Over the past nine months, sources have told Crain's of at least two examples of surgeons or nurses in DMC's adult hospitals in Detroit discovering dirty or bloody instruments. In all the examples, the dirty and contaminated instruments were discovered before operations.
Following last week's story that included a bloody instrument involving surgeon Hussein Darwische, Crain's confirmed another incident of dirty instruments reaching a DMC operating room, but not the sterile field within the operating room. In Darwische's case, he said in the Monday story that safety processes worked as intended.
In a second case, a surgeon doing foot surgery at Harper opened a tray and found it to contain bloody and dirty instruments, according to a source with direct knowledge of the incident. The surgeon ordered a second tray and found the same problem. A third tray was delivered and the surgery was completed.
Last week, two DMC doctors responded in an email to Crain's inquiries about problems with dirty instruments.
"The surgical instrument sterilization process at the DMC is significantly better, and I don't believe that there's another health system around that is as focused on this process as the DMC," Joseph Lelli, surgeon in chief at Children's Hospital of Michigan, said in a statement.
"Since the implementation of our process improvement plans with surgical instrumentation, I've had no concern about patient safety. While no process is perfect, we have a very reliable process with checks and balances so that any errors detected never reaches the patient," Brian Little, specialist in chief, DMC Orthopedics, said in a statement.
A pediatric surgeon at Children's told Crain's that hospital's new sterile processing department has been a success and a great improvement over the centralized department used for DMC's adult hospitals.
"I haven't had to contend with a single tray delay or contaminated case or lost instrument," the surgeon said. "(It is a) night-and-day transformation." Children's surgeons and nurses initially reported problems they had with dirty instruments to the media that led to the changes in 2017, he said.
But the adult sterile processing department, which is in the basement of Detroit Receiving Hospital, is another story, said more than five doctors who practice at DMC and tell Crain's of a variety of issues besides instrument cleaning.
Each day, DMC's sterile processing department cleans and assembles thousands of instruments into surgical sets, or trays, for the hospitals of the DMC's downtown campus, which includes Receiving, Harper University, Hutzel Women's and DMC Cardiovascular Center.