Whether it's a simple scale, a scope or an autoclave, every physician's office has equipment that needs maintenance, calibration and occasional repair.
"State code requires that any medical equipment that is portable -- meaning it can be unplugged and moved -- be checked annually to assure safety and that a performance verification be completed," said Rich Godwin, owner of Med Tech Biomedical Services.
The Alabama Department of Public Health performs inspections to make sure practices are following code. "However, since there are a limited number of inspectors, they mostly go to the hospitals and surgery centers, and they generally only go to a doctor's office if there has been a problem," Godwin said.
Nonetheless, medical equipment technicians warn against waiting for a problem or an inspection to have equipment serviced.
"Once you have an incident, it's too late," said Todd Fentress, co-owner of Medical Incorporated Equipment Service and Repair. "We've been deposed as industry experts many times. If a doctor can't provide documentation that equipment has been maintained according to manufacturer specifications, he can be held liable. We've seen hospitals that didn't have to write a lawsuit check because they had maintenance documentation."
Mitchell Sargent, Mohs Technician for Ginsburg Dermatology Center, is responsible for maintaining equipment in their lab, which includes documenting the maintenance daily. "My goal is to be as compliant as possible," he said. "The number of clipboards and charts and logs for quality control is daunting. If an inspector were to walk in the door, I'd want them to notice the faint smell of bleach in the air, from wiping down the equipment with bleach wipes. I try to keep the lab organized and maintained above and beyond what they expect.
"I don't want our equipment to slip into disrepair because I'm concerned about my safety, my coworkers' safety and the welfare of the patient. It's too important not to address on a daily basis."
Despite the most diligent maintenance schedule, however, equipment will, sooner or later, break down. That's when an outside service is needed. "Equipment fails," Fentress said. "Cars break down and we have wrecks. But if you can produce documentation that equipment was maintained to manufacturer recommendations, you will have a better time with your insurance company."
"A service contract doesn't mean they won't have a problem," Godwin said. "But saying you don't need it because you've never been inspected is like saying you don't need auto insurance because you never had a wreck. It's cheaper to pay for it up front rather than after you have a problem."
Professional maintenance services offer one-time repairs on a particular piece of equipment as well as regularly scheduled maintenance check-ups for an entire practice. "Once a practice reaches out to us, we come in and check their equipment and educate them," Fentress said. "We verify that the equipment is working, and then we calibrate it and repair it, if necessary. A scale is the simplest piece of equipment. We bring in 500 to 600 pound weights and prove it is weighing what it is supposed to weigh. And we'll check equipment right up to x-ray and anesthesia machines."
It is no small task to keep up to date on the breadth of equipment by various manufacturers and the many maintenance regulations.
"There are hundreds of modalities of equipment. It's like trying to nail down jello," Fentress said. "Healthcare practice managers have to be on top of a moving target."
"No one person can know it all," Godwin said. "This is a learning process every day. I'm qualified to talk to people who do know and to convey the answers to the parties who need my help."
"It's our job to know what is required for whom," Fentress said. "We do a risk assessment for a practice based on the type of equipment and its use. An ultrasound in an operating room is used more and should be checked more often than one in an ob/gyn office, for instance. A defibrillator is a life saving device, and the manufacturer recommends that it be checked quarterly. A scale only needs to be checked annually, because you aren't going to die if it's off. Physicians don't have time to keep up with all these regulations. They need to let us be the equipment professionals so they can take care of patients."