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Exeter Hospital Tech Had 'Open Lesions'

Cheryl Clark, for HealthLeaders Media, August 10, 2012

The complaint survey was conducted by the New Hampshire Bureau of Licensing and Certification on behalf of the Centers for Medicare & Medicaid Services. John Martin, the state bureau's manager, confirmed via e-mail late Thursday that the technician with weeping skin lesions referred to in the report and Kwiatkowski are the same person.

Asked if open skin lesions might have resulted in patients being infected, rather than an employee's alleged theft of fentanyl in syringes and the infection transmitted when the syringes were reused for patients, Martin replied, "It could have been either. What we were able to verify is that he was seen in the lab with open wounds. We also know that drug diversion was possible given the way they handled meds."

Medicare eligibility threatened
The CMS complaint survey resulted in "condition-level" findings, indicating that if they had not been fixed, the hospital could have become ineligible for federal reimbursement for care provided to Medicare and Medicaid patients. Such violations, however, virtually never reach that point.

The report quotes Centers for Disease Control and Prevention recommendations that "healthcare workers who have exudative lesions or weeping dermatitis should refrain from all direct care and from handling patient care equipment and devices used in performing invasive procedures until the condition resolves..."

According to the complaint survey report, the hospital's policy was to allow an employee with skin diseases, abscesses, infected acne, boils, skin lesions, impetigo, wounds, secretions, draining areas to work "if areas [sic] is adequately covered until healed."

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