TRAVERSE CITY – Munson Healthcare was on the receiving end of a second labor-related lawsuit in 2021.
Elizabet Alderman, a surgical technician at Munson Medical Center, accused hospital officials of terminating her employment unjustly after she blew the whistle on unsafe sterilization practices occurring in the operating room, according to the complaint. In response, the hospital has said that its sterilization practices aren’t illegal and requested the complaint to be dismissed outright.
The firing occurred in March of 2020, just a few days before the World Health Organization declared the coronavirus to be a global pandemic. Alderman filed suit in late October of 2021.
Alderman’s lawsuit says Munson changed protocols around the sterilization of surgical instruments in November 2017.
In a meeting, Alderman learned that the hospital would no longer use certain indicators that show whether an instrument has been sterilized, after which many employees expressed “significant concern” according to the complaint. The complaint states that the reason for the switch was “a lack of proper staffing in the central processing department.”
Following the announcement, Alderman refused to take part in surgeries where chemical indicators didn’t show that the tools had been sterilized, according to the lawsuit. In one instance, after being handed a tray with a laparoscope that lacked such an indicator, she asked her manager: “Would you want this to be used on your child?”
Alderman then refused to use the laparoscope and would repeatedly request new trays with proper chemical indicators in surgeries to come over the next year – a decision which she said led to her first disciplinary actions as an employee and the beginning of routine harassment from management.
“Elizabet was asked to do a procedure that she felt was unsafe to the patients. She complained about it and they almost immediately started treating her differently,” said Joseph X. Michaels, Alderman’s attorney.
On March 12, 2020, she was fired for “intentional insubordination” after applying to perform clinicals as a surgical first assistant.
“Ultimately they fired her for not dropping the issue,” said Michaels.
Reached for comment, Dale Killingbeck, a spokesperson for Munson Medical Center, said it was the hospital’s policy not to comment on employment matters or on pending litigation.
The hospital filed a motion to dismiss the suit. Lawyers for Munson wrote that Alderman’s claim failed to indicate that the new sterilization protocols broke any laws, and that Alderman “began to impose her own sterilization standards for acceptance of sterilized surgical instruments.”
Sterilization of reusable surgical tools is a critical protocol for preventing infection. Hospitals typically send contaminated instruments to a “central processing department”, where trays of tools are bathed in hot steam ovens. Chemical indicators — strips which change color when sterilization parameters have been met — allow employees to know if a set of tools is ready to be reused, or if a set of tools should be re-sterilized.
Guidelines from the CDC recommend that hospitals use both chemical and biological indicators, with biological indicators being the more accurate of the two. The guidelines identify chemical indicators as one of five parameters that should be assessed by an infection control professional.
In a newsletter from November 2017, Munson’s Operating Room Educator sent a newsletter addressing questions about the decision to drop the infection control parameter. The newsletter references standards from the American Association of Medical Instruments (AAMI), a nonprofit that sets national standards for the medical device industry.
“According to AAMI standards, a chemical indicator does not measure sterility but does measure that parameters of a load have been met,” the newsletter states. “Therefore, if your processed load is missing an indicator and CPD can verify that the parameters of the load were met, it is acceptable to use the instrument.”{p dir=”ltr”}A spokesperson for AAMI, Brian Stallard, said that the organization revised some of its standards in 2017. Stallard shared the latest standards, which continue to recommend chemical indicators.{p dir=”ltr”}“Every sterilization load should be monitored with a physical monitor and a chemical indicator monitor,” state the guidelines. “Releasing sterilized devices on the basis of all quality control measures is critical in providing safe and effective products for patient care.”{p dir=”ltr”}In some instances, federal regulators adopt guidelines produced by AAMI. However, the guidelines remain voluntary, Stellard said.
Tracking infections within hospitals – known as Healthcare Acquired Infections (HAI) – is a critical metric for hospitals that receive money from the federal government. HAIs are both deadly and preventable, which is why the CDC tracks how many occur in each hospital every year.
Since the implementation of Obamacare, the federal government has cut payments to hospitals that show high numbers of infection or patient injury. Data collected by Kaiser Health News show that Munson Medical Center has only once been financially penalized in that metric, which occurred in 2017.
The Record-Eagle reported on the announcement of those penalties in 2016. At the time, then-Communications Director Dianne Michalek said that “every single hospital-acquired condition has a team of people that look at it and try to eliminate it in the future.”
Infection data from 2020 – the most recent year for which data is available – show that Munson Medical Center was in line with national benchmarks on infection control.
Other hospitals run by Munson Healthcare, including facilities run in Grayling and in Manistee, were penalized in 2021. Munson’s Manistee location was most recently penalized in 2022.
Alderman’s lawsuit requests $25,000 in damages, as well as that she be reinstated as a hospital employee. The case is being tried in the 13th Circuit Court and is being heard by Judge Thomas Power.
