Veterans Affairs (VA) Ann Arbor Healthcare System raised concerns over contamination of surgical trays following the recent discovery of particulate matter on operating room equipment.
Derek Atkinson, the Ann Arbor VA public affairs officer, wrote in a press release Tuesday that the matter was identified by an investigation and that it was localized to operating room surgical trays.
“Through the routine tray inspection process, VA OR (Operating Room) staff proactively identify particulate and the tray is removed from use prior to surgery,” Atkinson wrote in the statement. “The health system has brought in a variety of experts over the past months to fully eradicate this problem.”
Atkinson cited last fall’s water pipe break as a potential source of the particulate contamination, according to the investigation by local experts. The proximity of the sterilization facility to the water pipe burst, he noted, could have contributed to the increased number of unusable surgical trays.
“Although the Ann Arbor VA has maintained a high volume of surgeries since the repair of a water pipe break adjacent to the sterile processing area last fall, sterile particulate continues to be found in some trays,” Atkinson wrote.
In response to the contamination, a portion of the surgical cases, in particular cardiac surgeries, has been transferred to the University of Michigan Health System. This move was a precaution taken due to the frequent turnover rate of surgical trays used in open-heart surgery. In an interview with the Daily, Atkinson said he hoped to return those operations quickly.
“We are looking to bring cardiac surgery back as soon as possible,” Atkinson said.
Atkinson also noted that, despite the precautions they are taking, the concerns over the surgical trays were isolated to the trays only and have not threatened the hospital’s sterilized surgical equipment.
“We still have some work to do to make sure that, whenever an OR nurse opens a tray, there is no particulate matter,” he said. “The presence of this particulate, however, is intermittent, so it doesn’t happen with every tray, and it is even unlikely that this sterile particulate is even harmful, but it shouldn’t be there, and we are working to make sure that no trays have this issue to ensure the high quality of care for our veterans.”
Until the source of the particulate is identified and fixed, all cases of cardiac surgery will continue to be sent primarily to UHS at the expense of VA.
Tuesday, U.S. Reps. Debbie Dingell (D–Dearborn) and Tim Walberg (R–Tipton) released a statement addressing the ongoing concerns over the presence of the particulate matter and responding to a meeting held last Sunday between officials from the Ann Arbor VA and the Representatives, in which they discussed the concerns.
In their statement, Dingell and Walberg wrote that the VA acted appropriately in its response to the potential source of contamination and worked with local sterilization experts to resolve the intermittent issue.
“This issue came to light because they were doing their job inspecting surgical instruments and discovered the problem,” the statement read. “To be clear, it does not appear that the particulate issue has caused an infection or harm to a patient.”
Dingell and Walberg also announced their intentions to introduce bipartisan legislation aimed at increasing reporting requirements within VA hospitals to improve transparency.
“We believe it is important that, like other hospitals, the VA should be open and transparent and report the number of patients that have acquired surgical infections while receiving care at the VA, and the number of surgeries that have been canceled or moved to another hospital,” they wrote.