The state Division of Occupational Safety issues 10 violations for unsafe conditions in the workplace after union employees draft a list of 47 complaints.

09:56 AM EST on Tuesday, December 28, 2004

BY EDWARD FITZPATRICK
Journal Staff Writer

PROVIDENCE -- The Rhode Island medical examiner's office has been accused of workplace safety violations and its union employees have filed a grievance, describing conditions there as dangerous and disorganized.

On Nov. 23, the state Division of Occupational Safety cited the medical examiner's office with 10 violations and unsafe conditions.

For example, the office was ordered to use a written respiratory protection program, to use a written exposure control plan for bloodborne pathogens and to use "engineering control measures to prevent atmospheric contamination" in a tissue dumping room.

In response, spokesman Robert J. Marshall Jr. said, "The Department of Health supports a safe and healthy workplace for employees. The department is responding to the inspection report and we have already made progress on many of the items."

The inspection took place after Occupational Safety was alerted by union officials, who also filed a grievance demanding "a safe working environment."

In pursuing the grievance, union officials met with the chief medical examiner and other administrators on Dec. 13, handing them an unsigned 47-item list of employee complaints. The list asserts, in part, that employees lack proper safety equipment and training and that human remains have been improperly stored and identified.

When The Journal inquired about eight of the items on that list, Marshall said, "The Office of the Medical Examiner operates according to the highest level of professional standards and shows the utmost respect for families and the remains of loved ones. These eight items are not credible and [do] not reflect professional knowledge of medico-legal sciences and procedures."

Union spokesman James A. Cenerini said, "We take exception to that characterization. If OSHA [Occupational Safety] found enough evidence to issue a list of violations, then obviously many of the employees' concerns are valid."

The state has been in contract negotiations with the union, Rhode Island Council 94 of the American Federation of State County and Municipal Employees, AFL-CIO. But the safety concerns are "absolutely not" connected to the contract talks, said John J. Tassoni Jr., Council 94 senior business agent. "If you look at the complaints, they have been around awhile and just came to a head," he said.

One item on the list of employee complaints stated that "a full-term baby has been left in a bucket of formaldehyde for three years. The case number is no longer identifiable."

Marshall said the medical examiner's office "deals with the remains of humans from the very young to the very old. Some of these remains involve ongoing/open investigations. All such remains are properly identified, labeled and stored with respect and with routine observance of OME [Office of the Medical Examiner] protocols regarding the retention of evidence until such time as the investigation is closed."

Another item stated that "thousands of pounds of tissue are stored in a room without proper ventilation and proper identification."

Marshall said the medical examiner's office "labels, stores and retains such evidence as is necessary for criminal investigations in accordance with appropriate protocols." He said Occupational Safety inspected storage areas with no violations resulting.

Much of the list focused on workplace safety and sanitation. For example, employees said they lacked proper safety equipment and training to work with formaldehyde, a probable cancer-causing substance. They said masks are not fitted to each employee, and straps are broken so masks have to be tied on.

Marshall said, "Employees handling formaldehyde wear a filter mask and goggles, Tyvex gowns and gloves at all times." After the Occupational Safety inspection, the office is increasing training, and respirators were to be tested last week to ensure they fit employees, he said.

Also, Marshall said, "The atmosphere in the office has been and is being tested and monitored to determine whether additional protection is necessary."

Another item on the employee list stated, "The autopsy table cleaning room does not properly disinfect tables. There is no cleaning agent. It is just hot water. The blood and bodily fluids from the table leak under the door and out onto the floor in the adjacent room."

Marshall said autopsy tables are thoroughly cleaned and disinfected in the examination rooms and merely re-rinsed with water in the "cleaning room." He said, "There was a leak -- water only -- in the area, but it has been repaired and cleaned up."

Some complaints on the list focused on office policies and practices. For example, employees said medical examiner's agents are sometimes asked to perform two autopsies at once, "moving from one table to another, creating a dangerous situation and cross-contamination of materials that can be crucial for trial."

Marshall said that only forensic doctors perform autopsies. "Agents may attend or assist the ME [medical examiner] during an autopsy but most follow appropriate protocols," he said. The medical examiner "only performs one post-mortem at a time. Cross-contamination is not an issue."

Employees also asserted that "procedures change daily on how to handle investigations, autopsies, fielding phone calls and assisting families."

Marshall said staff members have job descriptions that spell out their duties. But, he said, "Cases often require unique handling within general operational guidelines. As a result, there are daily meetings with staff to determine what particular protocols are required for the cases being handled that day."

THE COMPLAINTS first arose on Nov. 2, when a group of medical examiner's employees contacted Diane Rafferty, president of Health Department Local 2870 of Rhode Island Council 94, according to Cenerini, the Council 94 spokesman.

The next day, on Nov. 3, Rafferty filed a one-page "class-action" grievance, asking, "that the state provide a safe working environment in the state medical examiner's workplace."

On Nov. 8, a group of medical examiner's employees met with Council 94 leaders, including Tassoni and interim executive director Dennis Grilli.

Tassoni, who is also a state senator from Smithfield, said the employees raised so many complaints at the meeting that he asked them to send the union a list. He said the 47-item list arrived via e-mail the next day, Nov. 9.

Cenerini said the union wanted a written list so it would be prepared with specific issues during the grievance process.

The e-mail was not signed, and Cenerini said he did not know whether the list was compiled by one employee or a group of workers. He said Council 94 represents three medical examiner's agents, three scene investigators, one senior scene investigator and one senior word processing typist in the medical examiner's office. He said employees did not want to be identified by name.

AT ABOUT the time of the Nov. 8 meeting, Council 94 contacted the Division of Occupational Safety at the state Department of Labor and Training. "We felt the concerns of the workers were substantial enough that we decided to take direct action to protect the health and safety of the workers," Cenerini said.

The Division of Occupational Safety's chief compliance inspector, Scott F. Bateson, interviewed employees and walked through the medical examiner's office at 48 Orms St. And on Nov. 23, Bateson issued a compliance order, citing 10 "alleged violations and unsafe conditions which shall be corrected or eliminated within 30 days."

Bateson said the medical examiner's office could have contested the citations but didn't, so the office was given 30 business days to comply. He said he plans to reinspect the office next month.

"If they don't do anything, we'd issue a 15-day noncompliance order and then you could get into fines," which could run up to $10,000 per violation, Bateson said. But he said he expects the office to try to comply.

Marshall said, "We are continuing to work with employees in the department and with the Department of Labor and Training on these items. We expect full resolution of the items in the report within an appropriate time frame."

AS PART of the grievance process, union officials routinely meet with supervisors to detail complaints and to see whether issues can be resolved, Cenerini said. So on Dec. 13, Council 94's Tassoni and Rafferty met with Laposata, medical examiner administrative officer George F. Ducharme and Health Department human resources officer Edward D'Arezzo.

Tassoni said he handed Laposata and Ducharme copies of the 47-item list and asked them to respond in writing. He said he told the officials, "We have some major concerns down at that department." And, he said, "They acknowledged there were some problems they needed to correct and they wanted to address the concerns."

The union also asked for a departmental hearing, which would mark the next step in the grievance process, Cenerini said.

"The administration has been very receptive to the concerns raised by the employees," Cenerini said. "And we certainly hope they are as attentive to resolving the concerns quickly."

Shortly after the Dec. 13 meeting, supervisors told Rafferty that employees would be fitted for respirators, Cenerini said. "Management has taken some action to remedy some of the issues," he said.

But, Cenerini added, "We are not going to walk away until the employees receive enough protection in the environment they work in." He said, "We are very concerned about the health and safety of our workers, and we are also very concerned with providing strong state service to the public."

Tassoni objected to Marshall's statements questioning the credibility of eight of the complaints. He said the employee complaints are bolstered by the Occupational Safety citations, and he said the medical examiner's office has already acknowledged it has problems.

"Maybe this gentleman doesn't know what's going on," Tassoni said of Marshall. "Why isn't she [Laposata] talking for the department?"

On Thursday, Marshall said he had prepared the department's answers in consultation with Laposata, but he said she was not available for an interview at that time. Yesterday was a holiday for state employees.

Tassoni is a member of the legislature's Joint Committee on Health Care Oversight, which has been grilling the Health Department about nursing home problems. "And now this," Tassoni said. "My first thoughts were the department is in disarray. I think things need to be straightened out. It seems like it's one section of the department after another having a problem over there."

Marshall said, "If you look at the testimony on nursing homes, we don't have staff to carry out the responsibilities we have." He said, "There is a real problem of resources there."

As of yesterday, the union had not received a written response to the 47-item list and no departmental hearing date had been set, according to Tassoni, who said he'll be asking about those matters after the holidays.

"I hope we start to do things better for the employees," Tassoni said. "There are not a lot of people who like to do this job -- to do autopsies on a daily basis. So we have to protect them going forward because this is not a job where you want high turnover."