How Amazon’s On-Site Emergency Care Endangers the Warehouse Workers it’s Supposed to Protect

An investigation found instances in which Amcare clinic staffers violated Amazon’s own rules as well as government regulations.

Earlier this year, a falling object struck a worker’s head at an Amazon fulfillment center in Robbinsville, New Jersey. The worker visited Amcare, the company’s on-site medical unit, and told the emergency medical technicians on staff there that they had a headache and blurred vision — classic symptoms of a concussion. According to company protocol, Amazon’s medical staff should have sent the worker to a hospital or doctor’s office for further evaluation, or at least called a physician for advice. They did neither.

This was one of six instances at the Robbinsville fulfillment center between February and May in which staff at the Amcare clinic failed to provide adequate medical care to injured employees, according to a warning letter issued in August by the Department of Labor’s Occupational Safety and Health Administration, the federal agency responsible for workplace safety. In another incident, a worker came to the clinic with a possibly fractured finger, but Amcare medical staff failed to send them to an outside clinic for a professional opinion. A worker with an eye injury repeatedly asked to be sent to the hospital, but Amcare staff denied the requests. The next week, another worker came to the clinic four days in a row complaining of intense finger pain. According to company protocol, the clinic should have been checking on the employee every two hours. Instead, Amcare evaluated them once per day for three days without recommending outside care.

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In various instances, OSHA investigators found that Amcare medical staff decided to treat the employees in-house, rather than referring them to doctors or hospitals — decisions that potentially violated New Jersey state law and federal regulations, such as OSHA’s “general duty” clause requiring employers to maintain workplaces free of hazards that put workers in danger.

This wasn’t the first time OSHA had investigated Amcare, nor was it the first time the agency alerted Amazon to problems at the clinics. “The current OSHA inspection again revealed instances indicating that the EMTs and Athletic Trainers (ATs) at AMCARE are working outside their scope of practice, without proper supervision,” regulators wrote in a warning letter to Amazon, reported here for the first time. “New Jersey state laws do not allow EMTs and ATs to practice medicine independently; a physician must supervise their work.”

An investigation by The Intercept and Type Investigations — drawing on previously unreported documents, an interview with a former OSHA medical expert, and interviews with 15 current and former Amcare employees — found multiple instances in which clinic staffers violated Amazon’s own rules as well as government regulations. The investigation found that Amcare employees nationwide were pressured to sweep injuries and medical issues under the rug at the expense of employee health.

Amazon, a company that is now worth $800 billion and has reshaped the global retail landscape, will handle nearly 40 percent of all online shopping in the U.S. this year. The company’s warehouses are especially busy around Black Friday and Cyber Monday; last year, Amazon received orders for 180 million items during the holiday weekend — a company record. To handle the rising demand, Amazon has added fulfillment centers around the country and hired an army of workers to pick items off warehouse shelves and prepare packages for delivery. Since 2014, the company’s workforce has increased nearly fivefold, from 154,000 to around 750,000 — a figure that includes Amazon-owned Whole Foods, but does not take into account the thousands of additional contractors and temporary workers who are brought in to help fulfill orders in Amazon’s warehouses during the busy holiday shopping season.

The strenuous nature of the work at Amazon’s warehouses can take its toll on the human body: As Reveal and The Atlantic reported last week, the rates of serious injury at 23 fulfillment centers from which data could be obtained were more than double the industry average in 2018. The company’s Amcare clinics are intended to address the many minor aches and pains workers experience on the job. The company claims that this care falls under the category of “first aid,” which, according to an OSHA letter to Amazon, is defined as “emergency care provided for injury or sudden illness before emergency medical treatment is available.” These clinics operate in most, if not all, of the company’s warehouses, and they are staffed by EMTs and supervised by safety managers. According to a former OSHA medical officer and multiple former Amazon employees interviewed for this story, safety managers are not required to have extensive medical training. (Amazon declined to answer specific questions about its safety managers’ training as well as other details reported in this story.)

Some of the thousands of employees at the Amazon Fulfillment Center in Robbinsville, New Jersey, August 1, 2017Image: Mark Makela/Getty Images

About the reporter

H. Claire Brown

H. Claire Brown

H. Claire Brown is a staff writer for the New Food Economy focusing on food policy and the environment.