OSHA maintains a web site on SARS (Severe Acute Respiratory Syndrome) that is updated frequently and provides relevant information for employers and employees. The content includes specific information for healthcare facilities, laboratory workers, and other industries, as well as background details on the infection and employee training information. Visit www.osha.gov/dep/sars/index.html.

On March 19, 2003, the Securities and Exchange Commission (SEC) charged HealthSouth, the nation’s largest provider of outpatient surgery, diagnostic, and rehabilitative healthcare services and formerly a major player in the occupational medicine market, and its Chief Executive Officer and Chairman Richard M. Scrushy with a massive accounting fraud. The SEC suspended trading in HealthSouth stock (only the second time it has taken such an action in the last 25 years).

The following is a snapshot of the fraudulent activities contained in the complaint. The fraud began in 1986 when, at Mr. Scrushy’s instruction, the company began to artificially inflate its earnings to match Wall Street analysts’ expectations and maintain the market price for its stock.

On a quarterly basis, HealthSouth’s senior officers would present Scrushy with an analysis of the company’s actual, but as yet unreported, earnings for the quarter as compared to Wall Street’s expected earnings for the company. If the actual results fell short of expectations, Scrushy would tell HealthSouth’s management to "fix it" by recording false earnings on the company’s accounting records to make up the shortfall.

Between 1999 and the second quarter of 2002, HealthSouth intentionally overstated its earnings by at least $1.4 billion in reports filed with the SEC.

While the scheme was ongoing, HealthSouth’s senior officers and accounting personnel periodically discussed with Scrushy the false financial statements, trying to persuade him to abandon the scheme. Scrushy insisted that the scheme continue because he did not want HealthSouth’s stock price to suffer. Indeed, in the fall of 1997, when HealthSouth’s accounting personnel advised Scrushy to abandon the earnings manipulation scheme, Scrushy refused, stating in substance, "not until I sell my stock."

As reported in the Spring issue of the Tracker, injury rates nationally are falling. However, according to the Workplace Safety Index compiled by Liberty Mutual, from 1998 to 2000 the cost of disabling injuries has risen from 46% to 51%. The top three injuries are overexertion (e.g., excessive lifting), falls at the same level, and bodily reactions (e.g., slipping without falling). Disabling injuries are defined as those with six or more lost days with direct costs that include medical fees and lost wages. Program managers can review their treatment costs and lost time over this same period for these injuries and compare their findings. Read more at www.osha.gov/as/opa/quicktakes/qt04152003.html#cost.

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On April 9, 2003, the U.S. Equal Employment Opportunity Commission (EEOC) announced its largest sexual harassment settlement ever in the state of New York.

In the lawsuit filed under Title VII of the Civil Rights Act of 1964 (EEOC v. Lutheran Medical Center), the EEOC alleged that Dr. Conrado Ponio, employed at Lutheran Medical from 1997 to 2000, fondled and touched the breasts and genitals of at least eight female employees during pre-employment physical exams, asked prying and embarrassing questions, and threatened to deny or delay their employment if they did not cooperate. The EEOC alleged that Lutheran knew or should have known of the sexual harassment and failed to take adequate measures to prevent it.

In 2000, Lutheran Medical Center fired Dr. Ponio.

Separately, in an August 7, 2002 decision, a Hearing Committee for the Board for Professional Medical Conduct sustained charges that while employed at Lutheran Medical Center, Dr. Ponio abused six female patients during the course of pre-employment physical examinations. Dr. Ponio received a penalty of six months actual suspension and 18 months stayed suspension, and five years probation to include a mandatory chaperone.

The New York State Health Department appealed the decision. State Health Commissioner Dr. Antonia C. Novello stated: "I adamantly believe that a physician who commits such acts should never be permitted to practice medicine again in the State of New York. The egregious acts…
represent an unconscionable breach of trust between a doctor and his patients…And I believe that nothing less than a revocation will send the strong message that physician abuse of patients, whether male or female, will not be tolerated in New York State."

In February 2003, Dr. Ponio’s license was revoked.

Lutheran Medical Center, under the direction of Wendy Goldstein, who became president and chief executive two years ago, has instituted numerous changes. They include: training for employees on how to spot and prevent sexual harassment, an anonymous employee hot line, female chaperons in the room during all employment-related exams of women, and instruction that breast and gynecological exams should not be part of a pre-employment screening.

The Drug Testing Advisory Board announced that HHS (Health and Human Services) was withdrawing the proposed specimen validity testing guidelines (SVT). Service providers in the drug and alcohol testing industry felt strongly that employees could fail to meet the SVT standards because of treatment for health-related issues, working conditions, or dietary habits. View DATIA’s letter of concern at www.datia.org/resources/valid_testing.htm.

Ergonomics Guidelines for Nursing Homes issued by OSHA

OSHA Administrator John Henshaw announced the first in a series of industry-specific guidelines for the prevention of musculoskeletal disorders in the workplace. OSHA’s Guidelines for Nursing Homes focuses on practical recommendations for employers. Go to www.osha.gov/ergonomics/guidelines/nursinghome/index.html to download the guidelines in pdf format.

DATIA reported in March 2003 that the Ohio Supreme Court has struck down an employer’s right to deny workers’ compensation coverage to injured employees due to positive drug tests or failure to submit to a drug test at the time of the accident. Visit www.datia.org.

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The initial response from healthcare and emergency workers to the smallpox immunization program has been lackluster. As of April 25th, 285,700 doses of smallpox vaccine have been shipped and only 34,541 have been administered. As a result, Congress and the Bush administration have taken two steps to jumpstart the program. On Wednesday, April 30th, President Bush signed into law a system to compensate people injured by the smallpox vaccine. On May 5th, the Bush administration released $100 million to help the states run their programs.

Congress passed the new compensation law to reassure healthcare workers and emergency responders that the financial impact of adverse effects of the smallpox immunization would be covered by the government. Features of the new law include:

• Families of people killed by the vaccine who die without dependent are entitled to a lump sum payment of $262,100. 
• Estates of those who are killed and have dependents could choose the lump sum payment or up to $50,000 per year to make up for the deceased’s lost wages until the victim’s youngest child reached age 18.
• Those who are totally and permanently disabled would get up to $50,000 per year for lost wages until age 65, with no cap.
• Those who are permanently but not totally disabled, and those with temporary disability, would receive lost wages up to a maximum of $262,100.

On May 5th, Tommy G. Thompson announced that the Department of Health and Human Services would release $100 million to the states to help the states "better prepare our nation for a possible smallpox attack and strengthen the public health infrastructure."

"Because a smallpox attack is possible, we must prepare our public health workers to quickly respond to protect the American public," Secretary Thompson said. "This additional money is part of our overall commitment to our state and local partners to build a stronger public health system to care for Americans in the event of any emergency, including a smallpox attack."

Concern from healthcare and emergency providers results from the fact that as of April 25th there have been 53 adverse effects from the vaccine in 34,541 vaccinations. Please see www.systoc.com/newscomments/news/may2003/050803sp.htm for tables showing state by state vaccine dose shipments and number of persons vaccinated.

Visit www.bt.cdc.gov/agent/smallpox/index.asp for updates on smallpox vaccinations from the CDC.