Pennsylvania Department of Agriculture. The BANANA SPLIT. Rapid Response Team

Transcription

1 Pennsylvania Department of Agriculture The BANANA SPLIT Pennsylvania Department of Agriculture Rapid Response Team 1

2 Pennsylvania Department of Agriculture PDA - Rapid Response Team: Rocco DiPietro, CSP Senior Professional Cocciardi and Associates, Inc. RRT Project Manager x104 rdipietro@cocciardi.com 2

3 RRT Activations Banana Incident Incident: Banana Incident August 2017 Areas Affected: Montgomery/Philadelphia County Lives Affected: 1 Disciplines Involved: Montgomery County Health Dept. PA Department of Health Hospital & State Laboratories Law Enforcement (LPD and FBI) Description of the Event: After the discovery of what appeared to be blood inside of a banana, the patient reported to a local ED. A doctor conducted preliminary (non-exclusionary) testing & determined the sample be sent to a laboratory to detect blood. As the sample was examined/tested, the store was contacted & segregated the product. A law enforcement investigation was initiated. Testing was ultimately negative for blood. Lessons Learned: Activation vs. Mobilization Standardization of laboratory capabilities and protocols 3

4 Pennsylvania Department of Agriculture RRT PARTNERS.. LHDs Local Health Departments 4

5 Activation. Activation Process Objective Driven and Flexible The PDA core team meets (virtually, faceto-face, or by conference call) Decides response actions - notifying and/or deploying the RRT.. Activation Partial Mobilization Mobilization Lab interaction? Epi involvement? National significance? Additional notifications? Resolution/ Debriefing AAR/IP 5

6 PDA RRT Multi-Agency Preparation for Non- Routine Outbreaks and Incidents Activation Process Objective Driven and Flexible Prepare to successfully escalate response levels by identifying: Nationally Coordinated Incident (Level 1) Plans, procedures, checklists Triggers Organizational structure Roles, responsibilities, authorities Roster of staff who will fill leadership / ICS positions State/Federal Coordinated Incident (Level 2) State Coordinated Incident (Level 3) Expanded Event (Level 4) Local Event 6

7 Pennsylvania Department of Agriculture CDC - Foodborne Outbreak Online Database (FOOD Tool) 487 Single State Outbreaks 7

8 Pennsylvania Department of Agriculture CDC - Foodborne Outbreak Online Database (FOOD Tool) 105 MultiState Outbreaks 8

9 Pennsylvania Department of Agriculture CDC - Foodborne Outbreak Online Database (FOOD Tool) 592 Total Outbreaks 9

10 The Incident.. The Banana Split Incident General information regarding this incident: On August 2, 2017 the Pennsylvania Department of Health forwarded a message to the Pennsylvania Department of Agriculture which conveyed a physician in Montgomery County reported that after a patient consultation, the physician in the Holy Redeamer Hospital/E.R. believes someone is injecting blood into bananas based on an examination and testing of the substance found in a banana brought in by the patient. This prompted the initiation of a comprehensive investigation of the source at a Giant supermarket. 10

11 The Incident.. The Banana Split Incident General information regarding this incident: August 3, 2017 a report from PADOH to PDA reveals that an ED Physician reported a patient brought a banana into the ER with what appears to be blood inside it. Subsequent s identify that his is in Montgomery County, PA which has a Local (County) Health Department and will lead the investigation along with local Police. The PDA alerted the PDA-RRT to an activation and partial mobilization for the investigation to assist Montgomery County LHD. Activation/Partial Activation is to alert and notify all/specific agencies associated with the RRT to a situation and a possible need for resources they have responsibility for. Mobilization is the act of assembling/deploying those resources for active involvement in an emergency that are needed to support the requirements of a specific emergency No other reports of similar circumstance have been acknowledged as of this time. 11

12 The Incident.. The Banana Split Incident General information regarding this incident: Local Health led investigation Local Law Enforcement Involved State Food Safety Assisted FDA DO Assists Food Safety Lab Confirms Fungi v Blood Investigation Wrap up AAR/IP Conference Call/ Report 12

13 The Incident Strengths.. The Banana Split Incident Use of Available Personnel Resources: Due to the RRT activities in the last few years a major shift in collaborative efforts and information sharing on investigations, which included state agencies and local health departments/local police, was identified. Involvement of Internal/External Agencies: Through the use of RRT references, the Pennsylvania Department of Health (PA DOH) and Pennsylvania Department of Agriculture worked cohesively to assist the Montgomery County Health Department in options to a successful conclusion including laboratory services. The utilization of academia (PSU) and PI Seed Lab for ID purposes. Communications and Notifications: The RRT was able to notify and mobilize in a timely fashion to assist the Montgomery County Health Department in options to a successful conclusion including laboratory services. Stakeholders recognized the importance of data sharing in order to quickly and effectively prevent escalating of a public health threat. 13

14 The Banana Split Incident The Incident Areas for Improvement.. Throughout the incident, several opportunities for improvement in the RRT ability to respond to the incident were identified. The primary areas for improvement, including recommendations, are as follows: Planning: A number of planning issues arose to be modified in future planning adaptations, including an explanation of the differences between Activation and Mobilization of the assets necessary to respond to these type incidents. Local Health Departments: Further Local Health Department and local Police services involvement in emergency planning. Communications: Need for more exhaustive and improved communications before and during incidents. GIS: Continue to develop GIS capabilities within the department. 14

15 The Banana Split Incident The Incident Areas for Improvement.. Additional areas for improvement, including recommendations, are as follows: Bringing the incident to a close. Industry may be hesitate to share information Economic impact Political implications Information sharing between agencies which have restrictive levels and are sometimes difficult to over-come Confusion on establishing and using ICS particularly with industry and locals. 15

16 Activations. Lessons Learned. Challenges: According to the US Bureau of Justice Statistics' 2008 Census of State and Local Law Enforcement Agencies, Pennsylvania had 1,117 law enforcement agencies employing 27,413 sworn police officers. According to the Pennsylvania State Police, 1,287 of the 2,561 municipalities in Pennsylvania have no local police force. (4358 troopers ) 130 Plus Local Departments of Health (LHDs) conducting food inspections 16

17 MERCER LAWRENCE BEAVER ERIE WASHINGTON GREENE CRAWFORD BUTLER ALLEGHENY VENANGO FAYETTE CLARION ARMSTRONG WARREN FOREST WESTMORELAND JEFFERSON INDIANA SOMERSET CAMBRIA MCKEAN ELK CLEARFIELD BEDFORD BLAIR CAMERON POTTER HUNTINGDON FULTON CENTRE CLINTON MIFFLIN FRANKLIN JUNIATA TIOGA PERRY CUMBERLAND ADAMS LYCOMING UNION SNYDER DAUPHIN MON- TOUR NORTH- AMPTON NORTH- UMBERLAND YORK BRADFORD SULLIVAN COLUMBIA LEBANON SCHUYLKILL LANCASTER WYOMING LUZERNE SUSQUEHANNA BERKS CARBON LEHIGH CHESTER WAYNE MONROE Joint RRT Boundaries Investigation- Activation FSLS Regions LACKA- WANNA MONTGOMERY PIKE BUCKS DELAWARE PHILADELPHIA PA LHDs.. Working with our partners at the Local Health Departments 151 jurisdictions Counties cities Initial contact Pennsylvania Retail Food Inspection Jurisdictions Routine inspectioninvestigation PDA ICS Established Food Safety & Lab Services Regions 4S N 5 PDA-RRT 6W Process 6E Chart 7 2 Clinical Illness(s) Intentional tampering Severe weather Core Group Meets/Talks Notify/Activate RRT Multi region response/ coordination Partial RRT Activation County Boundary Incident Data: PDA Bureau of Food Safety & Laboratory Services resolution Created 8/11/2016 Local Municipality Miles Jurisdictions Department of Agriculture National Significance Multi state/region response Full RRT Activation PDA/FDA led-uc RRT Multi-agency Groups Deployed Act 315 City Act 315 County 17

18 PA LHDs jurisdictions Counties cities Working with our partners at the Local and State Police Departments Initial contact Routine inspectioninvestigation Clinical Illness(s) Intentional tampering Severe weather Core Group Meets/Talks Notify/Activate RRT National Significance Multi state/region response PDA ICS Established Multi region response/ coordination Full RRT Activation PDA/FDA led-uc Partial RRT Activation RRT Multi-agency Groups Deployed Joint RRT Investigation- Activation PDA-RRT Process Chart 2 Incident resolution 18

19 Activations. Lessons Learned. Lessons learned from several past food tampering investigations in PA ( ) PDA and PSP - developed a food tampering investigation SOP Other SOPs cover tactical roles/responsibilities and agencies that need to be involved 19

20 Activations. Lessons Learned. SA (Situational Awareness) COP (Common Operating Picture) How do we maintain documents and share.? Who is the custodian and where? SharePoint Sharing information electronically. Telecom conference calling 20

21 Activations. Lessons Learned. Communications Public Information (pre-scripted messaging) Governor s Office approval Risk Communication Agency Exchanges and Interactions 21

22 The Outcomes Through the Evaluation and Improvement Planning process, gaps are identified and when appropriate acted upon. In May, 2017 a PaCIC Brief on Food/Feed protocols was disseminated. 22

23 The Outcomes Through the Evaluation and Improvement Planning process, gaps are identified and when appropriate acted upon. In August, 2017 an additional PaCIC Brief on Food/Feed protocols was disseminated to L.E. and 911 centers. 23

24 Recovery. Response to Recovery and Beyond 24

25 Recovery. Response to Recovery and Beyond When is YOUR incident considered complete?? Closing the Loop.. Ending Operations AAR / IP with assignments Planning continues with improved versions 25

26 Pennsylvania Department of Agriculture PDA - Rapid Response Team Contacts: Dr. Lydia Johnson, Director Food Safety and Laboratory Services PA Department of Agriculture lydijohnso@pa.gov Rocco DiPietro, CSP Senior Professional Cocciardi and Associates, Inc. RRT Project Manager x104 rdipietro@cocciardi.com Bradley K. Tobin Emergency Preparedness & Safety Coordinator Phone: Cell: bratobin@pa.gov Arthur D. Kaplan, CEM, PCP PDA - RRT Project Coordinator c-akaplan@pa.gov