St. Mary’s might need to replace surgical tools
St. Mary’s Hospital might have to spend hundreds of thousands of dollars on new operating-room instruments after a major problem with its sterilization system caused damage to its surgical kits, the Montreal Gazette has learned.
Surgeons at the Côte-des-Neiges community hospital discovered last week that surgical instruments that had just been sterilized were coated with a fine black powder. But what is of even more concern is the fact that some of the instruments were “stained” permanently with carbon particles, rendering the tools useless for operations, a St. Mary’s source said.
The hospital is also bracing for the possibility that it might have to replace its entire sterilization system — a worst-case scenario that could cost more than $1 million, the source added. In June, a hospital in Halifax was forced to replace all its sterilizers after surgeons detected the presence of fine black powder on instruments, and health authorities ended up spending more than $1.1 million on new equipment, training and a maintenance contract.
Until St. Mary’s determines the cause of the sterilization problem, patients will have to get their elective surgeries done elsewhere in the public system — where months-long waits are already the norm. Hundreds of surgeries have been cancelled at St. Mary’s since the hospital found out about the tainted instruments on Oct. 28, and no timetable has been given as to when normal operations will resume.
Two sources spoke to the Montreal Gazette about the nature of the sterilization problem in the absence of a detailed public disclosure by the hospital. They did not want their names published for fear of professional reprisals.
The second source who confirmed that some instruments were damaged irreparably said that surgeons and other health professionals are upset by what they believe to be a lack of information from hospital administrators.
“They feel they are being fed bulls-t by the newly-established hospital administration,” the source said, alluding to the umbrella organization that assumed control of St. Mary’s on April 1, the Montreal West Island Integrated University Health and Social Services Centre.
Quebec Health Minister Gaétan Barrette established the umbrella organizations as part of a reform to reduce administrative expenses, but the source maintains St. Mary’s is being hampered in its sterilization investigation because senior administrators are based out of the Lakeshore General Hospital in Pointe-Claire and hard to reach.
Joanne Beauvais, Barrette’s press attaché, suggested in an email Wednesday that the minister is satisfied with the precautions that St. Mary’s has taken.
“As for St. Mary’s, the minister mentioned this morning in a scrum (with reporters) that he is reassured to see measures have been taken to avoid problems for the patients,” Beauvais said. “He was also questioned (about) transparency: whether the hospital should have issued a press release” earlier than Tuesday, six days after the problem was discovered.
“His answer was that since they had taken preventive measures — transferring sterilized material from other hospitals, cancelling surgeries and sending ambulances elsewhere when surgery would be necessary, and that patients’ life and safety was not threatened — he was satisfied with their actions,” she added.
Claire Roy, a spokesperson for the umbrella health organization, would neither confirm nor deny that instruments have been damaged. “The tests about the sterilization problem are not finalized, so we cannot comment on hypotheses about replacing surgical instruments or the price it would, might, could cost,” Roy said. “The same answer applies to the potential replacement of the sterilization equipment; we cannot (respond to that) hypothesis, we will wait for the results of the tests first.”
The sterilization problem arose as St. Mary’s has cut more than $7.7 million from its operating budget, with almost $900,000 in expenses that must still be eliminated. Staff morale is low, the second source said, and there are concerns that St. Mary’s might have been using inferior but cheaper sterilization solvents or reduced the number of inspections of the equipment.
Lynne McVey, assistant directorgeneral of the Montreal West Island health organization, spoke about the budget cuts to St. Mary’s staff at a meeting on Tuesday, but did not address the sterilization problem. In an interview afterward, she insisted that budget cuts have not affected quality of care to patients.
Surgeons at St. Mary’s noticed that the instruments were coated with a “fine black dust” after they were removed from the autoclaves, ovens that destroy bacteria and viruses using a combination of high temperatures, high pressure and chemical reactions, the first source said. It’s possible that a solvent is to blame, the source added.
The Lakeshore hospital is sterilizing St. Mary’s instruments for the time being, allowing surgeons to perform emergency operations. St. Mary’s is also borrowing surgical kits from other hospitals.
In April, the Halifax Infirmary — part of the Queen Elizabeth II Health Sciences Centre — cancelled 563 surgeries after discovering fine black dust on instruments. Two months later, the hospital installed new autoclaves.
The tests about the sterilization problem are not finalized, so we cannot comment on hypotheses about replacing surgical instruments.