A new report suggests doctors across the country are using surgical tools contaminated with blood and other debris and because the FDA doesn't require hospitals to report it, many incidents are unknown. NBC's chief medical editor Dr. Nancy Snyderman reports.
Most people feel anxiety before a surgical procedure. They may have an even bigger reason to worry. A new report from the Center for Public Integrity suggests there may be unseen perils lurking in the surgery suite: the very instruments used in the operation may be contaminated with dangerous pathogens.
Although surgical tools are supposed to be cleaned and sterilized between operations, researchers have discovered that these devices can emerge from the cleaning process with bits of bone, blood and tissue from the previous operation, contaminants that can become reservoirs for some potentially lethal bacteria.
Q: Do we know how widespread this problem is and how often patients actually come down with these scary infections?
A: That’s the crux of the issue. We really don’t know how many people end up with infections from surgical instruments. Studies that have looked specifically at dirty devices have shown that there is definitely a problem. A study at the University of Michigan, for example, looked at 350 suction cups that had been cleaned and sterilized. They found that every one of them contained blood, bone, tissue, even rust. If the devices are dirty it’s not only gross but potentially dangerous, since there’s a potential for passing on infection.
Q: What’s the problem with cleaning these tools? Can’t the heat just be turned up higher to kill all the bugs?
A: As surgery has moved more and more to high-tech devices it’s become a bigger problem. They’re not built just out of metal and glass anymore. Some of these polymers can melt if you heat them to high so they need to actually be cleaned. They’re sent to the hospital basement and cleaned in some cases by poorly paid and poorly trained technicians whose last job might have been Burger King. Some of these people are being paid as little as $8.50 per hour.
Q: If the devices are still dirty even after the hospital follows the manufacturer’s instructions, what’s the solution?
A: I think the solution is probably two-fold. First the manufacturers need to be required to design devices that can be cleaned in real world environments. Second, hospitals need to be forced to make sure the devices are clean before they’re used on patients. One thing that might help there is to require more training for the people doing the cleaning.
Q: What about the FDA? Aren’t they supposed to make sure these devices are designed properly and are being safely used?
A: There’s a real problem with follow-up. When there was an outbreak in Houston that was traced to dirty arthroscopic shavers, the FDA mandated a safety review of the shavers. But they asked the manufacturers to do their own testing. When the manufacturers came back with tests showing that the devices were not clean that was the end of it. There was no follow-up. So nothing happened.
Q: Is there anything patients can do to protect themselves?
A: The only thing you can do is go to the best hospital you can. But you need to realize that even there something could happen.
Q: What do you hope happens as a result of your story?
A: This is an issue just coming to the forefront within the community. I hope the story pushes it onto a larger stage and that people who set policy realize it’s a very serious issue. Even when it comes to surgeons, many do not know what happens to the instruments they use and where they’ve been before they wind up in the surgery suite.
Linda Carroll is a regular contributor to msnbc.com and TODAY.com. She is co-author of the new book "The Concussion Crisis: Anatomy of a Silent Epidemic.”