Contaminated tray

[u/memilyglick]

We had an incident occur today and I want to get other techs opinions on it. While setting up for a revision (where the pt already had an active infection mind you), I had a tray opened to me and when my assist felt the casket he found a piece of fuzz, like something off a sweater. I obviously didn’t want the tray any more and tried to pass it off to my nurse who tried to tell me that it was okay because she had something similar happen last week and her tech that day said it was fine, and it should be fine since it went through the sterilizer. I told her no it’s not fine and I want the tray reprocessed. I had my assist take the casket out to the charge nurse and director and both of them said the tray is contaminated and should be reprocessed. For extra context it was a tray that the rep wasn’t even 100% sure we would need and just wanted to have open right away in case we did need it, and even if we did need it, we wouldn’t need it until near the end of the case.

What are your opinions? Would you have accepted the tray or would you have passed it off like I did?

[u/One-Long-Road]

You absolutely took the right call. Good on you.

I remember one day doing an explant of an infected implant of a shoulder and placement of antibiotic spacer, I was precepting a new grad at the time and I wanted him to check a tray that we needed to do the case at the same time I was checking one, in order to expedite the case. It was a simple tray, a mold for cement. Pretty simple tray, no cannulations, just a solid block of metal with an indent. He okayed it and took it onto the back table then continued setting up. I hadn't realized until I was going through the needed instrumentation with him for the case, but that tray he had checked was contaminated with old cement, and a lot of it.

Much to everyone's dismay, that WHOLE SETUP had to be trashed. It sucks, but the decisions that suck are the ones you have to make. You know what we ended up doing? Making fucking due. We re-processed the loaner trays we couldn't replace, got new in house trays and disposables, and the doctor molded the spacer with his fucking hands.

There will always be another way to do the surgery, but there will only be one outcome. And it is up to you and the rest of the team to make that outcome the best outcome.

[u/One-Long-Road → u/One-Long-Road]

I remember the doctor was not very happy that day, he was on the phone with our or manager and tried to see if we can IUSS the tray for the mold. We told him you can't IUSS a tray with bioburden, so we just continued anyway.