AFTER THE UNIVERSITY of Washington Medical Center last month revealed a series of incidents in which doctors left surgical instruments inside patients in recent years, officials reassured the public that the UW's operating rooms were trustworthy.
Now Seattle Weekly has discovered a legal claim by a UW School of Medicine faculty member that says the medical center suffered from another instrument quality-control problem: a "high incidence" of contamination.
Arnold Benak, a UW medical technologist who worked with sterile equipment, made the claim while seeking damages for an infection he contracted during his own knee surgery at the hospital. The UW quietly settled his claim two years ago.
Benak says the UW labored under an outbreak of patient infections from 1994 to at least 1999 due to "sloppy procedures . . . tolerated" in the instrument room, which led to an investigation of possible staff negligence.
The probe was done "both internally and with outside investigators," Benak says without elaboration in a letter written by his attorney and presented to the UW as a settlement offer in 1999.
Questions about UW surgical-instrument procedures were raised anew recently when former patient Donald Church announced he had settled with the UW for $100,000 after doctors left a 13-inch flexible retractor in his abdomen in June 2000, requiring a second surgery.
To clear the air about similar incidents, UW officials admitted at a press conference last month that they had left a total of five large surgical instruments inside patients in the past five years.
Records obtained by Seattle Weekly turned up two more examples of "retained" instruments or material, including tubing left in a patient's scrotum (See "Forgetful Surgeons," Dec. 24, 2001).
UW medical director Erik Larson said the number of retained instruments was relatively low, and that "as one of the nation's top teaching hospitals and a public institution, we feel it is important to discuss these medical errors."
But the UW was staying mum about Benak's accusations, uncovered last week among state public records filed by claimants seeking redress for medical errors and malpractice. Such claims are routinely filed prior to instituting a lawsuit.
University officials would not deny nor comment on Benak's claims. But the school admits there has been a settlement.
"Legally," says medical center spokesperson L.G. Blanchard, "we cannot discuss this case."
Benak could not be reached for more comment. His Seattle attorney, David Richdale, said he also was bound by a legal gag order.
In 1999, Benak said, "We are uncertain at this point as to what corrective measures have been taken, but it is clear that UWMC has persistently and continuously failed to address and correct the sloppy procedures that have been tolerated over these many years."
He'd been unaware of just how widespread contamination problems were until he was infected, suffered additional arthritic complications, and then began to investigate on his own, Benak indicates.
He found that "examples of contaminated surgical instruments arriving in the operating room are abundant," and says the situation was "a disgrace to the UWMC and its physicians, who enjoy the highest level of reputation in the community."
For example, a surgical nurse rejected use of a power-drive instrument during his own treatment, Benak says, because it contained "schmutz" or residue left over from an operation on a different patient.
He later brought that danger to the attention of the operating-room director, he says, but was told if there was schmutz on the instrument, it was "sterile schmutz and presents no danger."
"This," says Benak, "is simply medically untrue." As a medical perfusionist—they operate heart-lung machines that take over for patients during surgery—he says he was well aware of the operating-room risks for disease and infections.
In his claim, Benak sought an "intentionally modest" $50,000 for pain and disability, and a guarantee that instrument-room procedures would be improved and administered by well-trained personnel. Both goals had to be met for an out-of-court settlement, he said.
According to several studies, as many as 3 million people contract hospital infections annually; up to 30 percent die from them.
Research assistance by John Hoff.