A local dentist in California had a surprise visit by a Cal OSHA inspector on a Friday afternoon. Not knowing the procedures, he refused the inspection. The auditor informed him that these inspections may not be rescheduled and if he insists, he has the right to obtain a warrant, and serve the warrant with the assistance of the Sheriff’s Department. Dr. said still refused.

But soon panic set in and he called his attorney, and in turn he called us because attorneys are not able to do much and this situation. After the doctor agreed to become a client, we called and postponed the inspection until the following Monday and sent a team to his office immediately. Over the weekend we brought his entire office into full compliance, trained his 15+ staff and completed all the paperwork.

Three weeks later we received the notice of citations & penalties totaling $42,000. We were surprised to see that high of an amount after all the work we had done. After reading the citations we found out the doctor had hired a Spanish-speaking janitor who was not there the day we arrived. He had already resigned a week before this inspection. He was a part-time cleaning guy who worked from 6 AM to 8 AM Monday to Friday before patients arrived. We were shocked to hear he was transferring contaminated sharps from smaller sharps containers in each exam room into a large sharps container in the sterilization area. This is illegal because of potential sharps injury. In fact, this janitor had sustained several needlestick incidents during this task.

If this was not enough, he was also removing Mercury/amalgam traps from 7 dental chairs and the vacuum system weekly and instead of disposing of them in the proper hazardous material waste container to be incinerated, he would wash them out in the sink and putting them back. During this illegal activity he was also splashed with bio-hazard material and Mercury to the face and body every time this activity took place.

This employee had already resigned before we were hired by the doctor. So, there was nothing we could have done about it except to try to negotiate the penalties down. At the end, we were able to reduce the penalties from $42,000 to $27,000 and mitigated a potential fraud case that still costs the doctor $25,000 in attorney’s fees (see details in the complete story below).

All in all, the estimated fine totaled over $242,000 if we were not in the picture.

Here’s some important dos and don’ts:

Have sufficient knowledge of these government agencies, their jurisdictions, and the legal process of how they do things. Ignorance is not bliss in this case.
Do not invite any regulatory inspector back to your private office to have a chat when they stop by. Remember, inspection begins as soon as you let them in beyond the patient waiting area.
Train all your staff the same way and thoroughly no matter clinical or administrative, full or part-time, English-speaking, or not, W-2 or 1099.
Offer hepatitis B vaccine to every single employee within the first 10 days of employment.
Do not ever backdate or doctor any documents no matter what. This is a felony offense that is punishable by imprisonment and heavy fines.
Make sure you have implemented all the components of a compliant office in place and that you conduct your own self inspections and annual reviews to stay up to date.
Be vigilant in observing the activities of all employees, so that you can ensure continued safety and compliance in your facility.

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