Medical License and the Importance of Infection Control

A recent decision from the New Jersey Appellate Division serves as reminder of the importance of maintaining effective infection control measures in a provider’s office or face the harsh consequences of the licensing board.

The Appellate Division affirmed a determination by the Board of Medical Examiners (BME) to revoke doctor’s license for failure to implement and maintain proper infection control procedures, improper handling of medications, and inadequately supervising staff. Such practices, the BME found and the Court later affirmed, posed actual harm to patients. Basing its conclusion on epidemiological investigations and rejecting all evidence presented by the doctor, the BME determined that the doctor’s practice was the source of a Hepatitis B outbreak that eleven patients contracted.

The situation was made worse for the doctor by “repeated health and safety violations” cited by OSHA investigators that dated back to 2002. Investigators also found that the office lacked standards regarding antiseptic use and that staff was not trained on the use of personal protective equipment.

Not only did the Appellate Division affirm the doctor’s license revocation but the Court also affirmed the obligation imposed on the doctor to pay the State’s fees and costs in investigating and litigating the matter–fees that amounted to nearly $400,000.

The case presents important lessons for doctors and dentists. Not only is it important to be up-to-date with infection control procedures for the providers but also for the staff. One of the issues uncovered by the investigators in the case was that the staff “often failed to change their gloves after performing invasive procedures. [Staff] would then touch surfaces, syringes and other materials, thereby potentially contaminating handled items, while shifting between sterile and non-sterile procedures.” The doctor argued that he was unaware of such breaches in infection control protocols but the Court agreed with the BME which found that “as the sole doctor in the office, [he] ultimately bore responsibility for the condition of his practice, the behavior of his staff, and knowledge of any breaches.”

Another issue in the case was the doctor’s failure to have a a written infection control manual or proper infection control policies and procedures. While the investigators found that staff had received some training it did little to mitigate the doctor’s predicament.

The BME, the Court noted, based its decision on among other reasons, that the doctor “was repeatedly grossly negligent by failing to correct infection control concerns or implement policies aimed at protecting his staff and patients… .” The BME’s decision, the Court found, was not so disproportionate to the offense as to shock one’s sense of fairness, and as such, the Court would not “substitute [its] judgment for that of the Board.”

If you have questions regarding OSHA, BME rules or have other questions concerning healthcare regulations, please contact our office.