Northwestern Medical Center resumed some operations Monday after suspending all surgical procedures last week due to the persistent presence of small particulates in sterilized surgical trays, the hospital’s leader said. The St. Albans City hospital continued Tuesday to increase the number and type of surgeries it performs.
During the temporary pause, first reported by WCAX-TV, which began August 18, the hospital installed a temporary reverse osmosis water filtering device to remove the particulates, hospital CEO Peter Wright said. The custom-made permanent reverse osmosis machine planned as a long-term solution will cost the hospital about $500,000, he said.
Though the hospital uses municipal water, its staff is not aware of any issues with the city’s supply that could have caused this. They also are unsure why the issue became more prevalent this summer.
The water standards needed for decontaminating surgical tools are stricter than what is required for clean drinking water, Wright said. The hospital’s particulate issue does not mean there is any danger in drinking or using city water for other purposes.
“I fill up my water bottle; I drink city water every day,” he said.
Operating room staff started noticing tiny particles in the sterilized, plastic-wrapped trays of surgical tools in the spring. When found, those tools had to be replaced or re-sterilized, sometimes requiring surgeons to delay operations. The problem persisted and surgical delays became more frequent, which brought the issue to Wright’s attention in June, he said.
At that point, the hospital began efforts to remediate the problem, changing water pipes and filters more frequently, and reviewing HVAC systems and workstations, among other preventative checks, hospital spokesperson Kate Laddison said. Medical device company Steris has also worked with the hospital to remediate the issue, she added.
Still, by late July, contamination in the trays became an even more frequent obstacle.
“It got to the point where the team said, ‘Hey, we don’t know that we can reliably do surgery with the right equipment.’ The moment we thought it was a safety issue, we said, ‘stop,’” Wright said.
Hospital leadership decided Friday, Aug. 15, to suspend surgeries the following Monday.
The additional step of filtering water used to clean surgical equipment through the temporary reverse osmosis machine appears to be addressing the problem, according to Wright. Last week, early testing showed the trays and kits cleaned with water that passes through the reverse osmosis machine were free of particulates, he said.
The hospital moved forward Monday with an incremental restart of surgeries and held four operations, all of which had trays free of particulates, Wright confirmed. They scaled up the number and type of surgeries Tuesday without any contamination.
Still, Northwestern Medical Center’s administration plans to continue evaluating its decontamination and sterilization process to isolate other potential sources of contamination, according to Wright. The surgical tools and trays generally undergo a multi-part cleaning process. The tools are inspected and hand washed before going into a large dishwasher-like decontaminator. Then they are assembled into trays, wrapped in plastic, and sent through sterilization. The review will include examining the quality of the wrap the trays are covered with and interrogating how the sterilization room itself is cleaned, he said.
“We do not think that [the water] is the only problem. We just think it’s the biggest bulk of the problem,” he said.
Some staff have expressed frustration with the ongoing nature of the problem.
Wright confirmed the administration received a letter from staff that expressed concerns about how long the contamination issues were allowed to go on and called for the removal of the person overseeing surgical processes. He declined to address the specific complaint, however.
“It would be inappropriate for me to comment about anything regarding any single member of our team,” he said of the letter, “but of course we will address it, absolutely.”
Christine Juaire, an operating room nurse and a member of the bargaining team for the newly-formed nurse’s union said in an emailed statement that “nurses don’t really know what is going on right now.” She did not address the letter or whether she signed it.
“Unfortunately, that is a trend with our current administration,” Juaire said in the statement. “There is often little transparency and little interest in involving staff who have years of experience in the processes and decisions.”
