Could traces of an acid that a linen service used to clean operating room towels have discolored and damaged surgical instruments? That's what a hospital claims in a lawsuit.

St. Anthony's Medical Center in St. Louis is suing its laundry service, Atlanta-based National Service Industries, for $150,000 over damages to its surgical instruments allegedly caused by the acid. National Service Industries is disputing the link between the acid and the damage.

The damage occurred when the hospital's staff used OR towels cleaned by the linen service in sterilizing stainless steel surgical instruments and titanium implants. The towels were wrapped around the devices, which were then put through a steam autoclave. At the end of the process, the OR towels had crumbled and some of the medical instruments they were wrapped in were discolored and had to be discarded.

Very small amounts of fluorosilicic acid were used in National Service Industries' cleaning process. This substance is related to hydrofluoric acid, which is moderately corrosive to many metals and is used in etching. Stainless steel instruments have a thin layer of chromium oxide, which, when removed, exposes them to corrosion and puts their use for surgery into question.

National Service Industries asked the court to exclude testimony of St. Anthony's expert witness establishing the link. The court denied the request and ruled that the expert's link could be used as evidence in the case. St. Anthony's expert, Carolyn Otten of Chemir Analytical Services, said it could not be known for certain how the instruments were damaged, but by ruling out other causes, she concluded the damage appeared to come from the fluorosilicic acid, which was used in National Service Industries' cleaning process. While it was only a small amount of acid, and might be tolerable under normal circumstances, she surmised that the towels' prolonged exposure to it may have led to the damage.

National Service Industries disputed Ms. Otten's conclusion, alleging that she failed to consider other explanations for the damage. For example, the company said the expert witness did not perform any tests on the autoclave itself. However, the court noted that the company's own expert witness testified that Ms. Otten performed a "fairly thorough" investigation and decided against performing additional analyses.

On Oct. 3, the U.S. District Court for the Eastern District of Missouri denied National Service Industries request to dismiss the lawsuit, ruled that Ms. Otten's findings were admissible and ruled that the hospital could recover attorneys' fees if it won the case. V. Scott Williams, the attorney for St. Anthony's, declined to comment on the lawsuit. James M. Paul, the attorney for National Service Industries, could not be reached for comment.

Leigh Page