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MrsThur01  
#1 Posted : 08 July 2019 17:26:10(UTC)
Rank: New forum user
MrsThur01

Hi All,

Names changed for obvious reasons but here’s my scenario if you could let me know your thoughts on whether or not this is reportable?

Tom called in sick with a knee infection on Monday 1st July, on his first day sick he reported that the previous Wednesday he had knelt on a drain at work and believes he cut his knee. He noticed the cut in the evening when he was at home and assumed it was a result of kneeling on a drain. He did not report this to his employer. He continued to work on the Wednesday/thu/fri.

Toms wife called on Thursday 4th and reported he had been admitted to hospital with possible sepsis, he was discharged Friday pm and has a sick note for a further 2 weeks, total of 21 days away from work.

Is this reportable as a workplace injury?

The accident was not reported to employer until off sick, no accident book entry, cannot now be proved/disproved to be a workplace accident and the reason for sick time off work (infection) is secondary to the injury itself (cut).

Secondly, if I do report it and it’s not a riddor will they tell me that?

Help?!



hilary  
#2 Posted : 09 July 2019 06:40:25(UTC)
Rank: Super forum user
hilary

I would say that it is reportable.  It did arise at a workplace and in connection with work activities in work time and regardless of whether he reported it or not, this would be seen as a workplace accident which goes over the 7 day reporting rule. 

There's no denying that Tom should probably have looked after it better, nonetheless, I believe it to be reportable.

Natasha.Graham  
#3 Posted : 09 July 2019 07:57:15(UTC)
Rank: Forum user
Natasha.Graham

I too would say it's reportable in this instance.

As you can't conclusively prove it to be a workplace accident I personally would err on the side of caution and treat it as one.  He should have reported it at the time, but this is not a perfect world and some people don't report things that they don't notice straight away.

So I agree with hilary in that it would be reportable.

CptBeaky  
#4 Posted : 09 July 2019 08:12:50(UTC)
Rank: Forum user
CptBeaky

Interesting one. So the IP (Tom) never reported this accident until 5 days after it happened? (reported Monday after injuring himself on previous Wednesday). The IP cannot say for sure that he did injure himself at work. (assumes he did it whilst kneeling on a drain). And he continued to work on this injury for 2 more days. (Thurs and Fri).

I wouldn't blame you if you didn't report it. There is no evidence that he did this at work. There is no evidence it is a work related injury of any sort. Even by the IP own admission he can't be certain that it is work related.

However, only you know if it is reasonably likely that he did hurt himself on the drain. If you think it is reasonable, then it would be reasonable to suggest that you should report it as a +7 day injury.

In either circumstance I would suggest you carry out a full investiigation, including examining the drain in question for sharp areas. I would also review PPE, do they need leg protection?

Finally, you will not be told by RIDDOR if it was not a reportable injury. In fact you will likely get no feedback at all, beyond the confirmation of the report.

A Kurdziel  
#5 Posted : 09 July 2019 08:49:26(UTC)
Rank: Super forum user
A Kurdziel

Why was he kneeling on drain? Was this part of their job or just a hobby they indulge during worktime?

The gap between the possible injury and the actual report is not that unusual. Once I had someone trip and fall on a farm while inspecting the daffodil crop. He returned to work then felt his hip go and went to the doctor who diagnosed a displaced hip which was probably as a result of his fall. That was a week later. He took a month off work which made it a RIDDOR.  Did not get any feedback from the HSE about the report. They have never ever, gotten back to me other than to say we fancy a visit to follow-up a report.

MrsThur01  
#6 Posted : 09 July 2019 10:33:41(UTC)
Rank: New forum user
MrsThur01

Thanks for replying all, Interesting views here...

My thought process really was that I/the IP cannot verify the causal link between him kneeling on the drain and the cut itself, it is entirely possible that he had the cut prior to or after this incident and didnt know. It is simply assumed by the IP this is when it happened. I also cannot verify the causal effect of the secondary infection as being directly related to the cut, the diagnosis can be linked to both cuts, one off severe trauma and repeated softer trauma's such as kneeling for/over long periods of time.

I have completed the investigation as best as possible at this moment in time (the IP is currently off sick) and have ascertained that it could have been possible for him to hurt his knee whilst kneeling, the drain is situated in front of a boiler at a sunken level in the floor and the job he was undertaking was re-lighting of boilers so it is possible he knelt in front of the boiler and caught his knee on the drain. Though uneven floor surfaces are contained within our RA's including those used on this particular job, I feel the control measures could be better and this is an action we will take away to resolve.   

I think the general conscensous is that if i believe it could of happened then I should report as a 7+. 

thanks 2 users thanked MrsThur01 for this useful post.
CptBeaky on 09/07/2019(UTC), Martin Fieldingt on 09/07/2019(UTC)
jmaclaughlin  
#7 Posted : 09 July 2019 11:01:53(UTC)
Rank: Forum user
jmaclaughlin

A cheap and effective control measure could be kneepads/inserts.

David68  
#8 Posted : 09 July 2019 11:19:33(UTC)
Rank: Forum user
David68

I would report this.  Whilst the cause of the injury cannot be proven to have been work related, there is a reasonable suspicion that it did.  I beleive it is better to be safe than sorry and you do not lose anything by reporting.

Hsquared14  
#9 Posted : 09 July 2019 11:52:28(UTC)
Rank: Super forum user
Hsquared14

Whilst I would agree that nothing will be lost by reporting it, I personally don't think it is reportable.  He is off work due to a medical condition arising out of the injury not due to the injury itself.  If you dig through the guidance I am pretty sure that this sort of scenario is covered and medical issues arising out of the injury are not reportable.

thanks 2 users thanked Hsquared14 for this useful post.
watcher on 17/07/2019(UTC), Dazzling Puddock on 18/09/2019(UTC)
chris42  
#10 Posted : 09 July 2019 12:42:38(UTC)
Rank: Super forum user
chris42

Originally Posted by: Hsquared14 Go to Quoted Post

Whilst I would agree that nothing will be lost by reporting it, I personally don't think it is reportable.  He is off work due to a medical condition arising out of the injury not due to the injury itself.  If you dig through the guidance I am pretty sure that this sort of scenario is covered and medical issues arising out of the injury are not reportable.


I thought the same, but could not find anything to support it. I’m sure this issue has been discussed on here in the past. However the HSE’s RIDDOR guidance is pants, their examples are limited and I tried to find something on this on the myth buster section of the HSE site to no avail, But the legislation isn’t the best to start with.

PS. So the work trousers have a corresponding cut ? food for thought.

Chris

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jwk on 09/07/2019(UTC)
alistair  
#11 Posted : 09 July 2019 12:52:05(UTC)
Rank: Forum user
alistair

Call me cynical but this is highly suspicious and I have come across many similar situations.  If not reported at the time or soon afterwards we would investigate but would not record it either on our accident forms or under RIDDOR.  If the emloyee wishes they can write to HR and ask for the details of their letter / email to be held on their personal file.

Good point made about checking the work trousers.

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Evans38004 on 10/07/2019(UTC)
jwk  
#12 Posted : 09 July 2019 14:30:26(UTC)
Rank: Super forum user
jwk

I'm with HSqaured and Chris42 on this one: the time off wasn't due to the injury. Back in the day HSE would have wanted it reporting, but since RIDDOR 2013 they've tightened up a lot on the reporting criteria, and I think a direct causal link between the injury and time off is now what they're after. So no, I wouldn't report it,

John

A Kurdziel  
#13 Posted : 09 July 2019 14:52:35(UTC)
Rank: Super forum user
A Kurdziel

I am not sure why people are calling this a secondary infection. Someone kneels on something and cuts their knee. What they kneel on is by its nature full of microorganisms and after a period of incubation, infection sets in.  There is a clear probably causal link between the cut and the infection.

If you are saying there is not what about the situation where someone pricks themselves with a dirty needle in a hospital lab.  The few days later there is evidence of infection. According to your criteria this would not be reportable as the original injury was only a minor pinprick and the infection was a secondary matter not directly linked to the needle stick.

thanks 6 users thanked A Kurdziel for this useful post.
jwk on 09/07/2019(UTC), Natasha.Graham on 09/07/2019(UTC), nosdohr on 09/07/2019(UTC), CptBeaky on 10/07/2019(UTC), Evans38004 on 10/07/2019(UTC), hilary on 17/07/2019(UTC)
jwk  
#14 Posted : 09 July 2019 15:12:28(UTC)
Rank: Super forum user
jwk

Originally Posted by: A Kurdziel Go to Quoted Post

I am not sure why people are calling this a secondary infection. Someone kneels on something and cuts their knee. What they kneel on is by its nature full of microorganisms and after a period of incubation, infection sets in.  There is a clear probably causal link between the cut and the infection.

If you are saying there is not what about the situation where someone pricks themselves with a dirty needle in a hospital lab.  The few days later there is evidence of infection. According to your criteria this would not be reportable as the original injury was only a minor pinprick and the infection was a secondary matter not directly linked to the needle stick.

Good points well made, I withdraw my previous opinion,

John

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A Kurdziel on 10/07/2019(UTC)
chris42  
#15 Posted : 09 July 2019 15:38:33(UTC)
Rank: Super forum user
chris42

I take your points, but drain covers are not normally known for being sharp and pointy, certainly not to get a very deep cut. So surly if the wound once noticed (no cut in trousers? to make you look) if cleaned and dressed properly either by a first aider or themselves, should not inevitably lead to a stay in hospital with possible sepsis. Therefore, the injury was just a cut, the infection was due to a lack of proper treatment of the wound at some point after. Hence why I considered it secondary.

Does the fact that it is a drain in a boiler room make it any more germ ridden that anywhere else, ie you trip and cut your knee on a public pavement that a dog has recently defecated on for instance.

I do take your point, and I think possible to look at it either way. No cut no infection I can see, but for me a cut knee does not inevitably mean infection, if cleaned and treated. I guess for me it is a separate domino.

Chris

johnc  
#16 Posted : 09 July 2019 17:37:44(UTC)
Rank: Forum user
johnc

Chris, Cleaning by a first aider or even anyone else will not guarantee no infection. I dealt with a case some years ago where a member of staff sustained a scratch type wound on his shin that was cleaned and dressed by a very good nurse in the site medical centre but two days later he was in hospital on a drip because of the infection. The hospital doctor was of the opinion that the bug that caused the infection just happened to be present on the filter plate that caused the scratch and would have entered the broken skin before any cleaning could be carried out. He said such infections showing up some time after the injury occurred was not uncommon and is the problem hospitals have in realising patients may be suffering sepsis for instance.

Edited by user 09 July 2019 17:40:27(UTC)  | Reason: Clarity

thanks 2 users thanked johnc for this useful post.
A Kurdziel on 10/07/2019(UTC), CptBeaky on 10/07/2019(UTC)
RayRapp  
#17 Posted : 10 July 2019 09:01:46(UTC)
Rank: Super forum user
RayRapp

An interesting thread. I am in the minority of not reporting the acccident as a RIDDOR. The causal link between the initial incident and the infection is too tenuous in my opinion. 

thanks 2 users thanked RayRapp for this useful post.
Evans38004 on 10/07/2019(UTC), SJP on 10/07/2019(UTC)
sidestep45  
#18 Posted : 11 July 2019 09:01:06(UTC)
Rank: Forum user
sidestep45

I would say not reportable basing this on the Reporting injuries, diseases and dangerous occurrences in health and social care information note issued by the HSE. In this it does discuss secondary infection noting that " Infections that could have been acquired as easily in the community as in work are not reportable, unless the infection was definitely acquired at work." making that point that the infection that has led to the absence could have infected the cut any time after it was open especialy as it would not appear to have been cleaned.

So the accident event that can be identified is the cut on the drain cover, the post accident infection is not, remembering the the HSE say "There must be an identifiable external event that causes the injury, eg a falling object striking someone. Cumulative exposures to hazards, which eventually cause injury (eg repetitive lifting), are not classed as ‘accidents’ under RIDDOR."

The information note can be found here: http://www.hse.gov.uk/pubns/hsis1.pdf

Hsquared14  
#19 Posted : 11 July 2019 11:45:24(UTC)
Rank: Super forum user
Hsquared14

Originally Posted by: sidestep45 Go to Quoted Post

I would say not reportable basing this on the Reporting injuries, diseases and dangerous occurrences in health and social care information note issued by the HSE. In this it does discuss secondary infection noting that " Infections that could have been acquired as easily in the community as in work are not reportable, unless the infection was definitely acquired at work." making that point that the infection that has led to the absence could have infected the cut any time after it was open especialy as it would not appear to have been cleaned.

So the accident event that can be identified is the cut on the drain cover, the post accident infection is not, remembering the the HSE say "There must be an identifiable external event that causes the injury, eg a falling object striking someone. Cumulative exposures to hazards, which eventually cause injury (eg repetitive lifting), are not classed as ‘accidents’ under RIDDOR."

The information note can be found here: http://www.hse.gov.uk/pubns/hsis1.pdf

Thank you SideStep this is what I wanted to refer to but on the day I did my post I couldn't access the HSE website, our web nanny system was having a hissy fit for some reason!

A Kurdziel  
#20 Posted : 11 July 2019 11:47:36(UTC)
Rank: Super forum user
A Kurdziel

HSE webpages mention exposure to biological agents and it makes it clear that these are reportable if they are work related, with no restriction to lab or health care settings. So this could be a RIDDOR

See http://www.hse.gov.uk/biosafety/about.htm for more details

WatsonD  
#21 Posted : 12 July 2019 11:15:18(UTC)
Rank: Super forum user
WatsonD

Like the torn trousers idea Chris, lets hope he wasn't wearing shorts...

I believe the question here is really: was it a workplace accident? - as this is key to whether it is reportable.

That the infection is a result of the cut is of no doubt. Whether this was an immediate infection or not, is largely irrelevant. It doesn't break the causal chain. It was still a result of the cut.

The accident book wasnt completed at the time, but no reason it could have been completed by a third party on his behalf when he called in sick, so thats not valid proof. But pehaps a red flag thag accident reporting needs improvement

There are no witnesses - doesn't meant it didn't happen. The question I would consider is why would he lie about it being an accident at work?

It could have happened. So why would it be fabricated? Seems like more of a reluctance to have a RIDDOR on the company records

Edited by user 12 July 2019 11:16:12(UTC)  | Reason: Spelling mistake

thanks 2 users thanked WatsonD for this useful post.
A Kurdziel on 12/07/2019(UTC), hilary on 15/07/2019(UTC)
Evans38004  
#22 Posted : 15 July 2019 07:20:17(UTC)
Rank: Forum user
Evans38004

Originally Posted by: WatsonD Go to Quoted Post

There are no witnesses - doesn't meant it didn't happen. The question I would consider is why would he lie about it being an accident at work?


WatsonD

Perhaps the company involved do not pay their employees for absence that is not a work related injury. Perhaps a mate down the pub / on tv advertising reminded him where there is blame - there's a claim

WatsonD  
#23 Posted : 15 July 2019 11:05:24(UTC)
Rank: Super forum user
WatsonD

Originally Posted by: Evans38004 Go to Quoted Post
Originally Posted by: WatsonD Go to Quoted Post

There are no witnesses - doesn't meant it didn't happen. The question I would consider is why would he lie about it being an accident at work?


WatsonD

Perhaps the company involved do not pay their employees for absence that is not a work related injury. Perhaps a mate down the pub / on tv advertising reminded him where there is blame - there's a claim

Exactly.

chris42  
#24 Posted : 16 July 2019 13:12:53(UTC)
Rank: Super forum user
chris42

The point about a needle stick incident, is good and made me think further, but I think that is a different sort of injury. Yes, if you get a needle stick injury, the end if used is likely to be contaminated with something or you are accidentally injected then you could transmit all sorts of things to yourself, I agree. But I consider that a different type of injury to a small everyday cut / wound as you could easily get in the world outside work, as in it. A wound which can be cleaned out and in fact would bleed, the body’s own way of flushing a wound. As noted by others cleaning the wound is not necessarily 100% effective, but can be, as otherwise why bother. A needle stick injury you can’t really do anything, until test and treatment if necessary.

The link A Kurdziel provided as he notes does not exclude such incidents outside of Labs or Health care work, in fact it mentions farmers. They may be working with all sorts of zoonosis type micro biological diseases and medication etc. However, do you really feel that the HSE had an infection to a minor cut, when not deliberately working with microorganisms in mind when they wrote all that guidance? nothing within it indicates so.

As Johnc noted “He said such infections showing up some time after the injury occurred was not uncommon “. So, it is not uncommon and every tiny cut or scratch that happens in the workplace could become infected. It will be just down to luck if it does or does not. So, a small company could have a number of these very minor initial injuries, but end up with a load of RIDDOR reports, which then affect their stats and so potential work. Some of the larger companies when getting pre-qualification info just ask how many, not what. In my current organisation none of our customers are interested in our stats, so makes no difference if I report or not in that way. Again, I would question, are the HSE really interested in knowing about these minor injuries that by pure luck end up becoming worse. This is why I feel there is two stages, a cut and then some luck or not and an infection, it is not a certainty there will be an infection.

Not only that, what happens next if you are one of these unlucky companies, do they end up trying to stop every very minor cut / scratch. That would become impossible, but they would try or at least make the H&S bod try, all with a cry in the background of “too much H&S”.

How may plasters does your company use each month / year (Now what % of those could become RIDDOR). Fine if you are in an office you can work with a dressing that has to be kept clean, but the moment you are in a trade of some sort any restriction of what you can do, because you have to keep your infected dressing clean, means you can no longer do your full range of duties and so becomes reportable.

I consider that when we answer questions on here this view and outlook remains a guide for all those who read in the future. Isn’t it up to us to make a sensible interpretation? Yes, I would report a needle stick injury if there became an issue, because I think the infection is more closely linked to the injury and almost inevitable with a contaminated needle. But a minor everyday cut / scratch, is what it is and should unluckiness strike does not make the initial injury more than it really was. The HSE are not bother about broken fingers, so a minor cut seems a stretch.

Don’t get me wrong, it is an accident and there should be an investigation and perhaps something done to prevent reoccurrence, if people need to kneel on rough surfaces.

So, as a profession giving advice to those in the future, do we really think this should always be reportable, given the arguments for and against?

Chris

RayRapp  
#25 Posted : 16 July 2019 19:41:34(UTC)
Rank: Super forum user
RayRapp

Chris, good points.

It did occur to me that a paper cut could get infected and be responsible for an over 7 day injury. Would I report it as a RIDDOR...nooooooooo! 

I suppose the only way of knowing for sure if the original query is deemed to be a RIDDOR is to ask the HSE.

hilary  
#26 Posted : 17 July 2019 07:39:03(UTC)
Rank: Super forum user
hilary

A lot of infections are caused by micro-organisms that are present on our skin, cellulitis for example is comes from the Staphylococcus and Streptococcus bacteria which can enter a small cut in the skin and can very quickly become sepsis and life threatening.  The same with the dreaded MRSA which is carried on the skin of approximately 2% of the population as standard.   You don't need to get the infection from the drain cover.  Cleaning the wound may have no positive effect whatsoever and because these are micro-organisms, they do not need a large cut to enter the blood stream.

It's very possible this was a very minor cut from a burr on the drain cover and the micro-organisms entered it and caused this infection.  I think I would give him the benefit of the doubt.

stevedm  
#27 Posted : 18 July 2019 07:24:19(UTC)
Rank: Super forum user
stevedm

The fact is that Sepsis is a killer.  It was probably diagnosed by a paramedic or a doctor at A&E and we investigate route cause so that we can adequatly treat...so it is the likely that this is cause of his infection and as it is work related it is RIDDOR.  rather a simplistic approach I know but it hasn't done me any harm so far..

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hilary on 18/07/2019(UTC)
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