Dozens of people waiting for hip and knee replacements face delays to their treatment because surgical instruments arriving from a central decontamination unit were not safe to be used.
Some 50 patients due to undergo elective orthopaedic surgery at Gartnavel Hospital in Glasgow were informed operations would not go ahead, but they were not told delays were down to faulty or potentially unhygienic tools.
Medics said they have been complaining for years about the standard of service from the central decontamination unit, that also serves Glasgow's Royal Hospital for Sick Children, Western Infirmary, Southern General, Victoria Infirmary, Stobhill Hospital and Royal Infirmary.
The latest equipment issues left orthopaedic surgeons unable to operate for a week because the instruments being delivered to theatre were either damaged or the paper wrappers they came in were ripped – meaning there was no guarantee they were sterile.
Dr Jean Turner, executive director of the Scotland Patients Association, said the situation was "appalling".
Surgical equipment is prepared at NHS Greater Glasgow and Clyde's central decontamination facility in Cowlairs, to the north-east of the city, and dispatched to all hospitals within the Yorkhill, North and South divisions.
One doctor told The Herald: "There is regular damage to surgical instruments, very poor turnaround times, instruments placed in wrong trays, difficulty with retention of staff, the sterile paper wrappers are not infrequently torn and so the instruments' sterility cannot be assured and the instruments cannot be used.
"It is not uncommon with some specialities to have to open three sets of equipment to get an operation done, as items are missing, broken or similar but from a different and incompatible manufacturer. We have endless meetings and there seems to be no improvement over several years."
The medic said patients undergoing joint replacements were particularly vulnerable to infection.
He added: "It must be having a huge impact on achieving the waiting-list targets. The equipment issues affect all branches of surgery [but] in orthopaedics, a huge portion of the work is joint replacement. If you get infection with any form of prosthesis it is catastrophic. It is not treatable with antibiotics and the joint needs to be removed. If you get soft tissue infections they may be treatable with antibiotics and is less serious an issue for other surgeons."
A spokeswoman for Greater Glasgow and Clyde NHS said steps were being taken to rearrange alternative surgery dates for the patients affected. She added improvements had now been made at Cowlairs following concerns and added safeguards were in place.
The Cowlairs unit, which is one of the largest in the UK, is leased by the health board for £108,000 a year on a minimum 23-year contract.
It began operating in 2005 after the city's previous six, smaller decontamination centres were merged to create a pan-Glasgow service as part of an upgrade intended to bring NHS Greater Glasgow and Clyde into line with new national technical and quality standards recommended by the Medicines and Healthcare Products Regulatory Agency.
Patients' champion Dr Turner said: "It is unforgivable that management haven't acted to address this before, if doctors have been raising concerns. Why are they not listening to their doctors? We know they are terrified to speak out because any time a doctor raises his or her head above the parapet management don't like it, which is why we are having a conference on whistleblowing in June.
"Centralising always seems like a good idea until it goes wrong. How is this saving money and what is the impact on waiting times? It's an absolute scandal that anyone should have an operation postponed because of dodgy equipment."
A spokeswoman for NHS Greater Glasgow and Clyde said: "Planned orthopaedic surgery at Gartnavel General Hospital has resumed on a phased basis following the temporary postponement of operations due to availability of theatre instrumentation.
"The decision was taken to suspend planned orthopaedic surgery during February due to various concerns regarding the quality and quantity of theatre instrumentation being made available.
"These issues were identified through our strict procedures of checking all equipment prior to use.
"We have reviewed the processes at our off-site decontamination unit at Cowlairs and are confident that procedures have been put in place to address the issues identified.
"An on-going enhanced quality assurance process has also been implemented to maintain the improvements.
"We have apologised to the patients affected and are currently making alternative arrangements for them to have their planned surgery."