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Here’s what to do if you’re worried about improperly cleaned equipment at the doctor’s office
Posted: April 14, 2025
(April 11, 2025) By: Serena Austin, The Toronto Star
It was a shock to thousands of Dr. Esther Park’s current and former patients to receive a letter from Toronto Public Health urging them to get tested for HIV, hepatitis B or hepatitis C due to improperly cleaned equipment used at the gynecologist’s office.
The letters said TPH’s investigation had to do with the “reprocessing” of some medical instruments used in procedures such as cervical growth removal, uterine biopsies and IUD insertion and removals between Oct. 10, 2020, and Oct. 10, 2024.
So far, TPH says it has not received notice of anyone testing positive for any of the viruses it was concerned about, but the news left questions about what the cleaning process looks like, how patients can tell it’s been done properly and what to do if they feel it hasn’t. (Park didn’t respond to previous attempts by the Star to contact her.)
Here’s what you need to know.
What is reprocessing?
The term reprocessing refers to the “cleaning, disinfection and sterilization of reusable medical equipment/devices in health care and personal service settings,” which contributes to reducing the spread of bacterial infections, according to Public Health Ontario.
There are six steps in the process, including precleaning; disassembly and soaking; cleaning; rinsing and drying; high-level disinfection or steam sterilization; and storage. Disinfection or sterilization must be documented once complete.
In the case of Park’s clinic, Dr. Herveen Sachdeva, TPH’s associate medical officer of health, told the Star the agency’s main concern was that “medical instruments (like speculums) were not disassembled prior to cleaning and disinfection.” There was also “significant overdiluting of the disinfecting solution the instruments were soaked in,” she said.
What are the signs to look for?
Elisabeth Boulanger is a midwife practising out of a clinic in Hamilton who has taken a reprocessing techniques course offered by the Medical Device Reprocessing Association of Ontario.
She recognizes the challenge for the average person in identifying signs that medical instruments have or have not been properly reprocessed. But she said patients should feel comfortable asking their doctors about what their cleaning process looks like, who in the office is involved and where it’s done.
Medical instruments get repackaged before being sterilized, so seeing a doctor opening up the packaging before a procedure can be a reassuring sign, said Boulanger. For some instruments, like speculums, it’s not uncommon to use plastic, disposable versions, to save time by avoiding having to reprocess them multiple times a day.
Public Health Ontario’s best practices for cleaning, disinfection and sterilization of medical equipment/devices in all health-care settings say there must be “clear separations” between “clean” work areas and areas where dirty equipment will be cleaned and decontaminated.
After Boulanger took the reprocessing course, her clinic began reprocessing instruments in a room with a “one-way work flow, meaning dirty stuff comes in at one end, gets processed and then it’s all clean at the other end of the room,” she explained. “You don’t want to be going back and forth between clean and dirty.”
How can I file a complaint?
The College of Physicians and Surgeons of Ontario deals with complaints regarding inadequate clinical care or treatment, poor or unprofessional conduct and sexual abuse and inappropriate conduct. Complaint forms are available on the college’s webpage. And while the college works with public health agencies when it comes to infection and prevention control, it does not handle complaints regarding that subject or other public health measures.
Instead, complaints of that nature should be made directly to the local public health department. It was a complaint from a member of the public that sparked TPH to launch its investigation at Park’s clinic last fall.
“People are reticent to make complaints about doctors,” said Natalie Mehra, executive director of the Ontario Health Coalition, an advocacy group focused on protecting public health care. “It’s a problem and the power imbalance is huge.
“But this is your health and it’s everyone else’s health. It’s good to speak up.”
If you have a public health concern about infection prevention and control in Toronto, you can file a complaint by calling TPH at 416-338-7600, or by emailing publichealth@toronto.ca.
