The world’s largest modular construction building opened in Brooklyn, NY, in late 2016. Approximately 90% of 461 Dean, a 32-story apartment complex, was built in a factory in the Brooklyn Navy Yard, enabling the developer to save about 20% on construction costs.¹

With construction costs on the rise, and the quality and convenience of modular construction improving, more of your contractor clients are likely to turn to it as a viable and profitable option. In fact, industry experts predict the modular construction segment will grow about 6% over the next several years.²

The move to modular

What’s the appeal? In addition to reducing construction costs, the inside, controlled work environment of modular construction also can:

• Increase employee safety because assembly on a factory floor minimizes height exposure and the likelihood of falls, which is the leading cause of fatal construction accidents
• Decrease build time by 30% to 50% because weather does not impact the work schedule. Additionally, tasks can be completed simultaneously
• Reduce potential damage to materials and equipment from extreme temperatures and moisture

Risks to consider

With the benefits of modular construction enticing more contractors to give it a try, you may have the opportunity to counsel your construction clients about having the right insurance solutions in place to protect themselves from the potential risks.

For example, fabricating large building elements offsite can require more cranes and heavy equipment onsite, signaling a need to review property, marine and general liability coverages. More equipment onsite could result in more theft, increasing an already big risk contractors face.

The National Equipment Register (NER) estimates the annual value of stolen construction equipment ranges from $300 million to $1 billion.⁴ How recently have your clients assessed the total value of their equipment and other property and adjusted their insurance to reflect changes?

Unanswered questions

Though modular construction has been around for decades, its increased popularity has introduced some new questions about risk and who owns it, including:

• What happens if damage or defects are detected during the onsite construction process?
• Who is responsible for costs associated with delays due to the manufacturing process?
• What contingencies and protection should be in place should pieces be damaged during transportation?

Build tailored coverage

One step your contractor clients can take to protect themselves is to enter into contracts that clearly define roles, responsibilities and risk ownership. Another is to partner with you and Hanover construction experts to identify hazards, implement controls to mitigate risk and tailor the coverages needed, including builder’s risk, property, general liability, workers’ compensation, umbrella and more.

¹ Business Insider
² UA Builders Group
³ Modular Construction Market, by Type Material, End-use sector, and Region - Global Forecast to 2023
⁴ Construction Connect

The importance of telematics in commercial fleets

Improve safety. Reduce costs. Get there on time. These are mandates commercial fleet managers often hear. They’re not easy to accomplish individually, let alone as a collective goal – and harder still given the many challenges drivers face on the road.

Consider this: People killed in motor vehicle traffic crashes hit a high in 2017 after a decade of decline, despite the many improvements in vehicle safety technologies. Additionally, in 2018, crashes involving single-unit straight trucks increased nearly 19%. The National Highway Traffic Safety Administration attributes these trends to “human behaviors,” such as speeding, distracted driving and driving under the influence.

What are wholesalers to do?

Increasingly, wholesale businesses are turning to telematics to help them monitor driver behavior – and reduce accidents, incidents and liabilities involving their fleet. “Implementing a telematics system averages about $150/vehicle, and $12/month for service" says Christina Villena, Vice President of Risk Solutions at The Hanover. "But just one accident fewer per year can offset the cost of the system for the entire fleet.” With increasing use of telematics in commercial fleets, data continues to indicate clear benefits.

Not just a fleeting opportunity

Telematics is not a “silver bullet” solution, but instead a powerful tool to be used in conjunction with an overall fleet management and safety program. Nonetheless, if you work with wholesalers and other clients who manage commercial fleets, encouraging the use of telematics is a value-added recommendation.

With projections indicating a 25% growth in telematics use each year for the next five years¹, many of your clients may already be thinking of budgeting and implementing telematics.

You can help them get off to a strong start by informing them of respected vendors. The Hanover has partnerships with several vendors—including Driver’s Alert, BlueArrow, IntelliCorp and Coaching Systems—that offer products, services and training at no charge or at a substantial discount to clients looking to control losses and improve auto-related performance.

Deliver value to wholesalers

Learn about The Hanover's flexible insurance solutions and services to help your clients protect the whole supply chain.

¹ Business Wire

This question might not have been taken seriously several years ago. But today, a hack can produce more than just a financial loss—it can become a life-threatening situation. This is because lifesaving or life-assisting devices such as pacemakers and insulin pumps are increasingly connected, making medical devices more vulnerable to cyberattacks than ever before. 

In fact, according to the ECRI Institute, the possibility of hackers exploiting remote access to systems and disrupting healthcare operations is one of 2019’s top 10 health technology hazards.¹ While remote access is intended to enhance medical care, this technology can allow attackers to take advantage of vulnerable systems to steal data, install malware or interfere with the operations of systems or devices.

Not just a hack

Physicians and computer scientists at the University of California, San Diego demonstrated the effects of such an attack at the Black Hat 2018 conference.²  Researchers changed the results of a normal blood test to show that a patient was suffering from diabetic ketoacidosis. Seeing this, a physician might remote into the patient’s insulin pump to adjust the settings. This could lead to an adverse reaction by the patient, potentially inducing a coma or worse.  

The Food and Drug Administration (FDA) has taken steps to ensure that medical device manufacturers make cybersecurity a part of their product development. Despite these regulations, the Department of Health and Human Services released a report recommending the FDA scrutinize medical device cybersecurity more closely, as they found that there were weaknesses in the FDA’s existing policies and procedures.³

One lifeline: an independent agent

“Agents serving the life sciences industry need a partner carrier that offers underwriting, claims and risk management experts who can assist in developing customized solutions for these risks and more,” according to Toby Levy, Vice President, Technology and Life Sciences at The Hanover.

Hanover Fusion helps agents solve for the challenges their life sciences organizations face, responding with coverages that are flexible and built to evolve with this dynamic market.

In addition to providing traditional product liability coverage, Hanover Fusion can be tailored to include coverage for errors and omissions, information security, privacy and personal injury.  

No business is immune to cyber risk, but for those with connected medical devices and records, the stakes are even higher. The Hanover is ready to help mitigate these risks. Learn more about Hanover Fusion, a multi-coverage solution for life sciences companies.

¹ ECRI Institute 2019 Top 10 Health Technology Hazards Executive Brief
² Medical Design & Outsourcing
³ Department of Health and Human Services Office of Inspector General

Exposure from lightning strikes and buildup of static electricity within the oil and gas industry has been around for years and continues to be a major source of oil field equipment losses across the United States. With the ongoing threat of inclement weather and moderate number of lightning strikes associated with storms, protection of equipment susceptible to lightning damage is at the forefront in risk mitigation. Here at Hanover we offer technical solutions aimed at maintaining less downtime and equipment losses associated with lightning strikes.

A common equipment related threat stems from aboveground tanks containing oilfield fluids. Hydrocarbon mixtures become volatile when the air to fuel ratio reaches ignition range and is presented with an ignition source. Listed below are common concerns and possible remedies with the above-mentioned. 

Lightning strikes-direct/indirect

Not all lightning strikes require direct contact to damage exposed oilfield equipment. A nearby lightning strike can create a chain reaction promoting fire/explosion to an entire site’s tanks, fluids and equipment. Although both are effective, two types of lightning protection are typically installed at well sites and well servicing operations — a “catenary” method and a “static dissipation” process. 

The preferred method is dissipation involving use of small wire brush apparatuses formed in the shape of spheres. Static electricity tends to flow more efficiently from sharp pointed edges as compared to flat wide surfaces. Static electricity suspended in the surrounding atmosphere is dissipated back into a ground system and creates a less attractive area for lightning to strike. 

Catenary lightning protection utilizes a pole grid system allowing lightning to strike a lightning rod mounted on a tall pole structure and directs the lightning strike and associate electric current to a grounded system.

Bonding/grounding

Equipment, especially aboveground fluid storage tanks, require a bonding/grounding method that ensures static electricity flows to the earth through a grounded system. Conductive materials that makeup construction of oilfield equipment, for example thief hatches or metal valves, should be bonded to a grounded system to maximize continuous electrical connectivity to ground. Properly bonded and grounded equipment controls electrical arcing, thus reducing the introduction of an ignition source within a potentially volatile vapor space associated with tanks containing oilfield fluids. 

 

 

 

 

Static concerns

Fluid movement and load out stations: Movement of fluids within tanks can create a static charge, which typically dissipates within conductive walls of a steel tank. However, fiberglass tanks typically contain a static charge allowing for a possible arcing process that provides an ignition source within potentially volatile atmospheres. Internal static dissipation applications connected to an outside grounded source provide a means to control arcing within the interior of a tank.

 

 

 

 

Oilfield workers can carry static charges within a high static environment. Typically, the first conductive object touched transfers the charge. For example, touching a thief hatch on a tank containing volatile fluids could introduce an ignition source. Bonding conductive materials to a secured grounding system is a best practice to control electric arcing.

Truck load out lines can also contain static charges and should be bonded to a secure grounded source to ensure electrical charges are dissipated into the earth. 

For more information contact your Hanover Risk Solutions consultant.

LC 2017-378

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

Below are suggestions pharmacies may want to include when developing their own best practices:

1. Demonstrate utilization of PDMP in a consistent and objective manner even if not in a mandatory required jurisdiction.^[1]

2. Show employment of educational material tailored to combating OUD (opioid use disorder). Encourage staff to document the provision of such material as well as the refusal of it.

3. Demonstrate continuing education for staff on opioid crisis etc. Topics may include fundamentals of addiction, treatment of opioid use disorder, and utilization of buprenorphine.^[2]

4. Empower pharmacists to question prescribing practices and address concerns to prescribing clinician or higher authority (e.g. boards of registration).^[2]

5. Consult with prescribing physician to verify prescription as well as validate clinical appropriateness.^[3]

6. Provide pharmacists with talking points when consulting with prescribers. For example: The 2016 Centers for Disease Control and Prevention prescribing guidelines encouraged non-opioid therapies for chronic pain and questioned daily dosages above 50 morphine milligram equivalents and advised avoidance of daily dosages of 90 MME or higher.^[4]

7. Be able to document that a review of patients’ current medications has been done in an effort to determine if other medications are interfering with pain management.^[5]

8. Consider including patient’s opioid status (opioid naïve or opioid tolerant). This can be utilized when reviewing orders for opioids and serving as a check for potential over medication.^[6]

9. Evaluate medication profile for concurrent opioid use.^[6]

10. Review patient history for allergies, obstructive sleep apnea, age, altered mental status, concomitant use of other sedating medications, opioid status, asthma or COPD, weight and renal function. These may impact tolerance to opioids.^[6]

11. Consider discussion with prescriber that the utilization of Long Acting (LA) opioids and doses greater than 40 mg be restricted to opioid tolerant patients and not used for acute pain management.^[6]

12. Consider segregating Morphine and Hydromorphone in the pharmacy storage.^[6]

13. Ensure patients utilizing opioids for chronic pain have access to naloxone.^[2]

14. Establish policies and procedures that focus on medication safety management to identify patients, providers and prescribers who may be inappropriately using or prescribing opioids.^[2]

15. The following are additional suggestions for the prevention of diversion of narcotics^[7]:

• Payment methods
• Early refills
• Out of area prescriptions
• Requiring identification of person picking up medications
• Process for ordering of opioids and the receiving of opioid deliveries are consistent with best practices
• Time delay on safe
• Disposal of medication for the community^[8]

16. Ensure that employees are knowledgeable regarding your Compliance Program and aware of how to access it.

References

1. http://www.pdmpassist.org/pdf/Reports_to_Dispensers_20190816.pdf Accessed 10/24/2019.

2. Botticelli M, Gottlieb M, Laderman M. EffectiveStrategies for Hospitals Responding to the Opioid Crisis. Boston: Institute for Healthcare Improvement and The Grayken Center for Addiction at Boston Medical Center; 2019. 

3. CMS 2019  Medicare Part D Opioid Policies: Information for Pharmacists. https://www.pharmacist.com/sites/default/files/audience/CMSPartDOpioid%20Pharmacy%20Tip%20Sheet_20181206_508.pdf Accessed 11/25/2019 

4. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain-United States, 2016. JAMA. 2016;315 (15):1624-1645. Doi:10.1001/jama.2016.1464

5. Pharmacy Today December 2017 Vol 23 Issue 12 Pages 40-41. Terri D’Arrigo.

6. Pennsylvania Hospital Engagement Network: Organization Assessment of Safe Opioid Practices. Patient Safety Authority An independent agency of the Commonwealth of Pennsylvania. 2014 http://patientsafety.pa.gov/pst/Documents/Opioids/organization.pdf

7. Philip W. Brummond, David F. Chen, William W. Churchill, John S. Clark, Kevin R. Dillon, Doina Dumitru, Lynn Eschenbacher, Toni Fera, Christopher R. Fortier, Kristine K. Gullickson, Kristen Jurakovich, Stan Kent, Jennifer Keonavong, Christine Marchese, Tricia Meyer, Lee B. Murdaugh, Richard K. Ogden, Brian C. O’Neal, Steve Rough, Rafael Saenz, Jacob S. Smith, ASHP Guidelines on Preventing Diversion of Controlled Substances, American Journal of Health-System Pharmacy, Volume 74, Issue 5, 1 March 2017, Pages 325–348, https://doi.org/10.2146/ajhp160919

8. Disposal of Unused Medicines; What You Should Know. U.S. Food & Drug Administration. https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know Accessed 12/5/2019

LC 2020-069

By Mary Beth Rhodes, MN, RN, CPHRM

The victims

Laura Hope Laws was prescribed an opioid-based medication after a broken jaw during a soccer game at age 14. She was a high school freshman. Addiction took over and she never made it to her senior year. She died of an accidental overdose on Nov. 17, 2013. She was seventeen.^[1]

A mother died after a 15-year battle with addiction to opioids that started with her third caesarean section. She was an extensive “doctor shopper.” She told her family she was “following doctor’s orders” by taking nearly 50 pills a day. She underwent 13 different treatment programs, but could not break the grasp of her addiction.^_[1]

How did it start?

In 1986 a paper written by Dr. Russell Portenoy was published in the journal PAIN describing the treatment of 38 chronic pain patients and it concluded that opioid painkillers could be prescribed safely on a long-term basis.[2] Dr. Portenoy was an early advocate for the use of opioids for chronic pain. He shared his opinion in journals, papers and conferences. He has now agreed to testify against drug manufacturers.^[11]

The manufacturer Purdue Pharma introduced OxyContin in 1996 and promoted it as a wonder drug suitable for all types of pain. Purdue started using a letter to the editor published in the New England Journal of Medicine in 1980 to say that less than 1 percent of patients became addicted. According to Herschel Dick, the author of the letter, the scope was extremely limited and not generalizable. This was a letter that was brief in content and that never went through a rigorous scientific process.^[9] According to the author he “was mortified this was used as an excuse by pharmaceutical companies to do what they did.”  In 2017 the editor of the New England Journal of Medicine issued a corrective to the 1980 letter. In it he notes that the original letter was heavily cited as evidence that addiction is rare with opioid therapy; he includes reference to a new study on the topic.  This is the only time in 17 years that the editor has taken such action. Questions have to be asked as to why it took 37 years.

In 1996, the rate of opioid prescribing began to rapidly increase following the 1995 FDA approval of OxyContin.^_[3] Drug manufacturers funded more than 20,000 pain-related educational programs through sponsorships or financial grants and launched a campaign to promote long-term use of opioid painkillers for chronic, non-cancer pain.4 In 2001 a campaign entitled “Pain is the Fifth Vital Sign” encouraged clinicians to assess and treat pain with the same urgency as other vital signs and use opioids for non-cancer pain.^[5] Both the Veterans Affairs (VA) and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) endorsed the campaign.^[1] In 2007 Purdue Pharma and three top executives pleaded guilty to misleading regulators, physicians and patients about OxyContin and agreed to pay $600 million in fines.^[10] In 2012 clinicians wrote prescriptions for 259 million bottles of narcotic pain killers, enough for every adult in the country according to the Centers for Disease Control.^[10] Opioids killed 28,000 people in 2014 and according to the CDC some 2.6 million people are addicted to opioids in the U.S.^[10]

The marketing push

Prior to this push, doctors were hesitant to prescribe opioids over fear that their patients would become addicted. Medical schools taught that opioids should be used for severe pain, cancer or surgery patients and not for back pain, headaches and osteoarthritis.^[8]  In order to increase the use of opioids, pharmaceutical companies had to change the mindset of doctors regarding opioids and addiction. Details of the various marketing campaigns were revealed in the corporate documents and emails that were unsealed in the Cleveland case after a year-long fight by the Washington Post.^[8]

The drug manufacturers paid physicians and Hollywood stars to promote more aggressive treatment with opioids. Industry provided funding to groups such as the American Pain Foundation and the American Pain Society with the purpose to drive up sales of opioid pain medications.^[8] Bonuses and various contests were deployed to reward top salespersons. Janssen incentivized sales representative with prizes such as Caribbean cruises, Washington DC family trips, Trek bikes and patio packages.^[8] A judge in a lawsuit in Oklahoma ruled that Johnson & Johnson and Janssen had engaged in “false, misleading and dangerous marketing campaigns” and caused “exponentially increasing rates of addiction, overdose deaths” and babies born addicted.^[8]

Crisis years

Between 2006 and 2012 Walgreens was the dominant player in the nation’s retail opioid market. They bought 13 billion pills—3 billion more than CVS, which was the closest competitor.^[6] Walgreens saw tremendous growth due in part to lack of oversight as pills were sent out without limit or review.^[6] In 2013 Walgreens agreed to pay $80 million dollars to resolve allegations that it failed to report suspicious orders, thus allowing oxycodone and other prescription pain medications to be diverted for abuse and illegal black market sales.^[6] In 2014 a pharmacy tech stole about 25,000 pain pills from a Walgreens in Missouri. He told investigators that another employee told him how to steal the pills and then sell them in the store bathroom and parking lot. In summer of 2016 a Walgreens pharmacy tech stole 7500 pain pills. She told investigators it was easy to take the pills and not be detected.

Because Walgreens was acting as its own distributor, it had the responsibility of reporting to the DEA suspicious activity of its own pharmacies. 2400 cities and counties throughout the nation allege Walgreens failed to report signs of diversion and incentivized pharmacists with bonuses to fill more opioid prescriptions. Walgreens denies they incentivized pharmacists. They have however removed sales of opioids from its bonus calculations for pharmacists according to court filings.^[6]

Since Walgreens acted as a distributor it had access to data regarding distribution within its pharmacies. Because they had this data they may be held to an even higher standard. Walgreens stopped internal distribution in 2014. In 2009 the Drug Enforcement Administration (DEA) threatened to revoke the registration of a store in San Diego. The investigation found that the store was filling prescriptions for providers not licensed in California.^[6] The DEA also found the store was dispensing controlled substances to people it knew or should have known were diverting these drugs. In 2011 Walgreens entered into an agreement with the DEA to settle the case. The DEA also found evidence that Walgreen stores in the Florida market were being ranked on the amount of oxycodone being dispensed and had instructed the pharmacists “to make sure they were not turning away legitimate prescriptions.” A California Walgreens location also came under scrutiny. This one was in Modesto and it was purchasing 17,500 pills per week. This put the store over the limit imposed by Walgreens corporate office. The allegation is that in order to obtain more pills the pharmacy ordered directly from Cardinal Health bypassing Walgreens’ distribution channel. At some point Cardinal Health had concerns regarding the distribution and cut off the store. The pharmacy then resorted to borrowing from other Walgreens locations. Cardinal Health in 2008 paid $34 million in fines for failure to report suspicious orders.^[6] Cardinal Health has recently reached an agreement in national opioid litigation.^[6]

Recent legal proceedings

In 2019 Purdue Pharma agreed to pay the state of Oklahoma $270 million dollars rather than go to trial on allegations of misleading marketing practices and misrepresentation of OxyContin.^[12] Endo Pharmaceuticals also agreed to pay Oklahoma $8.8 million to settle allegations that its marketing contributed to the opioid crisis.^[13] This money will go to the opioid lawsuit fund. Johnson & Johnson, the first case to go to trial in the U.S., resulted in a win for Oklahoma, but the original $572 million was reduced to $465 million in November 2019, the allegation being they, along with others, fueled the opioid crisis with deceptive marketing. Teva Pharmaceuticals, the world’s largest generic drug maker, agreed to pay $85 million in May 2019 to the Oklahoma opioid fund.^[14] Endo has also agreed to pay $10 million dollar to two counties in Ohio to settle suits related to opioids.^[13] Still pending is the Multidistrict Litigation (MDL) in the U.S. District Court for the Northern District of Ohio under Judge Dan Polster. The plaintiffs include cities, counties, states, individuals, consumers, hospitals, third-party payers and Native American tribes. The defendants include opioid manufacturers, distributors and physicians.^[16] On January 23, 2020 the founder of Insys Therapeutics, John Kapoor, was sentenced to 5.5 years of jail time for his role in the company’s plan to illegally boost sales of its prescription Fentanyl drug (Subsys). He and four other former Insys officials were convicted in federal court in Boston of conspiring to bribe physicians and defraud health insurers.^[17] Insys has settled with the U.S. Department of Justice for $225 million to end its criminal and civil probes. The company has filed for bankruptcy protection.^[18]

Summary

Prior to 2015, prescription opioid pain relievers were driving the opioid crisis, however, they now share equally with heroin, synthetic opioids other than methadone (mostly illicit fentanyl) and, increasingly, cocaine and methamphetamine. Due to leveling off and declines in opioid prescribing rates since 2012 and high dose prescribing rates since 2009 the data suggests providers have responded and are more cautious in their opioid prescribing practice. However additional measures are needed to address a diverse and changing utilization of different drug types.^[7] Today the drug manufacturers seem to be taking the brunt of the public outcry for this crisis; however, there may come a point in the future where all healthcare providers, accrediting bodies, associations, advocacy groups as well as patients and families may be called upon to examine their role in the national opioid crisis.

References

1. Prescription Drug Monitoring Programs: Critical Elements of Effective State Legislation March 2016. Shatter Proof: Stronger Than Addiction

2. Portenoy RK, Foley KM. (1986). Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain 25:171-86

3. The report of the International Narcotics Control Board for 2007. International Narcotics Control Board. Https://www.incb.org/incb/en/publications/annual-reports/annual-report-2007.html Accessed 12/16/2019.

4. Prescription drugs: OxyContin abuse and diversion and efforts to address the problem. (December 2003). Report to congressional requesters. United States General Accounting Office. Http://www.gao.gov/new.items/d04110.pdf Accessed 12/16/2019.

5. Haddox JD, Joranson D, Angarola RT, Brady A, Carr DB, et al. (1997) The use of opioids for the treatment of chronic pain: a consensus statement from the American Academy of Pain Medicine and the American Pain Society. Clin. J. Pain 13:6-8

6. Abelson, J., Williams, A; Ba Tran, A; Kornfield, M. (2019) ‘At Walgreens 13 billion pills and problems with oversight.’ The Washington Post.   Nov. 11. Page 1.

7. Centers for Disease Control and Prevention. Annual Surveillance Report of Drug- Related Risks and Outcomes-United States 2017. Surveillance Special Report 1. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2017. https://www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf Accessed 11/13/2019

8. Horwitz, S; Higham S; Bennett D; Kornfeld M.  (2019) ‘Inside the industry’s marketing machine.’ The Washington Post. Dec. 9. Page 1.

9. Zhang, S. The One Paragraph Letter from 1980 That Fueled the Opioid Crisis. The Atlantic. June 2, 2017. https://www.theatlantic.com/health/archive/2017/06/nejm-letter-opioids/528840/ Accessed 12/16/2019

10. Scharper, J. Administered for Pain Drugs like OxyContin have taken a massive toll. Johns Hopkins Magazine. Fall 2016.  https://hub.jhu.edu/magazine/2016/fall/opioid-addiction-pain-management/ Accessed 12/16/2019

11. https://www.cnbc.com/2019/04/08/physician-agrees-to-testify-against-purdue-and-other-opioid-drugmakers.html Accessed 1/20/2020

12. https://www.healio.com/rheumatology/practice-management/news/print/healio-rheumatology/%7B9563752c-75d5-47ea-ae5d-49d41645ff4e%7D/landmark-270-million-opioid-lawsuit-settlement-opens-door-for-dozens-of-pending-cases/ Accessed 1/20/2020

13. https://www.bizjournals.com/philadelphia/news/2019/09/05/endo-opioid-litigation-settlement.html Accessed 12/19/2019

14.  https://www.reuters.com/article/us-usa-opioids-litigation-oklahoma/teva-pharm-to-pay-oklahoma-85-million-to-settle-opioid-claims-idUSKCN1SW0MS Accessed 12/19/2019

15. https://www.reuters.com/article/us-usa-opioids-litigation-oklahoma/oklahoma-judge-reduces-johnson-johnson-opioid-payout-to-465-million-idUSKBN1XP27F  Accessed 12/20/2019

16. Berry, Melissa D. Thomson Reuters September 28, 2018. http://www.legalexecutiveinstitute.com/opioid-litigation-consolidated/ Accessed 1/20/2020

17. Walker, Joseph & Kamp Jon. The Wall Street Journal. Founder of opioid maker sentenced to 5.5 years in prison. January 23, 2021.

18. The Washington Post. Filed by the Associated Press. January 24, 2020. Page 2.

Preventive maintenance program

Mobile shredding trucks will have manufacturer manuals on recommended scheduled maintenance. Contractors should have documentation available that shows all units have been maintained per manufacturer recommendations. Most manufacturers will have daily, monthly and annual maintenance “checks” that need to be complied with.

Manufacturer training should be taken by in-house mechanics and/or service personnel to become familiar with proper operations. All users should be provided with daily documented inspection requirements and understand safe operating temperatures and general cleaning/maintenance requirements.

Lubrication of bearings and other metal components that could throw a spark if dry should be of primary concern. Belts should be tight so as not to overheat.

Theft

Trucks and trailers should be parked near buildings as company personnel retrieve document receptacles. Company policy should require locking vehicle doors and having company personnel nearby if the vehicle is left running. Drivers should be fully trained in proper security measures since contents can be of a sensitive nature to clients. King Pin, or other locking devices, should be used to prevent trailer theft. Ball/ring hitch locks used when trailers are parked.

Towing

Some smaller fleets may use shredding trailers towed behind other vehicles. Towing vehicles should be of proper size based on manufacturer requirements which typically require trucks of at least 3/4 ton. Trailer hitches should be inspected daily to ensure all connections are tight and lights are working properly. Safety chains should be attached and tires inflated to the proper level. Generators should be securely attached and operators should inspect electrical connections as required by manufacturer. Trailers should be on scheduled maintenance for lubrication and bearing inspection.

Vehicle damage

Vehicles will be parked near client buildings in a variety of settings. Designated loading areas should be determined prior to arrival to ensure drivers are aware of potential hazards such as nearby public streets and loading docks where forklifts and other material handling vehicles may be operating.

Safety cones should be available to operators who should be instructed on when and where to place cones to alert traffic. Drivers should be instructed to look for overhead obstructions and low clearance overheads. Vehicles with movable parts on bin tracks should be placed away from buildings to ensure they do not strike them. Placards inside of vehicles should be present that show maximum heights of a truck’s body.

Fire

Some vehicles will have fire suppression system as standard equipment and may be either automatic (sensor detection) or manual (operator detection). Operators should be familiar with how to read temperature gauges in order to ensure proper operating temperatures are not exceeded in hydraulic systems.

Remote camera systems should be constantly monitored by operators, to ensure foreign objects not designed to be shredded are not present in receptacles and to look for evidence of smoke or fire. Shredding hardware and documents together should not occur due to the potential for sparks igniting paper dust. Vehicles should be emptied before parking for the night or over weekends. Client personnel who may place materials to be destroyed into bins provided by the shredding company should be informed not to mix materials. Easily legible placards or color codes should be placed on bins to inform customer what can and cannot be placed in bin.

Operators should be trained in identifying hazardous locations that could produce excessive heat, sparks or other hot processes/areas where flammable/combustible vapors and liquids may be present. Shredding operations should not take place near these areas as paper dust could result in an ignition source and sparks may be produced when shredding metals.

Fire suppression systems should be inspected and tested on a scheduled basis, typically twice per year, by a professional firm trained to service the suppression system in use. A compliance certificate should be provided and maintained on file. Operators should have received training on the use of fire extinguishers and the proper methods to suppress fire.

Fixed storage facilities

Forklift training

Most storage facilities will use forklifts to move and stack pallets of documents. Damage to equipment can result in losses due to repair, replacement and loss of productivity. Properly trained operators are of primary importance when forklifts are used in any facility and all operators should be trained upon initial employment. If newly hired operators indicate they have already been trained, an evaluation of their ability should still be conducted by the facility owner, regardless if they provide documentation. All operators should be reevaluated at least every three (3) years or when conditions change within the facility (such as newly constructed facilities, or changes in the layout of aisles/passageways).

Forklift maintenance

Forklifts should be inspected and maintained to ensure their safe operation and ability to handle loads. Inspections should be conducted daily by each operator to ensure all controls, brakes and steering are working properly. A visual inspection should be made of the mast, forks and hydraulic system to ensure there is no obvious damage such as cracks or leaking hoses. Tires should be inspected to ensure they are in good condition and can safely support the machine.

Forklift operating areas

Operating areas should be clearly marked to indicate any sloping areas, drop-offs or other conditions that could cause forklifts to tip. Operators should be trained in and observe safe driving speeds and procedures when turning corners, driving down ramps and when driving outdoors.

When loading or unloading trucks/trailers, procedures should be in place to secure the trailers with either dock locks or the use of wheel chocks. Forklift operators should be instructed to inspect that trailers are properly secured before driving into them. Additionally operators should visually inspect trailer floors and the underside of trailers to ensure sufficient support. Missing, rusted or damaged trailer supports could fail and cause the forklift to fall through the trailer bottom. Proper procedures should be used and operators should be trained when working on or near loading docks with drop offs. Forklifts should be operated in reverse until a pre-determined point before turning and driving forward.

Security

Material handling equipment should be stored in designated areas that are properly secured. Open yard storage of equipment should be within fenced areas that are well lit. The use of security devices such as cameras and alarm systems should be considered, especially in neighborhoods that have higher crime rates.

Fire

Fueling areas for forktrucks and other material handling equipment should be in specified well-ventilated areas and performed by trained personnel only. Standard procedures should be in place to ensure equipment is turned off and cool prior to fueling. Proper grounding and bonding of all containers used to transfer flammable liquids should be in place to minimize the potential for static discharge.

All mobile shredding trucks and trailers should be cleaned each night of all paper or other materials that could catch fire. Each driver should be made accountable by requiring that a “sign out” system is used. They should state that they have cleaned out all mobile equipment prior to parking it for the evening.

Any hot work such as welding should require the use of a hot work permit authorized by a supervisor or other management. All welding equipment using compressed gases should be subject to frequent inspections of cylinder gauges, hoses and torches to ensure good condition.

Storage racks

Racks used to storage documents should be clearly marked with maximum loading capacity to minimize overloading. Rack supports on ground level should be protected from damage due to contact with forklifts which could cause rack failure. Damaged sections should be unloaded and “no storage” warning signs posted until repaired.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC JAN 2019 12‐83
171-0975 (01/14)