DMC Children’s Hospital of Michigan passed its early April inspection, federal officials said Tuesday — bringing all Detroit Medical System hospitals into compliance for the first time since September, when investigations began into dirty surgical instruments at the health system’s Midtown hospitals.
Probes were launched by the Michigan Department of Licensing and Regulatory Affairs (LARA) and the federal Centers for Medicare and Medicaid Services in response to a six-month Detroit News investigation, published in late August, that uncovered a nearly decade-old problem with dirty, broken and missing surgical instruments that delayed and canceled surgeries and put patients at risk.
Children’s, Harper University and Detroit Receiving hospitals all failed inspections, but have returned to good standing following massive reforms by the health system. Children’s, which failed an inspection in January, passed a follow-up survey conducted April 3 and 4. Harper and Receiving passed inspections in December and January.
“The revisit survey revealed that your hospital is now in compliance with the Conditions of Participation,” CMS wrote to Children’s Hospital officials in a letter forwarded to The News. “Therefore, we are rescinding our decision to terminate your participation in the Medicare program.”
Inspectors did not file an inspection report from the follow-up April visits to Children’s because no violations were cited, according to CMS.
In an email statement sent Tuesday to the News, DMC officials said: “The safety and well-being of our patients is our top priority and we remain committed to sustaining all improvements we have made regarding the processing of sterile instruments.”
The health system said it has invested at least $1.2 million since September to correct the problems. In addition, DMC said it has hired an outside firm to manage its instrument-cleaning department, reworked how the surgical instruments are cleaned and beefed up employee training and discipline.
The problems stemmed from a central sterile processing department, located in the basement of Detroit Receiving, which cleans, packages and delivers surgical instruments for Children’s, Harper, Receiving, Hutzel Women’s and DMC Heart hospitals, as well as for Karmanos Cancer Center.
Children’s, Harper and Receiving all stood to lose federal Medicare and Medicaid funding if the problems had not been fixed. Upon passage of the follow-up inspections, CMS has rescinded proceedings to terminate federal funding.
The Karmanos Cancer Center, which is not part of the DMC but uses the health system’s operating rooms, had also failed an inspection in January but passed a follow-up inspection in late March.
The hospitals were inspected again in January after The News reported that a patient was exposed to a dirty instrument during a surgery at Children’s one day after it was announced the hospitals had passed their December inspections. Inspectors determined at that time that Harper and Receiving were in “substantial compliance” with federal certification requirements.
A DMC official said the majority of the issues cited by inspectors in January were related to changes in the health system’s cleaning process that caused staining of some instruments, but those issues have been resolved and no patients were impacted.
“We’ve worked with the surveyors who were on site ... and have addressed their concerns,” the official said. “We have reorganized our operations extensively. ... Our CSP (Central Sterile Processing) team is engaged and supportive.”