Hospitals could save billions of dollars and tons of waste by reusing medical equipment, analysis shows.
- U.S. hospitals generate over four billion pounds of waste each year.
- Many types of medical equipment can be reused, from oxygen sensors to elastic bandages.
- Reusing equipment could reduce waste and save billions annually, research shows.
But much of this waste could be avoided, according to a new study, by cleaning, testing and re-sterilizing many types of medical equipment after first use, including elastic bandages, finger oxygen sensors and tourniquet cuffs "We estimate that reprocessing of open-but-never-used supplies alone can account for a one-billion-dollar savings in a system, not to mention the instruments that are used and are in perfect condition that can be reprocessed as well," he said. "There are billions of dollars of savings."
Certain health-care systems have already experienced over $1 million in savings over a single year, he said, by buying reprocessed equipment from companies approved by the FDA to collect items labeled by their original manufacturers as "single-use" and clean, test and resterilize them.
In 2008, according to Makary's study, one leading reprocessing service prevented 4.3 million pounds (2150 tons) of waste from reaching landfills, saving hospitals more than $138 million.
The reprocessing industry has been FDA-regulated since 2000.
"We have to prove to the FDA's satisfaction that our device will be as clean, as sterile and as functional as a new device," said Daniel Vukelich, president of the Association of Medical Device Reprocessors, an organization that represents the reprocessing industry, headquartered in Washington D.C.
"One thing that probably surprises patients is that they actually have a better track record when it comes to reprocessed devices than a new one," he said. "Devices tend to fail less when reprocessed because every product is individually tested."
The industry arose in the 1980s when medical device manufacturers started labeling many items that were once labeled reusable as single-use, Vukelich said. This may have been done for legal reasons or as a way to increase profits, Makary said.
Hospitals can reprocess items that are sold for multiple uses -- from gowns to surgical beds to scalpel handles and surgical clamps. But since the FDA regulations took effect, only licensed reprocessing companies can handle single-use devices -- even if they are unused.
Hospitals can buy these reprocessed items for an average of half what it costs to buy them new.
Only certain items are eligible for reprocessing. Perhaps the two most common items are the blood oxygen sensors that wrap around a finger or toe, and compression stockings used during surgery that periodically fill with air to promote circulation in the legs and prevent blood clots while the patient is lying flat.
Other commonly reprocessed items are drills, saw blades, gowns, scalpel handles, and surgery clamps. Because these items are labeled as reusable, hospitals can clean and sterilize them onsite.
Knife blades, or permanent medical implants like knee replacements, pacemakers, or cataract lenses -- things for which a failure or malfunction would cause patient harm -- are never reused.
So far, about 25 percent of U.S. hospitals are buying reprocessed equipment, according to Makary's study, published in the journal Academic Medicine.
"The places that have tried it, like it," said Makary, who has no financial ties to the industry. "It is simply a matter of health care institutions not being familiar with this service."
"After over a decade, there have been no patient safety concerns," he added.
Others agreed: "Separate certified reprocessing stations or companies that pass very rigorous FDA standards -- their stuff is as good as new," said T. Forscht Dagi of the Harvard-MIT Division of Health Sciences and Technology and head of an American College of Surgeons committee dealing with patient safety and well-being during surgery. "The FDA reprocessing companies do a very, very good job. No question."
Noone from AdvaMed, the industry organization that represents medical device manufacturers, was available to discuss reprocessing with Discovery News. However, they have posted several statements and press releases about reprocessing on their Web site.
Their 2004 position statement on reprocessing says that single use products were not designed for reuse and that it may not be possible to thoroughly clean these products or for these products to withstand the harsh conditions of reprocessing.