We had an employee receive a minor skin laceration from metal we process. Wound was treated with first aid by Company. But, since employee did not know when they had received last tetanus shot we sent employee to a local occupational medicine clinic. Clinic gave employee tetanus shot and also a shot of "TORADOL" for pain relief. Employee returned to work.

Does elective treatment of tetanus and "TOTADL" constitute medical treatment requiring this injury be treated as a "recordable OSHA injury"?

This is not what I expected. Check out 1904.7(b)(5). Paragraph (i) specifically rules out treatment which is considered 'first aid'. First aid is defined in paragraph (ii). It specifically includes tetanus shots, see (ii)(B). Check the regulation for yourself. I think the tetanus shot is considered first aid and therefore not recordable. However, if the TOTADL is available only by by presciption or was given at prescription strength, then it is recordable see (ii)(A).

MikeCJ

Thanks for your quick response MikeCJ.

The recommendation of giving a shot to employee of "TORADOL" is more of my concern. We had sent employee to get a current tetanus shot which would have kept incident as first aid only. Then, our medical service company decided to add a shot of TORADOL to help with pain. This "elective" decision now seems to move incident from first aid to medical treatment and recordable.

What type of instructions or interaction do you have with your Company Doctors or medical service providers to get them to help avoid recordable decisions that may be unnecessary?

If it were me, I would be on the phone to the clinic administrator.  I would make sure that they understand the OSHA recording rules, give them a copy and training if necessary.  I would also, if this situation would come up again, make sure when calling the clinic providing authorization, they understand that it is for the tetanus shot only, NO TREATMENT (Call if any another treatment is necessary).  I would also threaten to go to another clinic if something like this would re-occur. (Only if there is another clinic near).  Although it is still recordable, you might tell the clinic that they were not authorized to treat and will not pay for the other shot.  This can be done if whoever called the clinic to authorize the tetanus, also said that is all we want done.  The doctors need to understand that it is not the employee that makes all the decisions.  It really hurts when it is the doctors that mess you up!

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Safety Management '82
Indiana State Univ.

http://youtube.com/watch?v=1HGnDZwnLE0 

DDissafe:

If it were me, I would be on the phone to the clinic administrator.  I would make sure that they understand the OSHA recording rules, give them a copy and training if necessary.  I would also, if this situation would come up again, make sure when calling the clinic providing authorization, they understand that it is for the tetanus shot only, NO TREATMENT (Call if any another treatment is necessary).  I would also threaten to go to another clinic if something like this would re-occur. (Only if there is another clinic near).  Although it is still recordable, you might tell the clinic that they were not authorized to treat and will not pay for the other shot.  This can be done if whoever called the clinic to authorize the tetanus, also said that is all we want done.  The doctors need to understand that it is not the employee that makes all the decisions.  It really hurts when it is the doctors that mess you up!

If it were me, I would prefer a decent recordable rate based on solid numbers than an excellent recordable rate based on flaky numbers. Finding the "right" doctors  that will make the "right" decisions so you can doctor up your recordable rate is short term good, long term very bad. This erodes the integrity of the safety program from within, along with the trust of the employees. Anyone who was concerned with actual safety and not only concerned with impressing the bosses would understand this.

Huda that’s kinda harsh.

 

Torodal is a powerful anti-inflammatory and seems like overkill for a minor skin laceration. It’s likely that the torodal shot was given to ease the tetanus shot which can be very painful for some people.

 

I would be a little upset if an associate needed a prescription painkiller to deal with a shot. I would be more upset if the doctor gave it without the associate specifically requesting it.