, David Setchel, said at least one of red bags that originated at his facility contained items that don't fall under the definition of medical waste, including an empty IV bag with tubing.

"Thankfully, it wasn't something that was dangerous - it certainly could have been," Setchel said. "We believe we've educated and changed our practices so that's not going to happen again."

Amy Jeter, (757) 446-2730, amy.jeter@pilotonline.com

Scott Harper, (757) 446-2340, scott.harper@pilotonline.com