Parkland Memorial Hospital sent letters to dozens of women last year to let them know they may have been treated with instruments that were not properly sterilized, according to a newspaper report.
The U.S. Centers for Medicare & Medicaid Services has threatened to eliminate Parkland's Medicare funding after inspectors this summer found infection-control breakdowns, but the letters to obstetrical and gynecological patients were not part of those findings.
Those alerts were revealed after The Dallas Morning News obtained records through the Texas Public Information Act. All patient-identifying information was redacted.
Parkland officials said that 73 women were told last year that they might have come into contact with dirty instruments.
The hospital said in a statement to the newspaper that all of the women were contacted by phone or mail, and most returned for testing and preventive therapy such as vaccines.
The statement said that there were "no medical complications for women who chose follow up care," but added that one clinic patient "had an inconclusive lab result after the full course of follow up" and did not return for further evaluation.
A March 2010 letter to clinic patients said, "We would like to let you know that you may have been exposed to a speculum" -- a vaginal examination instrument -- "that may not have been properly sterilized." Although the infection risk was very low, the letter added, "we would like to evaluate you in our OB/Gyn Intermediate Care Center as soon as possible to offer you preventive medications."
Two days later, another letter told clinic patients they needed to also alert them to the possibility of infecting a sexual partner. "We would recommend that you abstain from sexual intercourse or use condoms until notified of negative results after your six month follow up," the letter said.
A third letter soon went out to a different group of women that warned of another possible failure to sterilize instruments. This time the problem had occurred in Parkland's labor and delivery department, one of the nation's busiest.
Parkland blamed the failures on two different issues.
At the clinic, "instruments were picked up from the processing area before proper cleaning," the hospital statement said. "An employee self-reported the issue."
In the labor and delivery department, the problem was described as an equipment failure which made it impossible to verify whether sterilization was complete.
The Texas Department of State Health Services, which conducted the recent inspection for CMS that has jeopardized Parkland's federal funding, said it heard about the hospital's obstetrics and gynecology problems last year but did not investigate.
"This type of situation does not have to be reported to us," department spokeswoman Carrie Williams said in an email to the newspaper. "However, if it is determined that disease transmission actually occurred or a cluster of infections were discovered as a result, that would have to be reported."
In the government's recent inspection of Parkland, regulators identified other delivery-room problems.
"The facility did not ensure instruments to be sterilized were arranged so all surfaces would be directly exposed to the sterilizing agent," according to the inspectors' report. All the clamps and scissors used during childbirth "had been sterilized with their tips in the `closed' position."
In its plan to address the problems cited by government inspectors, Parkland said it began taking corrective action as soon as it was made aware.