Minnesota Department of Corrections
Policy: 500.240 Title: Involuntary Blood Draw/Post Exposure
Issue Date: 8/3/10 Blood
Draws
Effective Date: 9/7/10
AUTHORITY: Minn. Stat. §§ 609.117;
241.33;
and 241.34.
PURPOSE: To establish a safe and efficient method
for obtaining a blood sample from an offender who refuses to comply with blood
draws ordered by the courts or after an employee experiences a significant
blood/body fluid exposure.
APPLICABILITY: All facilities.
POLICY: When department staff
sustain a significant exposure to an offender's blood or other
potentially infectious materials and the offender refuses to supply a blood
specimen for testing, the warden/superintendent or designee of the facility may
authorize an involuntary blood draw from an offender once a court order has
been obtained.
The
warden/superintendent or designee may also authorize an involuntary blood draw
from an offender subject to mandatory DNA specimen collection, or if a court
order for an involuntary blood draw has been received and the offender refuses
to supply a blood specimen for testing.
DEFINITIONS:
Blood - human blood, human blood components, and
products made from human blood.
Bloodborne pathogen – pathogenic microorganisms
present in human blood that can cause disease in humans. These pathogens include, but are not limited
to, hepatitis B virus (HBV), hepatitis C virus (HCV), and human
immunodeficiency virus (HIV).
Bloodborne
pathogen tests - Hepatitis B Surface Antigen
Hepatitis C Antibody – If positive get: Hepatitis C RNA by PCR Quantitative
HIV Antibody – If positive get:
Western Blot – If positive get:
HIV Viral Load
If offender record indicates any positive results, contact the
department medical director for specific lab orders.
Other Potentially Infectious Materials (OPIM) -
includes human body fluids--semen, vaginal secretions, cerebrospinal fluid,
synovial fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in
dental procedures, any body fluid visibly contaminated with blood, and all body
fluids in situations where it is difficult or impossible to differentiate
between body fluids.
Significant exposure - defined by Minn. Stat.
§144.761, subd. 7, as
"(1) contact, in a manner supported by contemporary epidemiological
research as a method of HIV or hepatitis B or hepatitis C transmission, of the
broken skin or mucous membrane of [correctional employees] with [an
individual's] blood, amniotic fluid, pericardial fluid, peritoneal fluid,
pleural fluid, synovial fluid, cerebrospinal fluid, semen, vaginal secretions,
or bodily fluids grossly contaminated with blood; (2) a needle stick, scalpel
or instrument wound, or other wound inflicted by an object that is contaminated
with blood, and that is capable of cutting or puncturing the skin of [an
employee]; or (3) an exposure that occurs by any other method of transmission
recognized by contemporary epidemiological standards as a significant
exposure."
PROCEDURES:
A. In the event
of a department staff exposed to offender blood and/or body fluids:
1. When a department employee believes he/she
may have experienced a significant exposure to an offender's blood and/or body
fluids, he/she may request a bloodborne pathogen test
of the offender's blood. Upon review of
the request, the department medical director may authorize the testing.
2. Minn. Stat. §241.331,
subd. 2 requires the
following conditions to be met before the department seeks a court order to
test the offender's blood for bloodborne pathogens:
a) A licensed physician (or independent
practitioner working under physician direction) determines a significant
exposure has occurred.
b) The licensed physician for the affected
department employee needs the offender's bloodborne
pathogens test result to begin, continue, modify, or discontinue treatment of
the employee.
c) The affected department employee
provides a sample of his/her blood for bloodborne
pathogens testing.
3. When
seeking the offender's consent for the bloodborne
pathogens test, a registered nurse will inform the offender that:
a) the test
results are for medical purposes only and may not be used by the department as
evidence against the offender in any criminal or civil proceeding.
b) the test
results will be reported to the requesting department employee’s health care
practitioner by the department medical director without the offender's name or
other uniquely identifying information, and the department employee will be
informed of confidentiality requirements and penalties before the employee's
health care practitioner discloses any test results.
c) the test results cannot be used by
health insurance providers to make a decision regarding providing health
insurance coverage, as per Minn. Stat. §72A.20
subd. 29.
d) the offender
may refuse to provide a blood sample, and the offender's refusal may result in
a request for a court order to require the offender to provide a blood sample.
4. Before disclosing any information about
the offender to the affected department employee, human resources will inform
the affected employee of confidentiality requirements and penalties contained
in Minn. Stat. §241.34
for unauthorized release of offender medical information, and also inform the
employee that per Minn. Stat. §72A.20
subd. 29 the test result cannot be used by health
insurance providers to make a decision regarding health insurance coverage.
5. A
registered nurse must attempt to obtain the offender's consent for bloodborne pathogens testing. If the offender is incapacitated or otherwise
unable to provide consent, department Health Services staff will seek consent
from a representative for the offender.
The department medical director is to be notified of all significant
exposures.
a) Consent is not required if the offender
is incapacitated or otherwise unable to provide consent and the department has
made reasonable efforts to obtain the representative's consent and consent
cannot be obtained within 24 hours of a significant exposure.
b) If testing of available blood occurs
without consent because the offender is unconscious or unable to provide
consent and a representative cannot be located, the department will notify the
offender or representative of the information required in step 3 above,
whenever it is possible to do so.
c) If an offender dies before an
opportunity to consent to bloodborne pathogens
testing, the department may test the offender's blood without consent.
6. If the offender does not consent to
providing a blood sample for testing, the facility litigation coordinator or
designee will notify the department litigation coordinator in Central Office to
file a petition for issuance of a court order requiring the offender to provide
a blood sample for testing.
a) The petition must be filed in the
county district court in which the offender is confined.
b) Department staff will serve the
petition on the offender 3 days before a hearing on the petition.
c) The petition must include one or more
affidavits attesting that:
1) The department has followed the
procedures of Minn.
Stat. §241.33 in an attempt to obtain the offender's bloodborne
pathogen test results;
2) A licensed physician, knowledgeable
about the most current recommendations of the United States Public Health
Service, has determined that the affected employee experienced a significant
exposure;
3) A licensed physician has documented
that the affected employee has provided a blood sample and consented to testing
it for bloodborne pathogens, and that the offender's bloodborne pathogen test results are needed for beginning,
continuing, modifying, or discontinuing medical treatment for the employee.
7. A Health Services nursing staff will
notify the department medical director/designee of the offender blood test
results.
8. The department medical director will
inform the employee’s health care practitioner of the offender blood test
results. The results will not contain the
offender’s name or other uniquely identifying information.
9. The facility Health Services
practitioner will inform the offender of his/her blood test results.
B. Mandatory DNA specimen collection
1. In the event of an offender's refusal
to provide a buccal swab sample required by mandatory
DNA specimen collection, Health Services staff will complete an incident report
and notify the watch commander of the refusal.
2. The watch commander will notify the
warden/superintendent the offender is refusing to comply with the procedure to
supply a buccal swab specimen for testing.
3. The warden/superintendent will consult
with the Assistant Commissioner of Facility Services or designee and determine
whether a blood sample will be drawn from the refusing offender.
4. If the warden/superintendent determines
the blood sample will be drawn, representative security and Health Services
staff will meet with the offender and give a direct order to him/her to submit
to the blood draw.
5. If the offender fails to comply, the
warden/superintendent may issue written authorization to Health Services staff
to complete the involuntary blood draw.
C. Court-ordered involuntary blood draws
1. Once a court order has been obtained
regarding the involuntary blood draw, representative security and Health
Services staff will meet with the offender and give a direct order to submit to
the blood draw.
2. If the offender fails to comply, the
warden/superintendent may issue written authorization to facility staff to
complete the involuntary blood draw.
D. Involuntary blood draw
procedure
1. Security staff will restrain the
offender in the presence of supervisory security staff using the minimal amount
of force necessary to safely complete the blood draw.
2. The offender will be positioned on
his/her back with the blood draw access site fully exposed.
3. The supervisory staff will consult with
the warden/superintendent if the restraint cannot be accomplished in a safe
manner.
4. A qualified heath services staff will
ensure that the offender's blood sample is drawn, processed and forwarded to
the designated laboratory to determine HIV, HBV, and HCV infectivity, or
testing as ordered.
5. The
Health Services staff performing the blood draw will document the procedure in
the medical record.
a) Mandatory DNA testing
Health Services staff will send
test results to the Minnesota Bureau of Criminal Apprehension.
b) Employee exposure testing - if the
offender has given consent for the test, the department medical director will transmit
the test results to the employee’s health care provider to be communicated to
the affected employee without the offender's name or other uniquely identifying
information. Health Services staff will
also enter the test results in the offender's medical record.
c) Other court ordered tests
Health Services staff will
distribute the test results as articulated on the court order.
REVIEW: Annually
REFERENCES: Policy
203.040, "DNA Analysis of Offenders."
Policy 105.113, "Personal Protective Equipment (PPE)."
Policy 301.080, "Use of Force and Restraints."
Policy 301.140, "Incident Command System."
SUPERSESSION: Policy 500.240, "Involuntary Blood
Draw," 10/6/09.
All facility
policies, memos, or other communications whether verbal, written, or
transmitted by electronic means regarding this topic.
ATTACHMENTS: None
/s/
Nanette M. Larson,
Director
Health Services
David R. Crist,
Deputy Commissioner
Facility Services
Chris Bray, Deputy
Commissioner
Community Services