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Workplace violence citation against health facility stands

Stressed nurse

An administrative law judge of the Occupational Safety and Health Review Commission has affirmed a general duty clause citation against a health care facility for exposing its employees to workplace violence, as well as a $12,471 penalty.

The U.S. Occupational Safety and Health Administration cited Brooke Glen Behavioral Hospital’s facility in Fort Washington, Pennsylvania, for exposing its employees to the workplace violence hazard in the form of patient aggression, according to review commission documents in Secretary of Labor v. BHC Northwest Psychiatric Hospital LLC, doing business as Brooke Glen Behavioral Hospital.

BGH employs about 200 employees at its 146-bed inpatient psychiatric hospital in Fort Washington, with eight separate units that can accommodate a range of patient impairments such as depression and schizophrenia, according to review commission documents.

On July 11, 2016, OSHA received an anonymous complaint alleging workplace violence incidents at the facility were increasing, partially because of understaffing. OSHA opened an investigation, with its compliance safety and health officer visiting the site four different times and eventually concluding there were at least 51 workplace violence incidents involving patients and staff in one year. This included 17 incidents of employees being punched, kicked or slapped; 16 incidents of bites or scratches; four incidents of employees being hit with an object; four incidents of spitting, hair-pulling, or grabbing; and 10 other physical injuries, including impacts to backs, hands and knees.

OSHA issued a general duty clause citation, and BGH conceded that its employees were exposed to the hazard of workplace violence and that both it and the industry recognized the hazard of patient-to-staff aggression — meeting the first two required elements to prove a general duty clause violation. However, the final two elements were in dispute: that the hazard was likely to cause death or serious physical harm; and that there was a feasible means of abatement that the health care provider could have implemented to materially reduce the hazard of workplace violence. The judge found that both of these elements existed in affirming the citation.

“Every non-management employee who testified described receiving workplace injuries from patient attacks,” the judge noted. “In 2016, there were fifty-one employee injuries from patient on staff violence at BGH.

“In short, the working conditions at BGH presented a serious risk of workplace violence and the staff was at risk of experiencing assaults with the potential for severe injuries,” the law judge continued. “Injuries to employees constitute at least prima facie evidence that the hazard was likely to cause death or serious injury. BGH offers no rebuttal to the Secretary’s position that the general duty clause covers head injuries and those serious enough to necessitate trips to the hospital. The Secretary established the presence of a hazard which BGH and its industry recognized, and this hazard is likely to cause death or serious physical harm.”

Both sides offered expert testimony on the sufficiency of BGH’s abatement efforts. But the judge found that the Secretary of Labor’s expert “credibly and directly addressed the sufficiency of BGH’s abatement methods and the feasibility of additional abatement measures” and was largely unrebutted either by fact witnesses or the facility’s expert witness in determining that BGH failed to adequately abate the hazard and that there were feasible methods of abatement BGH could adopt to materially reduce the hazard.

The law judge’s decision became a final order of the review commission on Friday.

The company and the attorneys could not be immediately reached for comment.

A bill aimed at reducing workplace violence incidents against health care and social service employees has been introduced in the U.S. House of Representatives, with a hearing on the bill scheduled for next week.


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