The emerging trend of medical device reprocessing continues to be a subject of live debate among doctors, legislators, and government and hospital administrators. The New York Times recently observed that in an effort to adopt environmentally-friendly practices while simultaneously reducing the financial burden of waste disposal, hospitals across the country are beginning to adopt reprocessing as standard practice in the operating room.
The American Society for Healthcare Central Service Professionals describes reprocessing as “any process which renders a used, reusable, or single-use device (SUD) to be patient-ready or which allows an unused product that has been opened to be made patient-ready.” Reprocessing has fallen out of favor at hospitals over the last two decades, with potential repercussions for patient safety cited as a chief concern. In light of these concerns, the government has launched several investigations into the reprocessing of SUDs, enacting tougher regulations on the practice and requiring that all reprocessed SUDs be labeled as such, along with the identity of the reprocessor.
Notably, the U.S. Government Accountability Office (GAO) released a comprehensive report in 2008 detailing the FDA’s supervision of the practice and outlining requirements for reporting any adverse effects. The report concluded that despite the limitations of current FDA data, the agency's analysis “of reported device-related adverse events does not show that reprocessed SUDs present an elevated
health risk.”
Stemming from the GAO’s findings, as well as their own experiences in the OR, surgeons at Johns Hopkins School of Medicine published commentary in Academic Medicine in March calling for more hospitals to begin recycling disposable SUDs. Their report observes that the U.S. healthcare industry is the second-largest contributor to landfills after the food industry, with medical centers discarding over four billion pounds of waste each year.
In 2002, the commentary noted, approximately 25% of hospitals used at least one-type of reprocessed SUD, including 45% of large hospitals (>250 beds). The writers expect that “the number of institutions engaging in reprocessing activities will continue to increase.” Indeed, one third-party processing service called Ascent Healthcare Solutions (AHC), purchased by Stryker in 2009, realized a 20% increase in business in 2008 alone across 1,700 client medical centers. Increasing awareness of the environmental impact certainly drives this upward trend, but financial concerns increasingly contribute to the trend. Reprocessing can reduce medical device costs by 50% annually compared with buying new equipment. AHC saved hospitals approximately $138,142,000 in 2008, rescuing landfills from 4,300,000 pounds of medical waste in the process.
Meanwhile, several non-profit organizations such as Practice Greenhealth and the American College of Cardiology are encouraging hospitals to adopt reprocessing as standard practice. Other organizations like InterVol are leveraging the additional social benefits made possible by recycling OR equipment. InterVol collects 8,000 pounds of reusable equipment from regional hospitals each week and ships the stock to clinics in over two dozen countries, including Somalia and Haiti.
