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Researcher Sustains Laceration to Leg and Exposure to a Bloodborne Pathogen

What Happened?

A researcher was harvesting bone marrow from mice that had, five months earlier, received transplants of primary human cells derived from umbilical cord blood. The researcher was seated at the lab bench, wearing a lab coat, during the procedure. After cutting off the femur, they placed the scissors very close to the edge of the bench. The scissors subsequently fell from the bench — possibly dislodged by an inadvertent movement — and penetrated the researcher's leg. A gap in the lab coat had left the pants exposed at the point of impact.

The researcher proceeded to the restroom, removed the affected clothing, expressed the wound to promote bleeding, cleaned the site with an alcohol pad, applied an adhesive bandage, and redressed. They reported the incident to their supervisor, who directed them to the Occupational Health and Safety Facility. The researcher elected to complete their ongoing experiment before seeking medical care and presented to the health facility approximately 2.5 hours after the incident. They also reported the incident to the EH&S hotline the same day.

What Was The Cause?

  • Immediate cause: Scissors placed near the edge of the bench fell onto the researcher's leg and punctured the skin through a gap in the lab coat that had exposed his pants.
  • Underlying causes:
    • Sharps were staged at the edge of the bench rather than in a defined safe location away from the edge.
    • The lab coat, matched to upright work, rode up when the researcher was seated, leaving the lap area unprotected during a procedure performed while sitting.
    • Wound decontamination used an alcohol pad rather than the standard 15-minute soap-and-water wash.
    • The researcher prioritized completing the experiment over immediate medical evaluation, delaying presentation by 2.5 hours.
    • No lab-level mechanism ensured that supervisor-directed OHS presentation actually occurred.
  • Root causes:
    • Sharps-staging gap: The lab's SOPs and training did not define a safe staging location for contaminated sharps between steps, nor prohibit edge-of-bench placement. This is the same underlying failure as the razor-on-benchtop case.
    • PPE-fit gap: The lab's PPE program did not account for seated procedures, in which standard-length coats ride up, leaving the lap exposed. No alternative garments (long coats, lap drapes) or seated-work-specific guidance were available.
    • Post-exposure response gap: The lab's training on first aid and post-exposure protocol was either absent, incomplete, or insufficiently emphatic about (a) the 15-minute soap-and-water wash standard, (b) the inappropriateness of alcohol/antiseptics in puncture wounds, and (c) the time-criticality of OHS evaluation. The lab also lacked a procedural norm to ensure that supervisor-directed OHS presentation actually occurred.
       

How Can Incidents Like This Be Prevented?

  • Provide a dedicated sharps staging tray or stand at the dissection bench station, a weighted, flat-bottomed tray (e.g., stainless-steel instrument tray) positioned away from the edge, where scissors, scalpels, and forceps rest between steps.
  • Provide lap-protection drapes (disposable or reusable puncture-resistant drapes) for use during seated procedures with sharps, placed across the lap to close the gap left by a seated lab coat - a known issue for seated positions.
  • Place a dedicated biohazard sharps container within arm's reach of every dissection station, so contaminated sharps can be disposed of immediately rather than staged on the bench for later cleanup.
  • Post a first-aid quick-reference card at every workstation covering BBP exposure response — 15-minute soap-and-water wash, no alcohol/antiseptics in wounds, immediate OHS presentation.
  • Develop or revise a sharps-staging SOP covering all procedures in the lab:
    • Every contaminated sharp has a defined resting location between steps,i.e., tray, stand, or magnetic strip, never loose on the bench.
    • Sharps are never placed within a defined distance (e.g., 10 cm) of a bench edge.
    • Disposal container location and disposal step are specified and within reach.
  • Revise BBP post-exposure training to emphasize:
    • The 15-minute soap-and-water wash standard for percutaneous exposures (Alcohol pads or antiseptics are not substitutes, as they damage tissue and do not reach the pathogen inoculated deep into tissue).
    • The time-criticality of OHS presentation; HIV PEP is most effective within 1–2 hours; HBV PEP should begin within 24 hours. Delays in presentation materially reduce the effectiveness of the intervention.
    • That ongoing experiments are never a justification for delaying post-exposure evaluation.
  • Establish a "stop work and escort" norm for BBP exposures. When a supervisor directs an injured person to OHS, the supervisor (or a designated lab member) escorts them, or at a minimum, confirms presentation within a defined timeframe. The decision is not left to the injured person at a moment when they are distracted by ongoing work.
  • Institute a stop-work authority and expectation for the injured person — any suspected BBP exposure triggers immediate stop-work on the current experiment. Samples can be refrigerated, frozen, or discarded; they are replaceable, BUT the exposure window is not.
  • Include seated-procedure PPE in onboarding training, specifically, the failure mode of standard lab coats riding up when seated, and the available remedies.

Resources

 

QUICK ACTION TIPS 

Exposure control plan:

  1. Wash the wound immediately for at least 15 min under running water and clean it thoroughly with soap; for injuries to the leg, bring a step stool to reach the faucet.
  2. For splashes to the eyes, nose, or mouth, rinse for at least 15 min at the eyewash station.
  3. Obtain medical care within 2 hours of exposure.
  4. Review HBV vaccination.
  5. Report the incident to your supervisor and safety office.