Union claims GPO swayed needle choice

SEIU files complaint against Yale-New Haven

A union complaint against Yale-New Haven (CT) Hospital alleges the hospital switched from a retractable needle to a safety device with a gliding cover because of a restrictive purchasing contract and without employee input.

The hospital has denied the allegation, asserting that employee input was solicited and the switch occurred because of supply problems. The U.S. Occupational Safety and Health Administration (OSHA) is investigating.

The complaint once again raises the issue of group purchasing organizations (GPO) and contracts that provide significant financial disincentives for buying products from outside vendors.

The Service Employees International Union (SEIU) in Washington, DC, recently launched a web site (www.gpowatch.com) to track information about GPO contract issues.

In 2002, The New York Times ran a series of articles on GPO financial dealings and anticompetitive activities. The Senate Judiciary Antitrust Subcommittee held hearings, as did the Federal Trade Commission and Department of Justice. Some changes occurred in GPO contracts since that time.

"My understanding is that most group purchasing organizations have made accommodations for individual facilities purchasing off-contract if the device they want to use is deemed more appropriate or preferable," says Jane Perry, MA, director of communications for the International Healthcare Worker Safety Center at the University of Virginia in Charlottesville.

The union became involved in the Yale case when workers said that they hadn’t had a say in the switch from the Vanish Point retractable device to the Becton Dickinson Safety Glide.

"When we analyzed the exposure control plan that Yale had, what we were struck by was that the hospital had made the switch without consulting workers," says Nicholas Rudikoff, senior field researcher at SEIU.

"That led us to believe that they acted more out of concern with their relationship with Novation [GPO] and less out of concern for their workers. We think workers should be consulted about needle purchases," he notes.

In fact, the bloodborne pathogen standard requires the input of frontline health care workers, and that formed the basis for an OSHA complaint.

In its complaint, the union also asserted:

  • The hospital failed to document the solicitation of employees in the exposure-control plan.
  • Employees were stuck due to recapping, improper needle disposal, and overfilled sharps containers.
  • "Some needles that are in use at [the hospital] do not have safety features that effectively reduce the risk of an exposure incident," the complaint said.

In fact, the hospital’s purchasing officers had tried to find a stable supply of the retractable syringes and had even looked into contracting directly with the manufacturer, but they were unable to obtain a commitment for the quantity the hospital would need, says Mark Russi, MD, MPH, director of occupational health. The hospital conducted a pilot test of the Safety Glide with general medicine wards, respiratory therapy, and adult and pediatric primary care, he says.

"We have an active process that involves input from employees. I think it’s been a very successful process," Russi adds. Needlesticks have actually declined since the switch; the hospital will continue to evaluate available safety devices, he says.

"We have taken this issue [of sharps safety] very seriously for a long time," Russi explains. "We’re continuing to identify new products on the market."