MUSC, medical division fined $120,000 in probe of infectious waste violations

The Medical University of South Carolina and an associated facility have been fined nearly $120,000 for dozens of infectious waste violations, including failing to protect the public from potential exposure to germ-carrying medical garbage, as part of a state probe of Charleston area hospitals.

State enforcement documents released this week show MUSC and Ashley River Tower were not properly securing needles and other infectious waste, and the medical refuse wound up at unapproved disposal sites.

MUSC and Ashley River allowed infectious waste to be shipped to Charleston area landfills without treating the refuse to kill germs, as is required by state law, enforcement records show. Three landfills reported finding infectious waste from MUSC and Ashley River in the fall of 2021, enforcement orders show.

The waste included body tissue from MUSC at one landfill. Bloody tubing and used needles also were found at some of the landfills and waste was discovered spilling onto the ground, enforcement records show.

Both MUSC and Ashley River were each fined $58,000 — two years after regulators cited the medical centers for some of the same violations.

One former DHEC waste regulator said failing to treat infectious waste before sending it to landfills is a serious matter.

“If it is infectious, it needs to be treated to avoid exposing people to whatever contamination or infection there is,’’ said Art Braswell, a landfill consultant and former DHEC solid waste director.

The medical university hospital system, which treats patients from across South Carolina, is one the state’s most prestigious health care systems. The university, founded in 1824, is the oldest medical school in the South, according to its website.

MUSC’s main campus is in downtown Charleston, but the university hospital system has been expanding in recent years into other parts of South Carolina. Ashley River Tower is a Charleston-area digestive health, cancer and heart facility that is part of the MUSC system.

MUSC spokeswoman Heather Woolwine said the medical university system is working to improve its waste disposal practices.

The system has beefed up training, conducted an analysis of what caused the problem and is using daily waste audits in an effort to improve, she said. The university system, which is continuing to meet with DHEC about the issue, also has launched a waste disposal education campaign for employees and holds regular meetings “to reinforce the importance of and steps related to proper waste disposal,’’ she said in an email Wednesday.

Other hospitals cited

Two other health care facilities, Trident Medical Center and the Naval Health Clinic Charleston, also were fined for failing to follow infectious waste rules, according to the Department of Health and Environmental Control. DHEC hit Trident Medical with a $55,300 fine and Naval Health with a $14,400 fine.

In Trident’s case, the violations centered on the discovery of infectious waste at both a landfill and a garbage transfer station, neither of which should have wound up with the material.

An enforcement order indicates that Trident sent infectious trash to a transfer station in North Charleston from October through December 2021. DHEC ordered that Trident remove the waste from the transfer station. Medical waste found at the transfer station included bloody syringes and tubes, as well as a bag of urine, a DHEC enforcement order said.

Trident spokesman Rod Whiting said the medical facility is committed to following the rules and “we quickly took steps to address’’ DHEC’s findings. The company, like MUSC and the naval clinic, paid the fines.

“Our efforts have been centered around colleague training and education,’’ Whiting said in a text message. “We want to make sure we are doing all we can to keep our staff, patients and community safe.’’

Trident Medical is a part of the HCA Heathcare system, a leading national health care business with 182 hospitals.

A spokesman for Naval Health was not available.

Larger issue

The fines, first made public this week in a report to the DHEC board, are the latest developments in investigations of how hospitals are handling and disposing of medical waste.

Earlier this year, the agency smacked three other Charleston area hospitals and one in Conway with more than $143,000 in fines for medical waste violations. Those enforcement actions were made public in May.

With the most recent fines totaling $185,000, DHEC has now levied at least $328,000 in fines against major coastal medical facilities this year for infectious waste violations.

Agency officials say solid waste landfills had expressed concern about the improper disposal of infectious medical trash. These landfills typically take household garbage and are not set up to accept untreated, disease-ridden medical waste.

By law, hospitals, doctor’s offices and other health care facilities are supposed to treat infectious waste to kill germs, before shipping it off to landfills for disposal. Treatment includes incinerating the material, sterilizing the refuse with steam or chemically disinfecting it, according to DHEC.

Infectious waste includes bloody bandages, body parts and fluids, and used needles. Such waste can be dangerous if not properly disposed of because it can carry germs from sick patients.

South Carolina has about 9,000 entities that generate infectious waste and 30 registered transporters of the material. The state has two facilities, including one in West Columbia, that treat medical waste. For hospitals that do not treat their own waste, the treatment facilities will do that for them.

The latest fines for infectious waste violations aren’t the first for MUSC and Ashley River.

In 2020, they were fined $14,800 apiece for some of the same violations cited in the most recent enforcement actions, according to DHEC records.

Those include failing to manage waste to protect the public from exposure and failure to treat infectious waste before disposal, records show. MUSC and Ashley River were each fined after state inspectors noted eight violations for each medical facility.