Nhs Trust Convicted Under Coshh Law Following Patient Fatality

Following a breach of CoSHH Legislation, the Health and Safety Executive (HSE) prosecuted The Royal United Hospital, Bath, NHS Trust

. A fine of 80,000 was implemented after the Trust failed to maintain a hot and cold water system which concluded in the death of a patient from legionnaire's disease.

Legionnaire's disease is a type of pneumonia which has a high morbidity and mortality rate. The bacterium is inhaled via small droplets of water suspended in the air. Certain aquatic conditions increase the risk of the bacterium spreading, in particular where the water is maintained at a temperature high enough to encourage growth. Examples include; domestic hot water systems, air conditioning and respiratory equipment.

Following the death of in-patient Daryl Eyles in 2004, it was found that the Trust had not completed an adequate legionella CoSHH risk assessment and they did not have effective controls in place.

In the case of the Royal United Hospital in Bath, an earlier risk assessment in 2001 had found that water tanks were not sufficiently screened to stop debris falling into them. However, no action was taken to correct this failing. Also, the trust did not have an adequate water temperature system in place and temperature readings from the calorifiers used for heating water, were not recorded.

The risk assessment also failed to highlight that the area of the hospital in which Eyles was treated, was a high risk one. A large number of patients here had compromised immune systems and would have been more vulnerable to the legionnaire's bacterium.

Susan Chivers, who led the HSE's investigation said:

"This prosecution sends a clear message to all NHS Trusts that they need to assess the risks of Legionella bacteria in their water systems and put in place measures which effectively reduce these risks. They particularly need to ensure that their risk assessment takes into account the vulnerability of certain patients, such as those with reduced immunity to infection.

"Keeping the risk assessment up-to-date is vital, so whenever changes to water systems or to the use of Trust buildings are planned, then risk assessments and control measures need to be updated accordingly. Additionally, control measures need to be properly monitored to ensure that they continue to be effective. Protecting the health and safety of patients, visitors and employees in this way is a responsibility Trusts must take seriously - failure to do so may lead to a fatal conclusion."

The Trust was prosecuted under Regulations 6(1) and 7(1) of the Control of Substances Hazardous to Health (CoSHH) Regulations which state that employers must prevent or control the exposure to hazardous substances to their employees and they must not carry out any work which may expose them without an adequate risk assessment. Regulation 3 extends this to non-employees.

by: Dale Allen

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