An aside - why does it seem like when I go out of town that come back with a cold of some kind? It feels like my head is about to explode today, and I’m hacking up a lung. Speaking of health care, check this out.
Nothing to see here, move along — Hospitals Reuse Medical Devices To Lower Costs.
In a bid to save costs and stem a rising tide of medical waste, hospitals are recycling a growing number of medical devices labeled as single-use, from scissors and scrubs to the sharp blades surgeons use to saw through bones.OK. Saving the planet is a laudable goal, but I wonder what controls are in place to ensure appropriate oversight of the reprocessing. It seems like a situation ripe for corruption at the expense of good (safe) health care.Recycling medical devices labeled for single use is legal as long as certain Food and Drug Administration guidelines are followed. But the practice, which involves shipping devices to reprocessing facilities to be cleaned, sterilized and tested for reuse, has raised concerns about safety. Medical device makers say their single-use products are just that, and pose a higher risk of failure and harm when recycled.
…At Catholic Healthcare West, the nation’s eighth-largest hospital system, a wide range of medical devices labeled as “single use” are reprocessed each year. Last year, the San Francisco-based concern figures it reduced waste volume by 41 tons and saved $1.8 million.
“The safe use of these reprocessed devices helps us conserve resources so we can be more cost-effective in delivering care” says Sister Susan Vickers, vice president of community health. “And we are diverting significant amounts of medical waste, which definitely benefits our planet.”
When I posted this at the Blend, one reader made this unsettling comment:
Disclaimer: I work for a medical device company, but have held these views since the time when I was working in hospitals as an employee.Mad Cow and CJD are caused by prions, snippets of protein that can invade cells and damage them. no sterilization technique can guarantee to eradicate prions.
I encourage everyone to advocate for their own health care and ask your health care providers whether they reuse single-use medical devices and to ask for new product if you (or your SO or family) need some kind of invasive care.
15 Responses to “Recycling the saw that cut you open”
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i guess the WSJ noticed this big scandal in Las Vegas.
And it’s a little nervewracking to discover that Kaiser does such extensive reprocessing. I was with Kaiser Southern California, which is pretty good, but Kaiser Northern California is a gigantic mess. They’re in big trouble over their incredibly screwed-up kidney transplant program.
Pam,
I think the cold thing happens because when you travel you expose yourself to a different “germ pool” where you haven’t built up the immunities to fully fight off a cold. And if you’re like me, and you don’t necessarily thrive on traveling, the stresses of the trip could lower you resistance to illness even further.
Prions are nasty little things and can pretty much be transmitted through any medical device. I’ve even heard they can be transmitted through speculums. Should doctors really use disposable speculums to prevent the uncommon transmission of prions during a pelvic exam?
Although, I do agree with you on the oversight angle. Also, if these clinics are reusing equipment, they need to buy more durable devices and not reuse items intended for single use.
The knowingly reusing of needles just shocked me to the core; was a lab tech for over a decade and used thousands of needles. I cannot at all fathom what on Earth made the employees go along with this cost-saving idea, let alone not whistleblow to every news media. OMFG…
I saw a show on this some years ago. The makers of the overpriced single use products came of just as badly as the reprocessors. There are two pretty ugly sides to this story.
Is there any side to American healthcare that isn’t ugly?
I agree with the concerns about prions, and appropriate cleansing of materials.
On top of that, what about the people who end up working with these medically contaminated materials to be recycled? Is this done in third-world countries with little or no regulation and a desperate, deliberately undereducated workforce?
On the other hand, my father had a $12,000 pacemaker implanted (and that $12,000 was in 1992 dollars) and then he died two days later. I found out later they might have recycled it — if we’d specifically asked and paid to have it removed. The waste and cost can be ridiculous.
Without comment on the subject of the article, there are some misconceptions about prions that bear correcting.
While prions are certainly quite resistant to conventional sterilisation techniques, the statement “no sterilization technique can guarantee to eradicate prions” is grossly overstated and factually incorrect.
The current WHO guidelines detail three different methods which reliably denature any type of protein, and any of these methods are suitable for use on surgical equipment intended to be sterilised by conventional means (loosely, “steel things that can be safely boiled in an autoclave”).
In addition, the infectious path of prions (and indeed their basic nature) is still poorly understood and the subject of much research, but the general consensus is that initial infection is through the oral ingestion of an infectious agent, not through external exposure such as a speculum.
What freaks me is that a study released recently reported that they were able to grow MRSA from autoclaved surgical instruments!
I mentioned during a blood draw when I did a drug research test that the vacutainer needle carriers looked like they nearly always had a small amount of blood in them near where the needle locks into the carrier. Well the nurse (don’t think she was a phlebotomist) thought it was odd that I’s note that. She thought that the small amount wouldn’t infect anyone but I mentioned the chance that a sample could be contaminated with what ever might be in those little drops of blood. She thought about it for a few seconds and shrugged.
Dentists are where people should focus their efforts in safe reusable medical products. Drills and polishers and suction and the various picks and scrappers could very well sicken hundreds. And then the air and water hoses in their equipment. The fungus and mold potential is probably high. Yikes…
Many years ago all medical instruments were reused. I have spent many hours resharpening needles. IVs were glass and could be washed and reused. Linens are reused. Only in Merica would we be rich enough to through things away after the first use.
Many years ago all medical instruments were reused.
Many years ago, doctors didn’t wash their hands between patients. Shall we return to those days?
You may want to look up a few basic diseases like “hepatitis,” “AIDS” and “drug-resistant staph” before you wonder why we spend so much time sterilizing things and think that single-use items are better when you’re dealing with blood.
Pinky, supposedly the Vacutainer system was a sealed system because of its double-ended needles. Lemme see if I can described this enough so everyone can envision this…
You have a double-ended needle covered by 2 plastic sheaths and sealed. You unscrew the back end, then screw that into the holder. The other needle is only uncapped just prior to penetrating the cleansed skin. So the holder part Pinky mentions is a good 3/4″ or more, depending on the size of the needle, from the actual opening of the needle (either end).
The needle’s “backend” was covered with a sheath of rubber that only came out of its sheath and pierced the vacuum-sealed tube when enough pressure was applied. As one took off the filled tube and put on another, the sheath came back down over the end of the needle, preventing blood from coming out.
So how there was ANY blood in the holder is a mystery to me, and I worked with those from 1983 to 1997 (was a lab tech with lots of phlebotomy duties, including teaching new students using my own arm for them to train upon). NEVER had one leak. Plus, Vacutainer holders were extremely inexpensive, so one could toss them whenever they wanted to; hell, we used to buy them 500 to a bag and replace worn ones as needed.
But… it is possible that the nurses were somehow using their supplies incorrectly??
Considering that the Vacutainer system was used for blood cultures,
Crap, sent too soon.
Considering that the Vacutainer was routinely used for collecting blood cultures, they HAD to be completely a completely aseptic closed system.
Maybe the design and usage capabilities has changed since I ‘retired”? The only manual needles or butterflies had no threads; they just came out of their package and popped directly onto a syringe…so I’m at a loss as to how any blood would have been inside the tip of the holder to start with.
One would think that if the vacutainer used the same body that the needle attached to and the sample vial was pressed onto to pierce the rubber stopper that the common items were the needle carrier itself.
Given that the vials are what gives the vacutainer the ‘vacu’ part, they are under a vacuum, one would hope that the chance of catching anything would be slight, depending on use but could possibly taint the sample. I was rather curious how blood could end up on the inside of the vacutainer but if one were to pull the vial off while the vial was sucking the blood out, it could leak due to the velocity of the blood at the time of removal of the vial.
I wasn’t panicked but rather curious how it would yield a ‘clean’ sample if there was still a small amount of blood still in the carrier.
On to dentists, in a rather high area of HIV contamination my dentist reveled that he used older style all metal drills heads because the plastic ones wore out too fast. He autoclaved everything and used a chemical rinse too and thought that everything was being done. Then I herd that his practice was hit by a lawsuit alleging that his tubing in his dentist stands wasn’t cleaned or replaced in like forever. Nice I thought. I switched dentists after that…
I think getting sick from fllying is not only from the exposure to different germs, but also the abuse that all the pressure changes wreak on your sinuses. Sadly, my nose is quite sensitive to changes in pressure, temperature, and other environmental factors, and a series of rapid changes can be enough to give me a serious cold. It’s not all bad, though — nose sprays help a lot, even if they are sort of gross…