Volume 12, No. 4 • Winter 1997

“Real Danger” in Reusing Disposables

Gerald S. Linder, M.D., F.A.C.A.

To the Editor

The recent issue [Summer 1997] of the APSF Newsletter served to bring focus on a festering problem: the reuse of disposable anesthesia equipment.

As an Anesthesiologist with 31 years of clinical practice, President and CEO of a medical device manufacturing company, and an Associate Clinical Professor of Anesthesia with 30 years of teaching experience, I am perhaps uniquely qualified to comment on this matter.

There is no lack of evidence as to the real dangers of reusing disposable medical devices. The anesthesia literature is replete with accounts of patient burns from residual sterilizing solutions or gases on reused disposable devices as well as device failure and breakage due to product fatigue with concomitant patient injury.

Indeed, two ASA committees joined in study of this problem eight years ago with the resultant booklet: “recommendations for Infection Control in the Practice of Anesthesiology,” available from the ASA publications and services catalogue. The reuse of disposable anesthesia equipment is clearly CONDEMNED in this guide to anesthesia practice.

Yet, I am repeatedly abhorred by the illogical, baseless and fundamentally unsound practice I witness at “The Best Hospital in the West” – my alma mater (undergraduate, graduate, medical school and residency), each and every time I teach and supervise anesthesia residents in the OR. One would expect a better example from a teaching institution. Because of overpowering, cost-cutting concerns of purchasing, a procession of Anesthesia Department heads over the past 10 years, who I made aware of the common practice of using dirty, uncleaned, unresterilized, disposable, one time use stylets, repeatedly in STERILE, DISPOSABLE ENDOTRACHEAL TUBES were unable to change the practice which essentially insults one’s intelligence by ignoring basic medical principles! Anesthesia residents have often cited this blatant discrepancy in medical technique and sought an explanation from me as to why they could not have an adequate supply of disposable, sterile stylets commensurate with the disposable, sterile endotracheal tubes in which they are inserted. The answer, unfortunately, is clearly to PENNY PINCH AT THE XPENSE OF PATIENT SAFETY. This is the same philosophy and mentality of most HMOs whose bottom line profits override patient care.

I laud France and Quebec’s PROHIBITION of the reuse of disposables. Similar legislation is needed in the United States to avoid the staggering costs of inspection and monitoring which would be required to ensure compliance with proper resterilization and reuse protocols for disposable devices. This is the only rational and effective means to prevent the opportunity for further abuse of disposables.

Gerald S. Linder, M.D., F.A.C.A. President and CEO POLAMEDCO, Inc.