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Audit Finds Security and Supply Chain Gaps at Knox County Health Department

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Richa Nathan
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The Knox County Health Department had little security or inventory protocols in place when it accidentally threw out about a thousand vaccine doses in February, according to a newly-released audit commissioned by Mayor Jacobs. 

 

Knox County paid Pugh and Company about $30,000 for its investigation. The report, issued June 30, details a slew of gaps that paved the way for the health department’s tossing of the vaccines before they were widely available. 

 

Auditors found that two out of ten vendor invoices in the pharmacy were not dated or signed off by a technician.  The report also says there was a lack of written procedures for tracking inventory; this could make the department unable to prevent or detect errors in the supply chain in time.

 

The report details a lack of written procedures for handling inventory and keeping track of medical supplies. The distribution of approval was also skewed as the same employee was responsible for ordering vaccines and receiving the shipments, according to auditors. Read the full audit here. 

 

Although the department keeps a manual count, the report says there wasn’t a formal system to account for received shipments. Auditors recommended seven changes, including increased security and improved documentation processes. A health department administrator told the Knox County Commission most of the changes will be implemented within a month.

 

“Of the seven recommendations we are in process or will be finishing those, with the exception of number seven which involves a formal inventory control system,” said Kevin Patton, the Knox County Health Department’s chief administrative officer. 

 

According to a police report about the tossing of the vaccines, a health department employee signed for a package. A health department vaccine program manager said the box only contained dry ice and told the employee to throw it in the dumpster. Security footage shows the box of vaccines sitting on the dumpster for three days and eventually being picked up by Waste Management. Both employees still work at the Knox County Health Department. 

 

The total number of wasted vaccines was first reported as 975 doses. The Tennessee Department of Health now logs the wastage as 1,170 doses because of the change in how many doses are counted for each vial.

 

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Credit video still/Knox County Health Department
Knox County Health Director Martha Buchanan

The county health department says most of the recommendations in the new auditor's report mirror the gaps their internal investigation found. 

“The following measures are a few of what we have put in place since then based on our internal review: Hiring a pharmacist to assist with vaccine management, creating a team built specifically to oversee vaccine management, developing a documented receiving system with redundancies for all three vaccines, and designing a new COVID-19 vaccine nomenclature and tracking system,” the health department said in a statement. 

At the time that the vaccines were thrown out, thousands of people were still waiting to be vaccinated. Now, Tennessee is sending vaccines back to the federal government as health officials try to combat vaccine hesitancy. 

“We are currently not ordering any COVID vaccines,” health director Martha Buchanan told the Knox County Commission Monday. “We’re running through our supply that we had because uptake has diminished that much. We haven’t ordered COVID vaccines in several weeks.”

Tennessee has distributed 86% of the vaccine doses it has received from the federal government, according to CDC data. Almost a million vaccine doses have not been administered. In early June, the federal government moved from distributing a set number of vaccine doses based on population size to states ordering based on demand. 

 

Currently, 38.5% of Tennessee’s population and 45.7% of Knox County residents are fully vaccinated, according to CDC data.

 

WUOT's Claire Heddles contributed to this report. 

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