by Keerthi Kanubaddi Founder & CEO ReadySet Surgical
I was first educated about the importance of surgical sterility at 15 years old. I was shadowing an anesthesiologist in the OR and just before the procedure was to begin, I brushed up against a sterile mayo stand holding case critical instruments and implants. I had contaminated the field and everything had to be re-sterilized while the patient waited…. under anesthesia. It was a terrible feeling to know that I had caused the patient harm by delaying the procedure.

That experience taught me the critical importance of surgical sterilization and its potential impact on patient care. More than a decade later, I was privileged to earn a job in the healthcare field supporting a variety of Orthopedic, Neurosurgical and ENT procedures. As a Medical Device Rep, I received an extensive training on human anatomy, surgical treatment options and product specifications.

One area of training that received very little attention was the proper cleaning and sterilization of our instruments and implants, which in hindsight was a glaring outage. After all, wasn’t I supposed to be an expert on the full continuum of use for the devices I was representing?

This lack of training in product sterilization dovetails into a larger problem because Reps usually have little to no exposure to the workflow of a typical CS department. It is this lack awareness that often causes Reps to seemingly ignore department and facility policies related to the delivery, support, sterilization and pick-up of loaner equipment. In an effort to clear up some common misunderstandings between CS staff and Medical Device Reps, I wanted to share a few things you may not know about the Reps that support your facility:

  1. Good outcomes are good business. Reps want to do everything in their power to ensure that a procedure goes as smoothly as possible for the surgeon and patient. Good outcomes usually lead to additional business for the Rep. Educate your Reps on their importance in patient care and sterile processing workflow. Encourage Reps to undertake the CCSVP certification provided by IAHCSMM so that they can understand the time, energy and expense required to follow the Manufacturer’s Sterilization Guidelines for their products. It is equally important for the surgeon office and operating room staff to do their part to ensure that Reps know when and why their inventory is needed well in advance of the procedure.


  1. All Reps are not created equal. We’ve all seen the experienced veteran as well as the newbie assistant Rep show up in the CS department to drop off trays. Just as consistent patient outcomes are a hallmark of an effective hospital, the standards of your facility should not be subject to the varying degrees of professionalism or expertise within your Rep community. Make sure to collaborate with the good Reps and document and track the behavior of the bad ones. You’ll then be in a position to effectively partner with the OR to reduce problems caused by Reps.


  1. Inventory control is a problem for everyone. It is estimated that $5+ Billion is wasted annually in the vendor-managed surgical supply chain and is shared equally between hospitals and device manufacturers. In fact, it is not uncommon for a Rep to deliver hundreds of thousands of dollars of inventory for a single procedure (a single pedicle screw or screwdriver can cost in excess of $1,000). With such high stakes, it only makes sense that Reps are under constant pressure to manage field-based surgical inventory more effectively. Increasing transparency in the vendor-managed supply chain allows hospitals and manufacturers to establish a chain of custody for this expensive inventory and ensure that every patient gets exactly what they need when they need it. The best way to increase transparency is to facilitate collaboration by sharing procedural specifics between the surgeon, OR, CS, Rep and Device Manufacturer.

It is not uncommon for a Rep to spend 5-6 hours preparing and setting up for a single surgical procedure. If this preparation is coordinated effectively with the hospital staff, the likelihood of a positive patient outcome increases.

Hospitals should include their Reps in patient planning so that they can be held to the same standard as the internal team members when it comes to delivering the best possible patient care.