OSHA is the agency that details what all workers in the country must receive. One of those things is appropriate working conditions, equipment, etc. I don't know about their ability to fine employers. Maybe they can. Maybe it has something to do with whatever the particular breach was. I think it's more in the hands of the state whether or not an employer is fined, shut down, etc. Since a hospital is licensed by the state I would think that any fines, inspections, shutting it down, etc. would be done by the state.
OSHA seems to be more about making sure that employers provide information about standards for workers and providing information to workers to notify them of any issues. I'm not sure how far they go in disciplining of an employer, but I think they would research a complaint, and if there is a valid one they then notify the state as to what's done about it.
The hospital is liable for not protecting its workers appropriately concerning Mr. Duncan's care, but they were advised by the CDC, so I'm guessing if the hospital were sued they would point fingers of responsibility to the CDC - which I think is appropriate. Still, whether legally at fault or not they would likely settle any suit for a lot of money to Ms. Pham if she lives or her family if she doesn't (same for the other infected nurse) anyway.
The hospital was in the position of already having Mr. Duncan in their facility. It was the decision of the CDC for him to remain there for care without appropriate protocols, disinfections, infrastructure, training of the staff, etc. nor did they monitor or supervise what was going on. Once the CDC says he's here, take care of him here, you can do it, here's a powerpoint about how, best of luck, see ya, well then, the hospital is stuck. They can't lock the patient in a closet and pretend he's not there or throw him out into the street... they HAVE to care for him as best they can because the CDC made the decision for him to be cared for there. And of course, because they were not prepared for such a patient and never should have had to care for him in the first place, they were stuck with having to do the best they could thanks to the inept CDC.
ANY regular hospital would have made the same mistakes since they are also not prepared nor have the infrastructure, equipment, trained and experienced staff, etc. For all we know, another hospital may have had even more problems. THE mistake was the CDC telling this hospital they would care for the patient and that he would not be transferred to an appropriate facility. This decision by the CDC was willful negligence. They KNOW not all hospitals are capable of caring for a BSL-4 infected patient and that the entire nation has only 4 that can. So, why in the world did the CDC make the lunatic decision for Mr. Duncan to be cared for in a completely inappropriate facility?
Not every hospital is capable of handling every patient. This is common knowledge. Not every hospital has a special burn unit, trauma center, etc. and don't need to. To imagine that every hospital is prepared to handle a BSL-4 infected patient is fucking lunacy. Of COURSE they don't, and don't need to. Patients needing specialized care are flown or otherwise transported to the nearest facility that does have the ability to care for them appropriately. Happens every day all over the country. A BSL-4 infected patient needs to be cared for in one of the four hospitals in the country that are capable of handling their care not only for the sake of the patient but to stop the spread of whatever contagion they have BECAUSE that facility has that high level of capability.
Had the CDC made the obviously appropriate decision for Mr. Duncan to be cared for at one of the four facilities designed for just that two more innocent people would not have become infected nor the possibility of many more of them. And if there ARE many more of them, we may be in trouble... those four hospitals have a total of 19 beds between them.
The single biggest question that requires an answer is WHY did the CDC decide that Mr. Duncan would be cared for in a facility they KNEW was not capable of it, did not provide appropriate protocols nor any training or supervision of the staff nor monitor and supervise his care to make sure that there weren't mistakes occurring that could endanger workers' lives?
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