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The Midtown hospitals of the Detroit Medical Center have struggled for years to properly clean surgical instruments, stoking doctors’ fears about patient safety, a Detroit News investigation has found. The News has obtained more than 200 pages of internal emails and reports indicating that surgeons and staffers have complained for at least 11 years about improperly cleaned, broken and missing instruments. The complaints have continued under the tenure of the for-profit Tenet Healthcare of Dallas, Texas, which acquired the DMC in 2013, the documents show. (Bouffard and Kurth, 8/26)

No state requires that hospitals report exposures to dirty instruments, which may or may not lead to infection. As a result, it can be difficult to track whether patients become sick or die as a result. State reporting requirements, if they exist, typically are based on the National Quality Forum’s list of reportable events. That list includes contamination by drugs, devices or biologics, but only if the exposure results in serious injury or death. “It’s a resource issue and it’s also a politically tense issue,” said Jill Rosenthal, senior program director at the National Academy for State Health Policy. (Bouffard and Kurth, 8/25)