Document pnx4jmb01bm6pwazxMO8Jxw

TO: FROM: D. R. MILLER H. WALTEMATE ( LAPORTE J DATE: 5/8/84 LIBERTY MUTUAL MEDICAL VISIT I received the attached comments from Dr. Guyton with regards to Liberty Mutual Medical visit of April 3, 1984. Please advise me plans for handling these recommendations and a time schedule for implementation. the of your In the Liberty Mutual report, they referred to an employee becoming ill due to exposure to EDC. Subsequently, you provided me with additional information on this 1983 case. After reviewing this additional information, it was determined this case meets the BFG criteria for recording as an occupational illness. It meets the classification of C.2.d Poisoning (Systemic Effects of Toxic Material). Please change this case and revise your 1983 OSHA log accordingly. /A H. Waltemate HW/kp 5044q Attachments cc: V. Goode - attach only Guyton letter R. A. Kelley - with attachments t^i g ii i ! innfiyii i Tr Q, nin1i~r - with attachments R. Masternak - witn attachments G. F. Lefebvre - with attachments 4 c) % h> H1 ?i 1 BFG44q05 April 25, 1984 H. W. Waltemate LaPorte Medical Practices The Liberty Mutual nurse's report on medical practices at the LaPorte> Texas plant pointed out some major deviations from good medical practice and from BFG policy. No doubt you have addressed these issues, but I would like to emphasize the need for their correction and to offer any needed reinforcement. Routine pre-employment spine x-rays were dropped long ago, and the issue was specifically addressed again in the Occupational Health Policies Manual section on pre-employment examinations issued last month (4.01-2. 3/84). Chest x-rays are required on some initial examinations and certain occupational examinations only, but not on vinyl chloride periodic examinations (5.02-2 and 1.21-1). A nurse with an expired license can be permitted to do first aid only. Absolutely no injections should be allowed, and I seriously question allowing an unsupervised nurse to give -allergy shots in any BFG facility. No medication, other than perhaps aspirin or Tylenol, should be dispensed and an unsupervised nurse may not dispense prescription drugs at any time without a physician's order. Lf_The plant physician should have written standing orders the facility has a licensed nurse, and all examinations or medical treatment should always be fully recorded., I must say that A. M. Mitchell, R.N. was right on target in her review on these points. Please let me know if we can be of any help. Richard A. Guyton, M.D BFG44906 Z00ZV8SZ