How difficult is it to get the regulated medical waste (RMW) into a red bag, then to the licensed waste hauler, and disposed of according to state law? Apparently it isn’t as easy as you would think.
My Google search for regulated medical waste routinely digs up incidents where healthcare facilities appear to violate RMW laws. Though vastly different in circumstances, here are two examples that generated a dumpster full of problems.
A dentist, Thomas W. McFarland Jr., of Wynnewood, PA, was indicted for unlawful discharge of a pollutant and unlawful disposal of regulated medical waste, reports The Philadelphia Inquirer, November 19. McFarland, who practices in Pennsylvania but owns a beach house in Township, NJ, allegedly took small motor boat to the Townsend Inlet and dumped syringes, swabs, and capsules of used filling material. (Didn’t Tony Soprano try this “disposal” method with the rat Sal Bonpensiero?)
A day later, debris washed onto the Avalon shores. If convicted, he could face 10 years in prison and up to $125,000 in fines.
A clinic in Livonia, MI, received months of bad press when antiabortion activists accused it of violating state RMW laws. Michigan Department of Environmental Quality officials confirmed that the Women’s Advisory Center was in violation of the Michigan Medical Waste Regulatory Act, according to the June 27 report from the Detroit Free Press. The center, which performs abortions, and its waste disposal practices were under scrutiny by the Citizens for a Pro-Life Society. A complaint by the group that the clinic’s trash contained fetal remains and patient records lead to a three-month investigation. Michigan officials found no evidence of fetal remains or patient records in the clinic’s regular trash, but other problems cropped up, such as violations for comingling medical and regular waste, not labeling medical waste containers, not having a medical waste management plan, and failing to register as a medical waste-producing facility. The clinic was not fined because it was a first offense.
Admittedly the former example appears to be a deliberate act, indeed a felony, that no workplace procedures could have forestalled, but the latter could have been prevented by better monitoring of RMW procedures. In fact, the New Jersey State Assembly has already passed a bill that would suspend the license of health professionals who illegally dump waste.
By knowing your state’s RMW laws, you can not only avoid investigations and violations, but save money by making sure nonregulated waste doesn’t get mixed into the more expensive RMW stream, according to What You Need to Know about Hazardous Waste in Healthcare Clinics, an HCPro special report available for download from the Tools page . At 25-50 cents per pound for RMW compared to 4 cents for regular trash, waste segregation is an economic factor as well as a safety and regulatory concern.
RWM laws vary from state to state not only by definition but also for generating, handling, storing and transporting, so check with your waste hauling contractors, who should be available to advise you. Also, the Practice Greenhealth RMW page  is a good resource for state definitions and regulations. Also, check out the “What a Waste”  post for situations specific to laboratories and a list of regulatory links.
To assess your facility’s compliance with RMW laws, download the Regulated Medical Waste Disposal Checklist from the Tools page . This checklist appeared in the August issue of Medical Environment Update .
Do waste matters plague your practice, or have you latched onto good solutions or alternative technologies? Let us know in the comment section below.