Sterilization of medical instruments has resumed in Hay River after concern arose about whether the process was being done properly.
On May 2, sterilization was halted – and only disposal instruments were used – and dental surgeries were cancelled at the Hay River Regional Health Centre until the process could be checked.
Dr. Andre Corriveau, the chief medical health officer for the NWT, said he gave the green light on May 10 for sterilization operations to resume.
“In terms of sterilization, people can be assured that things were working,” he said.
The concern was that a final biological indicator test – in which a small sample of bacteria in a tube is added to the sterilization equipment and then an incubator to see if the bacteria were killed – was not being done because the incubator was not working.
The Hay River Health and Social Services Authority obtained a loaner incubator from Stanton Territorial Hospital in Yellowknife and ran a test sterilization with the bacteria test included.
Corriveau said the bacteria were killed, which tells him the sterilization was being properly done.
“The final test told us that, when the machine says that it has done its cycle, it actually has killed the bacteria,” he said.
Corriveau noted he is “quite satisfied” the concern has been addressed.
The sterilization equipment is housed in the old H.H. Williams Memorial Hospital.
“The equipment looked like it was in good shape. It had been well maintained. It’s not old equipment,” said Corriveau. “It’s one of the reasons they didn’t buy new equipment for the new hospital.”
As for how long the defective incubator was not working, Corriveau said, “We were told it was almost two years. So it was quite some time.”
That situation raises a number of questions for Corriveau, who travelled to Hay River on May 5 with an infection control specialist.
“What kind of training are people receiving on an ongoing basis?” he said. “What’s the quality assurance oversight? How is it performed and how should it be performed? It’s not so much looking back, but it’s learning from what happened or what didn’t happen. It’s ensuring that these things don’t happen again.”
Corriveau said it is not completely clear why the sterilization process was not being done according to Canadian standards of verification.
The chief medical health officer is also puzzled that an accreditation process last year did not pick up the problem.
“So there was a glitch there, as well,” he said. “To me, it should have probably been picked up and it wasn’t.”
Corriveau has asked the Hay River Health and Social Services Authority for an external review that would take a broader look at more than just the sterilization equipment and how it’s working.
“I’m asking for an external person who’s not part of our system to come and look at the process, the management and the oversight that we offer so we can receive those recommendations from somebody who’s completely unbiased,” he said.
Mike Maher, the public administrator with the Hay River Health and Social Services Authority, said he is “very pleased” that the sterilization process has been confirmed to be working properly.
Like Corriveau, Maher said he is “very confident” no one was put in harm’s way.
“We have no reason to indicate that anything was actually malfunctioning,” he said of the sterilization equipment. “But that’s why you have the multiple steps to ensure quality care and skipping a step or forgetting that something’s broken, or whatever happened there, that’s not an excuse. We have to make sure the processes are in place, whether it’s another check or a double check or however that works that these things just don’t go missed for that length of time.”
Maher said he hadn’t heard that the biological testing wasn’t done for almost two years, as stated by Corriveau.
However, he noted the authority is doing an internal investigation and will be getting a third-party to look at the process
“So we’ll figure out where the problem was and take steps to ensure that nothing like this ever happens again,” he said.
Ten dental surgeries were cancelled in May. They will be made up in June.
Along with Hay River, sterilization of medical instruments takes place in Yellowknife, Inuvik and Fort Smith.
Health-care facilities in smaller communities use only disposal medical instruments.