THE AVIAN FLU: THE NEXT PANDEMIC?
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FALL/WINTER 2005
“Partnering with Businesses to promote
a safe and healthy workplace.”
PINNACLE HEALTHCARE INDUSTRIAL QUARTERLY
THE AVIAN FLU: THE NEXT PANDEMIC?
On October 7, 2005, health officials from Hong Kong Flu pandemic of 1968 killed
80 countries met in Washington D.C. to more than 70,000 and 34,000 Americans
discuss the potential threat of a deadly respectively.
outbreak of the Avian Flu, also known as
H5NI or the Asian Bird Flu. The growing Where did the flu come from?
global fears of a virulent new strain of In 1918, during the final year of World
influenza has raised doubts on whether War I’s trench warfare, a new nemesis
we are prepared to deal with a pandemic began to claim victims outside the
(severe flu epidemic) on a national and battlefields. Although the Spanish Flu
international level. pandemic of 1918 did not originate in
Spain (Spain remained a neutral country
Flu pandemics usually manifest after the during World War I), it got its namesake been studying the genetic blueprint of the
exposure of a new influenza virus to from outbreaks documented in May of 1918 Spanish Flu virus. The direct
which humans have yet to develop 1918. The outbreaks returned in late comparison of the 1918 genetic viral
immunity. There have been three summer throughout Europe and spread sequence to those of the more common
pandemics during the last century. The world wide. and recent flu viruses confirmed what Dr.
1918 Spanish Flu pandemic is the Taubenberger had long suspected: “The
catastrophe by which all modern flu The severity of the illness was Spanish Flu virus had crossed into people
epidemics are measured. The Spanish Flu unmistakable. Approximately 5% of the from some unknown animal, leaving
was responsible for killing more than 20 patients died, some in 2-3 days after the victims with little immunity to this
million people worldwide including more onset of symptoms. Dr. Jeffrey threat.”
than 600,000 in the U.S. More recently, the Taubenberger of the Armed Forces -continued on page 2
Asian Flu pandemic of 1957 and the Institution of Pathology in Maryland has
In This Issue... ARIZONA SUPREME COURT DECLARES
Avian Flu ............................................1 WORKERS’ COMPENSATION DRUG AND
AZ Supreme Court Ruling ................1 ALCOHOL STATUTES UNCONSTITUTIONAL
Sexual Harassment Training ............2 In a landmark unanimous decision, the The Cases
Arizona Supreme Court deemed that two David Grammatico installed metal trim
Heat Illness Update ..........................3 existing Arizona statutes regarding drug on building exteriors while standing on
and alcohol use in the workplace were 42-inch stilts. Grammatico sustained an
Fluids and Hydration ........................4 unconstitutional. The Supreme Court on-the-job injury when he fell off the
analyzed two statutes in the consolidated stilts into a cluttered area at the jobsite.
Wrist Injuries ......................................5 cases of Grammatico vs. Industrial In the process he injured his wrist and
Commission and Komalestewa vs. knee. In a post-accident drug screen,
Tetanus ................................................6 Industrial Commission, concluding that Grammatico tested positive for
certain statute provisions were marijuana, amphetamines, and
Soft Tissue Wounds ............................6 unconstitutional. The Supreme Court methamphetamines. Mr. Grammatico
decision essentially eliminated drug and was initially denied workers’
Pinnacle Goes “Electronic” ..............7 alcohol consumption as a possible factor compensation coverage pursuant to
used to deny workers’ compensation Arizona Revised Statute §23-1021(D).
Pinnacle Healthcare - Rossi ............7 awards and benefits. -continued on page 3
2 F A L L / W I N T E R 2 0 0 5
-continued from page 1
In studies performed in the late
1960’s and 1970’s from Australia to
FLU FACTS
northern Canada, Dr. Robert
What is the Flu? ill and to avoid close contact with people.
Webster and his colleagues tracked
The flu is a contagious disease caused by Everyone is encouraged to wash and clean
influenza to its source. His studies
the influenza virus and usually occurs their hands frequently. It is further
concluded that the flu virus comes
from “the wild birds of the world between November and March. There are recommended to avoid touching your eyes,
including wild aquatic birds, water three types of influenza viruses: A, B, and nose, and mouth. The flu virus may be
fowl, ducks, and shore birds.” C. Influenza Types A and B are the two transmitted when a patient touches
types of influenza viruses that cause something that is contaminated with germs
How serious is the threat? epidemic disease every winter. and then touches his or her eyes, nose, or
Serious enough that the Federal mouth.
Government has contemplated Mode of Transmission
regional quarantine measures as a Influenza is a respiratory illness that is Why are flu shots
means to arrest and reduce viral highly contagious. It is usually transmitted administered yearly?
transmission. President Bush stated in the form of respiratory droplets when an The circulating flu viruses have a tendency
that he is considering the use of infected individual coughs, sneezes, or has to mutate and change yearly, and the
military troops to impose a direct contact with another individual. It vaccine must be updated annually to
quarantine in the event of an Avian can also be spread by sharing eating include the current viral strains. Also, the
Flu epidemic. The President utensils, cups, or common objects such as body’s immune response to influenza
expressed concerns about the telephones. declines over time and offers minimal
governments ability to direct an protection to the newer flu strains the
effective response, especially in the Signs and Symptoms of the Flu following winter.
aftermath of FEMA’s performance Flu symptoms include fever, headache, sore
following the hurricanes. For this throat, dry cough, nasal congestion, muscle Who needs a flu shot?
reason, proactive planning and aches, fatigue, and chills that typically last In most circumstances the following groups
collaboration on both a national five to ten days. Gastrointestinal symptoms, are highly encouraged to have flu shots:
and international level are such as nausea, vomiting, and diarrhea, are • Children ages 6 months to 24 months.
paramount. much more common among children than • Adults 65 and over.
adults. Unlike other viral respiratory • Anyone ages 2-64 with underlying
The “Bird Flu” H5NI, has raised infections like the common cold, influenza chronic medical problems.
concerns over the past several can cause severe illness and life-threatening • Nursing home residents.
years given its recurring nature complications. • Women who will be pregnant during the
and ability to mutate. Asia has seen upcoming flu season.
an alarming increase in H5NI What is the treatment for the flu? • Children ages 6 months through 18 years
related deaths in both poultry and The number one preventive modality is an who are on long-term Aspirin therapy.
humans. If the H5NI Bird Flu virus annual flu vaccination. Individuals that • Healthcare workers, specifically those
further mutates, as was the case in develop the flu are encouraged to see their who have direct patient contact.
1918, and gains the ability to physician for possible anti-viral • Anyone who lives with or cares for
spread quickly among humans, we medications that are commercially children younger than 6 months.
have the potential for a global flu available. Individuals with the flu are
pandemic. encouraged to stay at home when they are
LEGISLATIVE UPDATE
SEXUAL HARASSMENT TRAINING: AB1825
ATTENTION ALL CALIFORNIA EMPLOYERS:
The deadline to complete mandatory sexual harassment training is around the corner. All employers with California employees and
50 or more workers in any jurisdiction have until 12/31/05 to complete the mandated sexual harassment training of supervisory
personnel. Failure to comply with AB1825 could adversely affect your business via penalties and may increase a company’s risk of
liability.
F A L L / W I N T E R 2 0 0 5
3
LEGISLATIVE UPDATE
-continued from page 1 job accident that is truly an accident, and not intentional, must
be compensated. The Supreme Court explained, “While alcohol
Austin Komalestewa was injured on the job when he crawled consumption and illegal drug use shortly before work or during
under a broken conveyor belt to try to fix a belt that had work undeniably increases the chances of being injured on the
“bogged down.” Komalestewa caught his arm in the drum and job, it cannot be unequivocally said that employees with alcohol
was seriously injured. Post injury blood test performed at the or drugs in their system who sustain injuries have intentionally
hospital revealed the presence of alcohol in his system, and a injured themselves. The constitutional system for workers’
doctor later testified that his blood alcohol content at the time of compensation requires the payment of benefits if a necessary
the accident was around 0.176%. Komalestewa admitted he had risk or danger of employment partially caused or contributed to
four mixed drinks containing vodka the night before the an industrial accident, without consideration of any fault by the
accident. He was denied workers’ compensation coverage injured employee.”
pursuant to Arizona Revised Statute §23-1021(C).
Practical Effects and Impact
The Statutes The Arizona Supreme Court decision has invalidated a valuable
ARS§23-1021(D) provides that if an employer maintains a law originally intended to ensure a drug and alcohol free
certified drug testing policy, “an employee’s injury…shall not be environment. Mr. Sam Sorich of the Property Casualty
considered a personal injury by accident arising out of and in Insurance Association says, “Striking down this law sends the
the course of employment and is not compensable…if the wrong message to Arizona residents that they may place
employee fails to pass a drug test for the unlawful use of any themselves, their coworkers, and the public at a significant and
controlled substance,” unless the employee proves that the use unjustifiable risk of serious harm by going to work drunk or
of an unlawful substance “was not a contributing cause of the high, without the fear of losing work comp benefits. The ruling
employee’s injury.” is also likely to jeopardize the 5% premium credit that SCF of
ARS§23-102(C) provides that “an employee’s injury…shall not Arizona offers policyholders that have a certified drug and
be considered a personal injury by accident arising out of and in alcohol program.
the course of employment and is not compensable…if the It is still recommended that employers have clear, well-
impairment of the employee is due to the employee’s use of delineated drug and alcohol policies in place. Arizona
alcohol…and is a substantial contributing cause of the employers can still ban drug and alcohol use in the workplace
employee’s personal injury.” and “take adverse employment action based on a positive drug
The Ruling test or alcohol impairment test” including the termination of
The Arizona Supreme Court combined Grammatico and employment as stipulated in ARS§23-493.05. At this point, the
Komalestewa to resolve the dispute. The primary focus was on Arizona courts will err on the side of employees with respect to
Article 18, Section 8, of the Arizona Constitution, which injury causation and subsequent benefits even when drugs and
established a “no fault” system for workers’ compensation. The alcohol are involved. Despite the controversial ruling, the
court determined that Article 18, Section 8, prohibited the Arizona Supreme Court suggested that a constitutional
legislature from injecting fault into the workers’ compensation amendment may remove the barrier for future statutes that are
system. Furthermore, the Supreme Court stated that an on-the- similar to ARS§23-1021(C) and (D). A proposed amendment has
recently been circulated in the state legislature.
HEAT ILLNESS UPDATE
NEW CAL/OSHA HEAT ILLNESS PREVENTION STANDARDS
On August 22, 2005, the new Cal/OSHA Emergency Safety Access to Shade
Standard for Heat Illnesses took effect. The standard becomes Employees suffering from heat illness or believing a
permanent after a 120 day comment period. Here are the preventative recovery period is needed shall be provided access
highlights of the recently enacted legislation §3395. to an area with shade that is either open to the air or provided
with ventilation or cooling for a period of no less than five
Heat Illness Prevention Standard minutes. Such access to shade shall be permitted at all times.
Provision of Water Training
Employees shall have access to potable drinking water meeting
the requirements of Section 1524, 3363, and 3457. Water shall be Employee Training
provided in sufficient quantity at the beginning of the work Training in the following topics shall be provided to all
shift to provide one quart per employee per hour for drinking supervisory and non-supervisory employees.
during the entire shift. Employers may begin the shift with
smaller quantities of water if they have effective procedures for • The environmental and personal risk factors for heat illness.
replenishment during the shift as needed to allow employees to • The employer’s procedures for identifying, evaluating, and
drink one quart or more per hour. controlling exposures to the environmental and personal risk
factors of heat illness.
4 F A L L / W I N T E R 2 0 0 5
-continued from page 3 Supervisor Training
• The importance of frequent consumption of small quantities of Prior to assignment to supervision of employees working in the
water, up to four cups per hour under extreme conditions of heat, training on the following topics shall be provided.
work and heat.
• The importance of acclimatization. • All information identified in the employee training section.
• The different types of heat illness and the common signs and • The procedures the supervisor is to follow to implement the
symptoms of heat illness. applicable provisions and information required to be provided
• The importance of immediately reporting to the employer, by the standard.
directly or through the employee’s supervisor, signs and • The procedures the supervisor is to follow when an employee
symptoms of heat illness in themselves or in coworkers. exhibits signs and symptoms consistent with possible heat
• The employer’s procedures for responding to signs and illness including emergency response procedures.
symptoms of possible heat illness, including emergency
medical services should they become necessary. For more information on heat illness prevention, visit the
• Procedures for contacting emergency medical services and if following Cal/OSHA webpage: HYPERLINK
necessary for transporting employees to a point where they "http://www.dir.ca.gov/dosh/heatillnessinfo.html"
can be reached by an emergency medical service provider. www.dir.ca.gov/dosh/heatillnessinfo.html.
• How to provide clear and precise directions to the worksite.
FLUIDS AND HYDRATION
Fluid replacement is one of the most important nutritional
concerns for athletes and individuals who work outdoors.
Approximately 60% of body weight is water. With exercise or
physical exertion due to work, fluid is lost through the skin as
sweat and through the lungs when breathing. If this fluid is not
replaced at regular intervals during exertion, an individual may
become dehydrated. When an individual becomes dehydrated,
they have a smaller volume of blood circulating through the
body. Consequently, the amount of blood the heart pumps with
each beat decreases, and consequently the body tissues do not
receive enough oxygen from the bloodstream. Proper fluid Drinks containing less than 5% carbohydrates will not provide
replacement is the key to preventing dehydration and reducing substantial energy sources to maintain a good blood sugar
the risk of heat injury during work or exercise. level. Conversely, beverages that exceed 10% carbohydrate
levels, like most non-diet soda drinks and some fruit juices, can
How can dehydration be prevented? often have a negative effect such as abdominal cramps, nausea,
The best way to prevent dehydration is maintaining body fluid and diarrhea.
levels by drinking plenty of fluids before, during, and after
exercising or working outdoors. Oftentimes, athletes and What about sodium in sports drinks?
workers are unaware that they are losing body fluid. Sodium is an electrolyte needed to maintain proper fluid
balance in the body. Sodium helps the body absorb and retain
Thirst is not an accurate indicator of how much fluid an more water. Researchers have found that the fluid from an 8
individual has lost. If an individual waits until they are thirsty ounce serving of a sports drink with 6% carbohydrates and 110
to replenish body fluids, then it is likely that they are already milligrams of sodium absorbs into the body faster than plain
dehydrated. Most people do not become thirsty until they have water. Most sports drinks are actually low in sodium. For
lost more than 2% of their body weight. And, if an individual example, an 8 ounce serving of Gatorade has a sodium content
only drinks enough to quench their thirst, they may still be similar to a cup of 2% milk. Many Americans get too much
dehydrated. Keeping a water bottle available when working or sodium but unfortunately, it is from eating fast foods and not
exercising and drinking as often as every 30-45 minutes will from drinking sports drinks.
provide adequate hydration in most circumstances.
General Guides for Fluid Replacement
Sports Drinks • Drink a sports drink containing 6%-8% carbohydrates.
Researchers have found that sports drinks containing 6-8% • Drink a beverage that contains a small amount of sodium
carbohydrates (sugars) are absorbed into the body as rapidly as and other electrolytes such as potassium and chloride.
water and can provide the necessary energy to working muscles • Find a beverage that tastes good. This will promote
that water alone cannot. This extra energy can delay fatigue and hydration and will be easy to drink.
offset the effects of dehydration. When an individual drinks a • Avoid carbonated drinks which can cause gastrointestinal
sports drink, they can maintain their blood sugar level even distress such as cramps, nausea, and diarrhea.
when the sugar stored in their muscles is running low. This • Avoid beverages containing caffeine and alcohol due to their
allows the body to continue producing energy at a high rate. diuretic effect.
F A L L / W I N T E R 2 0 0 5
5
WRIST INJURIES inflammation or “tendinitis” of these
structures. Wrist tendinitis is usually
caused by repetitive use but on rare
Injuries of the wrist are common occasions can occur acutely with trauma.
workplace injuries that can have a
profound impact on employers and What are the signs and symptoms
employees alike. These injuries can of a wrist injury?
develop gradually due to repetitive The signs and symptoms of a wrist injury
microtrauma in occupations involving vary depending on the severity of the
data entry, packing, sorting, lifting, etc. or injury and the mechanism. For example, a
acutely due to a fall on an outstretched wrist injury due to acute trauma may
hand. In most cases, wrist injuries have more pronounced changes such as
respond favorably to conservative swelling and discoloration. Some or all of
treatment such as medications, splinting, the following may occur depending on
modified work duties, and occupational the specific type of injury.
therapy. The more severe cases such as • Pain with repetitive activity. This can
carpal tunnel syndrome may require be mild to severe.
surgical intervention, but these comprise • Local tenderness with palpation of the
the minority of wrist injuries encountered tendon, muscle, or ligament.
in the occupational workplace setting. • Swelling around the inflamed tendon
or muscle.
Anatomy and Physiology • Discoloration and swelling are
The musculoskeletal system is a complex oftentimes seen in acute trauma.
network of skeletal muscles, bones, joints, • Crepitation with movement. In severe
nerves, blood vessels, tendons, ligaments, cases the patient will have a “Rice
and aponeurosis. Each upper extremity Krispies” sensation over the area of the
has 32 bones, 49 muscles, and many inflamed tendon.
neurovascular structures. The wrist has • Painful and oftentimes limited motion.
eight carpal bones that connect to the • Weakness and difficulty with gripping,
hand bones (metacarpals) and the flexing (bending) and/or extending of
forearm bones (radius and ulna). wrist and hand.
Definitions: How is a wrist injury diagnosed?
Ligament To diagnose a wrist injury such as a
A ligament is a connective tissue that sprain, strain, or tendinitis, the medical
connects bone to bone. provider will review the history and
Tendon mechanism of the injury and perform a
A tendon is a tough fibrous tissue that comprehensive evaluation of the upper
connects muscle to bone. extremity. After a complete history and
Aponeurosis physical examination, x-rays may be
A fibrous sheath that attaches muscle to taken to rule out any underlying
muscle. orthopedic injury.
Types of Injuries How are wrist injuries treated?
Wrist Sprain The typical treatment for a wrist injury
A wrist sprain is an injury to a joint that may include the following:
causes a stretch or tear in the ligament. A
wrist sprain can occur due to a fall on the • Local ice applications several times a the patient will be referred to a
wrist or hand or during a forced motion day for the first couple of days or until physical therapist or occupational
of the wrist. the pain subsides. therapist for strengthening and
• Elevating the wrist on a pillow while rehabilitation.
Wrist Strain sleeping or on the back of a
A wrist strain is an injury to the muscles chair/couch while sitting. Can wrist injuries be prevented?
and tendons. This could occur due to a • Wearing a wrist support or splint that Some wrist injuries can be prevented.
sudden motion on the muscles and immobilizes the wrist (and in some Tendinitis is caused from overuse, and
tendons that pass through the wrist joint cases the thumb). proper stretching exercises will reduce
or due to repetitive motion injuries. • Taking anti-inflammatory medications the recurrence of tendinitis. Traumatic
and pain medication in more severe wrist injuries such as those due to a fall
Wrist Tendinitis cases. are not preventable. However, employees
Wrist tendinitis occurs when a tendon is • After the acute phase, the patient will are encouraged to do repetitive stretching
inflamed from overuse. The overuse of be instructed to begin stretching and activities prior to work if they have had
the so-called wrist tendons will result in strengthening exercises. In many cases, tendinitis in the past.
6 F A L L / W I N T E R 2 0 0 5
TETANUS
respiratory tract that leads to respiratory
compromise and suffocation.
Tetanus is a serious and potentially life- What are the risks?
threatening disease. It is caused by a Tetanus immunizations are routine in the
bacteria, clostridium tetani, that lives in the United States, and as a result, tetanus
soil. These bacteria can invade the human disease is rare. The CDC reports that 48-
body through a wound from an object 64 cases have been reported annually
that has the bacteria on it or from a since 1986. The predominant age of
“dirty” wound. The object can be patients with tetanus infection is greater
anything from a nail to a thorn. than 60 years of age. Infants are
immunized against the disease during
The tetanus bacteria produces a their first year, and booster injections are
neurotoxin (tetanospasmin) that attacks normally given at ten-year intervals. In
the nerve cells and the spinal cord, that some cases, boosters may be
controls muscle activity. After an administered within five to nine years in construction industry workers. Keep an
incubation period of 2-14 days, the toxin patients with high risk tetanus prone active record of dates for immunizations
(which acts as a poison) causes the wounds or individuals with a and boosters. Always clean out small
muscles to become rigid and subject to questionable immunization history. wounds with soap and water and then
extremely painful spasms. The common apply an antiseptic. This should be done
lay term for tetanus, “lockjaw,” references What should be done? even if you believe you are immune.
the muscular rigidity of the jaw and facial Remember, illness from this disease is Deeper or tetanus prone dirty wounds
muscles. In spite of medical advances and preventable. If a patient has not been require further evaluation with a
antibiotic treatment, about 60% of tetanus immunized within the past ten years, do healthcare provider.
cases end in death due to the it immediately. This is a paramount
uncontrolled muscle spasm in the consideration in agricultural and
SOFT TISSUE WOUNDS
There are many soft tissue injuries that can occur in the
workplace. The severity and outcome of a soft tissue injury is
directly dependent on three variables: the location of the
wound, the depth of the wound, and the mechanism of the
wound.
Anatomy and Physiology - Skin
The skin, also known as the integumentary system, is the largest
organ in the body. The skin is comprised of three layers. The
outermost layer is called the epidermis, it is thin and comprised
of cells that are constantly shedding and sloughing. The dermis
is the second layer of the skin, and within this layer we find Laceration Puncture Wound
blood vessels, sebaceous glands, sweat glands, and nerve
endings. The deepest layer is the subcutaneous fatty tissue
which provides insulation, padding, and protection of the Depth of Wound:
deeper structures such as bone, muscles, and tendons. A deep puncture wound may cause greater injury than a wider,
shallower laceration. Deeper wounds may cause underlying
The Three Variables injury to the deeper structures such as tendons, muscles,
Location of Wound: nerves, etc.
Injuries involving the face, fingers, or hand (specifically the
palmar aspect of the hand and fingers) are regarded as serious Mechanism:
injuries until proven otherwise. High pressure injection injuries, bite wounds, foreign body
injuries and dirty wounds from grease, dirt/soil have a high
Injuries directly over tendons, nerves, arteries, and joints pose a rate of infection and possible complications. These wounds
secondary threat of deep structure injury and subsequent need close follow-up, extensive cleaning, debridement, and
complication. prophylactic antibiotics.
F A L L / W I N T E R 2 0 0 5
7
-continued from page 6 First Aid Treatment • In cases of amputation, bring the
and Wound Care amputated part (e.g. fingertip) to the
Things to Look For • Avoid direct contact with a bleeding hospital emergency department. The
Tendon laceration: Unable to bend (flex) wound; use gloves if available. amputated tissue should be covered
or straighten (extend) a finger at a joint. • Apply direct pressure with clean gauze with gauze and then moistened with
or dressing and then cover the wound water.
Laceration to artery: Bright red, spurting with a dressing. • If the patient has an arterial wound,
blood that can spray up to several feet in • Elevate the extremity during transport. identified by bright red spurting blood,
the air. • Lacerations can only be repaired on the apply direct digital pressure to the
date of injury. Do not wait until the adjacent arterial pressure point.
Laceration to vein: Dark red, flowing next day for treatment; lacerations
blood from a wound. must be sutured (stitched) within the • Transport patient to the designated
first 12 hours of injury. Neglected medical facility.
Laceration to nerve: Numbness or lacerations have a higher rate of • Ensure that injured worker keeps the
impaired sensation to the area distal (or infection and can take two to three wound clean and dry for the first
away) from the wound. times longer to heal than a wound that several days post injury to reduce the
was sutured on the day of injury. chances of infection.
PINNACLE GOES “ELECTRONIC” • Retrieve disability status reports directly online.
• Order services online from a personalized client service list
Pinnacle HealthCare is proud to offer employers the first in our including drug screens, history and physical examinations,
new state-of-the art “electronic medical records” system. A fitness for duty tests, schedule onsite ergonomic evaluations
primary feature for our industrial clients is the ease of access to and a host of other services.
information and quick reference to order services for any
Pinnacle HealthCare location. With nothing more than an ID • Direct access to clearance reports for all pre-employment
and a password especially designated for you, access to medical services, drug screening, medical surveillance, and other state
records or appointment scheduling are just a click away and federally regulated medical services.
through the software feature known as the Employer Portal.
• View and print all required industrial and occupational
• View and update your company profile including workers’ reports and disability statuses.
compensation billing information and list of services.
• Insurance carriers will have direct access to all state regulated
• Direct email access to any Pinnacle HealthCare provider. reports, including DFR’s, PR3’s and PR4’s.
PINNACLE HEALTHCARE – SALINAS
ROSSI CLINIC NOW OPEN 7 DAYS A WEEK
The Pinnacle HealthCare Rossi facility, in Salinas, will expand its services to include urgent care and occupational medical care in
November of 2005. The spacious, 5,400 square foot, state-of-the-art medical facility is located at 2 Rossi Circle, near the Westridge
Shopping Center in North Salinas.
The clinic will have extended hours and will be open seven days a week.
The Rossi facility will also provide a full spectrum of occupational medical
services and primary care.
The Rossi clinic, one of two Pinnacle facilities in Salinas, currently houses
one of the largest multi-specialty medical teams in the central coast. The
professional staff has numerous doctors specializing in the following fields:
• Orthopedic Surgery • Occupational Medicine
• Physical Medicine & Rehabilitation • Plastic Surgery/Hand Surgery
• General Surgery • Emergency Medicine
• Internal Medicine • Sports Medicine
• Family Practice • Chiropractics
Pinnacle HealthCare Facilities
San Benito County Monterey County Santa Clara County Yuma County
Pinnacle HealthCare Pinnacle HealthCare Pinnacle HealthCare Pinnacle HealthCare
551 McCray Street 947-A Blanco Circle 7793 Wren Avenue 3939 South Avenue 3E
Hollister, CA 95023 Salinas, CA 93901 Gilroy, CA 95020 Yuma, AZ 85365
Ph (831) 634-4444 Ph (831) 422-5555 Ph (408) 848-0444 Ph (928) 341-4544
Fax (831) 634-4440 Fax (831) 422-5199 Fax (408) 848-0443 Fax (928) 341-4514
Hrs: M–F • 8am – 8pm Hrs: M–F • 8am – 5pm Hrs: M–F • 8am – 8pm Hrs: M–F • 8am – 7pm
Sat/Sun • 9am – 5pm Sat/Sun • 9am – 5pm Sat. • 9am – 3pm
Pinnacle Multispecialty *On call 24 hours
Santa Cruz County 2 Rossi Circle Merced County
Pinnacle HealthCare Salinas, CA 93907 Pinnacle HealthCare
Watsonville Community Hospital Ph (831) 770-0444 285 Mercey Springs Rd. Editorial Board:
75 Nielson Street Fax (831) 770-0445 Suite A Donald Pompan, M.D.
Suite 1507 Hrs: M–F • 8am – 8pm Los Banos, CA 93635 Troy Manchester, M.D.
Watsonville, CA 95076 Sat/Sun • 9am – 5pm Ph (209) 829-0444
Fax (209) 829-0445 Ernesto Alvero, PA-C
Ph (831) 763-6088 (winter hours)
Fax (831) 763-6463 *On call 24 hours Hrs: M–F • 8am – 8pm Marlene Werner, Director of
Hrs: M–F • 8am – 5pm Sat. • 9am – 5pm Marketing
California
5
101
Watsonville Gilroy
152
Salinas-Rossi Clinic
129
156 Hollister
Los Banos OPEN DAILY
Salinas November 28th, 2005
visit our website: www.pinnaclehealthcarecenters.com
4 Rossi Circle • Suite 141
Salinas, CA 93907You can also read
