The Defense Health Agency is asking private companies whether they can take over sterilizing surgical tools for Brooke Army Medical Center, Wilford Hall and 19 other military hospitals, after years of contaminated instruments, canceled operations and understaffed sterile processing units disrupted care. The agency says it is not committing to outsource anything yet, but the request comes after a 41-day stretch in 2023 when at least 49 unusable surgical tool sets reached San Antonio operating rooms.
A Business-Case Study, Not a Contract
According to a request for information reviewed by govtribe.com, the Defense Health Agency is conducting a business-case analysis of alternatives to on-site surgical instrument sterilization across eight of its nine networks, including facilities like Walter Reed, Brooke Army Medical Center and Tripler Army Medical Center. As reported by the San Antonio Express-News, the Pentagon is seeking private-sector help sterilizing surgical tools after staffing and equipment issues limited the number of surgeries at some military hospitals. The RFI states plainly that it is a request for information only, not a commitment to issue a contract, and the Defense Health Agency has said it will not award a contract as part of the study itself.
Instead, the agency says it will use the responses to identify qualified, experienced and interested organizations that could provide off-site services in the future, and it has urged healthcare companies and hospitals offering off-site sterile processing to respond. Industry responses to the notice were due March 13, 2026, at 11 a.m. Central time. The RFI estimates a need to sterilize roughly 150,000 trays at each listed military treatment facility, while the Defense Health Agency separately estimates outside providers would handle about 12 types of surgical equipment and roughly 2,000 trays per hospital each month — figures that were not reconciled in the agency's own materials. The requested services would cover everything from transporting instruments between hospitals and off-site facilities to decontamination, assembly, sterilization and quality-control verification, with equipment ranging from minimally invasive surgical cases to power tools, arthroscopy instruments and shoulder-repair sets.
San Antoino Hospital's Repeated Breakdowns
Brooke Army Medical Center's sterile processing team, which cleans and sanitizes thousands of surgical tools every day with a staff of 70, has struggled with recurring failures for years. In the summer of 2023, sterile processing problems resulted in the delivery of at least 49 unusable sets to operating rooms over a 41-day span, according to the San Antonio Express-News. That same stretch saw more than two dozen surgeries canceled outright and at least four procedures delayed by anywhere from 90 minutes to four and a half hours. One patient, per the Express-News, was kept under general anesthesia for an extra three hours because of tool-related delays.
The problems were serious enough that all 19 of BAMC's orthopedic surgeons signed a 10-page memo warning hospital leaders of what they called unacceptable risk, describing contaminated, missing, incorrect and broken instruments reaching operating rooms. Hospital officials maintained they had not identified any surgical-site infections or patient illnesses linked to bioburden or hardware problems in orthopedic cases. BAMC surgeons also reported dozens of additional procedure delays and cancellations between mid-2023 and January 2024 tied to contaminated tools and improperly sealed sets, and the hospital stopped surgeries altogether for 10 days in January 2024, limiting operations through the following month. Hospital leaders cited staffing shortages, including in sterile processing, for the decrease. BAMC did not respond to questions about the current unit's condition, ongoing problems or existing outsourcing, the Express-News reported.
The stakes at BAMC are especially high because it operates the Army's sole Level 1 trauma center and the Defense Department's only burn treatment facility. This is not the hospital's first bout with sterilization trouble — similar problems surfaced in 2016 and again in 2017, when the Army Times reported the hospital shut more than half of its 28 operating rooms and curtailed elective surgeries due to a shortage of properly sterilized instruments, after inspectors found 73 cases of improperly sterilized tools in a single month, including 16 involving organic material like bone, skin fragments or blood left on surgical tools.
Walter Reed and Other Bases Hit Too
San Antonio is not the only post dealing with this. Walter Reed National Military Medical Center in Maryland experienced a steam leak in January 2025 that shut down its sterile processing unit for about two weeks, leaving nearly 270 patients with procedures that were deferred, rescheduled or sent elsewhere. The Defense Health Agency's own account, published by dha.mil, notes that Walter Reed also dealt with a major sprinkler pipe burst that released approximately 60,000 gallons of water into five connected buildings around the same period.
During the disruption, Walter Reed typically completes about 40 surgeries each day, but staffers estimated that number had fallen into the single digits, according to the Spokesman-Review. The hospital had to send instruments to regional hospitals to be sterilized, a process that could take up to two days to get equipment back, and officials expected appointments to be pushed back with non-emergency procedures canceled or delayed for weeks or longer. Naval hospitals in Guantanamo Bay, Cuba, and Bremerton, Washington, also experienced sterile processing issues over the prior year, per the Express-News account.
Why the Pentagon Says It Can't Wait
The RFI itself lays out the stakes bluntly: when sterile processing departments become unusable, operating room and clinic procedures decrease by more than 90%, essentially halting a military hospital's surgical capability. The Defense Health Agency's request warns that a cessation of surgical cases decreases provider readiness, risks citations against graduate medical education programs, and severely impacts healthcare delivery overall. A 2019 federal watchdog review found that officials at five of six selected military hospitals reported having to send patients outside the system for care due to workforce-related challenges, according to the Government Accountability Office, though that finding carries low confidence and predates the current review.
For now, the Defense Health Agency's outreach remains an information-gathering exercise rather than a decision. The agency has said any outside providers brought on in the future would supply transportation, staff, facilities, equipment and quality-control verification.
