Doctors cite dirty tools

Doctors at Auckland City Hospital have found pieces of human flesh on instruments cleaned by the new $10 million sterile supply service.

More than a year after New Zealand's most advanced hospital opened, doctors reaching for their surgical instruments are sometimes finding them dirty or missing.

And problems with the sterile supply service at the hospital and the Greenlane Clinical Centre, along with staff shortages, have contributed to less heart surgery being performed.

From the day the hospital opened in October last year, doctors have reported problems with the supply service.

Hospital managers say that problems are being ironed out, and that even though a few instruments get through the best cleaning systems with human debris stuck to them, the debris is sterile.

Doctors spoken to by the Herald told of surgical instruments having pieces of flesh on them.

Sometimes tubes were blocked by blood, or instruments were missing, which delayed operations while fresh equipment was sought.

The same problems are reported from National Women's, which shifted in two months ago, in relation to special scissors and forceps.

Hospital general manager Nigel Murray said infection rates had not increased.

"We've been studying it carefully. We confirmed the infection rate has not worsened since the arrival here."

The rate had initially increased slightly in heart surgery, but had since returned to the pre-shift rate.

The temporary increase was thought to be due to the cardiac surgery service at first treating only acute patients, who were more susceptible to infection.

Dr Murray said the new hospital's infection rate was lower than the combined rate of its three predecessor hospitals.

He said the hospital was catching up on heart surgery, but waiting times were still too long.

Health Ministry figures show that in September, nearly 20 per cent of the hospital's cardiothoracic patients judged sick enough for elective surgery had waited longer than the benchmark six months for treatment - compared with 13 per cent nationally in August.

Dr Murray said his hospital was flying locum heart surgeons from Australia to fill gaps and paying for 40 heart operations - plus about 20 hip replacements - at the private MercyAscot hospital.

Despite fewer-than-planned patients being treated in some areas, this was almost balanced by surpluses in other specialties.

He said the sterile supply service had been subjected to several reviews.

"We've got a new manager who has run sterile supply departments in Holland for a whole metropolitan area.

"It's not unusual to centralise sterile supply for a whole city. All we've done is centralise for Auckland City Hospital."

The $500 million redevelopment saw the Grafton hospital progressively take the in-patient services of the Auckland, Green Lane and National Women's hospitals.

Dr Murray said that despite the problems, the integrated hospital was saving lives. He cited the survival of a child suffering severe chest trauma who probably would have died previously. The paediatric cardiac team, formerly located at the old Green Lane Hospital, was able to start surgery quickly.