HCA Florida North Florida Hospital in Gainesville could use some good news. It may have it in an encouraging report from state investigators, even as the hospital operates at reduced capacity due to a crisis involving improperly sterilized surgical instruments.  

Inspectors for Florida’s Agency for Health Care Administration (AHCA) visited North Florida Hospital on Feb. 6, three weeks into a surgical shutdown that began on Jan. 17.  

AHCA, which investigates healthcare facilities on behalf of the federal government’s Center for Medicare and Medicaid Services (CMS), posted a two-word “inspection status” on its website Thursday: “No deficiencies.”  

Mainstreet has been unable to access two, one-page investigative summaries through links at AHCA’s website. The links returned an “error” message Wednesday, then a scripted message Thursday through Saturday. 

“The requested document is not available for online viewing at this time,” the website said.  AHCA’s communications office acknowledged the website issues but did not respond to requests for help accessing the reports online or through email. 

Fresh Take Florida, a news service of the University of Florida’s College of Journalism and Communications, first reported the surgical meltdown on Jan. 18. On Feb. 19, Mainstreet reported that surgeons had complained for at least a year about instruments arriving in operating rooms with blood, tissue and other matter—which hospital staff called “bio-burden”—clinging to instruments.  

The instrument issues came to a head during a period when North Florida Hospital was without a chief operating officer. In December, COO John Gerhold accepted a promotion to lead an HCA Healthcare hospital near Orlando. On Thursday, North Florida Hospital CEO Eric Lawson announced internally that Gerhold’s replacement, Mark Amox, an administrator at a hospital in Searcy, Arkansas, would start work on March 11.  

Amox previously held posts at other HCA Healthcare-owned facilities. In a statement Friday afternoon, North Florida Hospital spokesperson Lauren Lettelier said that the hospital is excited about Amox’s impending arrival as COO and confirmed that Gerhold left in early December. 

The hospital removed its vice president for surgical services, Patty Gursky, on Feb. 12, amid the fallout from the shutdown and the hospital’s ongoing recovery efforts. The hospital had hired Gursky late last summer, and, according to a source in a position to know, she assessed the hospital’s Sterile Processing Department (SPD) and made recommendations for improvement.  

When reached by phone and email, Gursky would not comment on the record regarding circumstances surrounding her removal. The hospital has also declined to comment. Two surgeons told Mainstreet they believe Gursky was made the “scapegoat” for the surgeries debacle. 

The hospital fired other employees connected to the SPD, according to three sources who spoke to Fresh Take Florida on the condition of anonymity. The hospital also began administering a “no strikes” rule, firing employees immediately for lapses involving contaminated surgical equipment, employees said. 

In an internal message addressed to “Dear Colleagues” on Tuesday, CEO Lawson said the hospital was “nearing 100 percent capacity for the scheduling of elective surgeries.” He provided no target date for completion.  

A hospital spokeswoman published Lawson’s message and the separate announcement about the new chief operating officer on a private, internal messaging board for hospital employees, which were obtained by a reporter. 

North Florida Hospital—previously known as North Florida Regional Medical Center—is one of the largest hospitals in Florida with 510 beds and 15 operating rooms. It treats more than 50,000 patients each year and has more than 1,000 employees. 

Mainstreet has obtained numerous internal hospital communications detailing a “blitz” response to the problem of dirty surgical instruments. It was launched after an early morning meeting on Jan. 10, when “more than 50” doctors expressed “disgust” over the administration’s failure to effectively respond to a “festering” issue they had repeatedly complained about for “upwards of two years.” 

In a Jan. 12 message to surgeons, the hospital’s chief medical officer, Dr. Sherrie Somers—who took her post in August—was contrite in acknowledging unfulfilled promises of improvement for “6-12 months.”   

The hospital called in the cavalry, enlisting the aid of the Steris Corporation, a federally approved “disaster response” contractor that brought a convoy of trucks to the back parking lot. Steris technicians worked to process “a lot, probably thousands” of surgical instruments that had “pock marks, scrapes” or other physical flaws. They also trained North Florida’s SPD staff, according to Somers.  

Internal emails show the sterilization problems were worse than leadership knew.  

“We discovered additional layers of vulnerability and have worked diligently to change our processes,” Somers wrote to “Surgical Colleagues” in a “high priority” email on Sunday, Jan. 14. Among the discoveries: “Rusted instruments were more severe than anticipated.” 

Doctors and staff told Mainstreet that a “temporary” surgical processing facility was constructed “almost overnight” outside near the emergency room, where staff could clean instruments while the main SPD was “totally ripped out and redone.” 

Surgeons and patients have shared stories of hardship caused by the surgical disruption.  One patient languished in “excruciating” pain for three weeks before her arm and shoulder—broken in multiple places—were reconstructed at another hospital 48 miles away. Doctors took a “huge hit” from revenues lost while operating rooms remained dark.   

The hospital and its parent, HCA Healthcare, Inc., have released no details in response to repeated inquiries. Mainstreet’s reporting has been based on internal hospital documents and input from surgeons, patients, hospital staff, medical practice staff and others – most of whom have spoken on condition of anonymity, for fear of reprisals. 

HCA Healthcare is the nation’s largest, for-profit hospital chain. It has steadfastly denied published allegations of prioritizing profit over patient care. 

Editor’s note: This reporting is part of a joint investigation between Mainstreet Daily News and Fresh Take Florida, a news service operated by the University of Florida College of Journalism and Communications. Fresh Take Florida reporters Valentina Sandoval and Jared Teitel contributed to this story. 

If you or someone you know has been impacted by, or has information about, the surgical shutdown at HCA Florida North Florida Hospital, please email editor@mainstreetdailynews.com or call 352-313-3192.