A practical, field-tested checklist for hospitals ordering STERIS ETO sterilizers, energy devices, surgical staplers, fluoroscopy systems, and other O.R. equipment under a deadline.

I coordinate emergency equipment replacements for hospitals. That's not a 'strategic sourcing' title—it means when a device goes down on a Thursday and the O.R. has a full slate Monday, I'm the one who figures out how to bridge the gap. In five years, I've handled more than 60 rush orders: STERIS ETO sterilizers, surgical tables, washer disinfectors, parts ordered through the STERIS Shop, and one memorable week when a fluoroscopy system replacement landed in the same cycle as a new energy device in surgery.

I've made enough mistakes to know the difference between a fast order and a correct fast order. This checklist is the one I wish someone had given me before the first time I heard the phrase 'we didn't check the door dimensions.'

When to use this checklist

Use this when your situation fits one of these:

• The repair estimate on your existing equipment is over half the cost of a replacement, and the timeline is shorter than a capital project.
• You're ordering from the STERIS Shop or a distributor and need to avoid an availability surprise.
• You're about to approve a rush order for a fluoroscopy system, surgical stapler, or energy device in surgery that's tied to a scheduled case.
• You're in a phase where the building blocks still work—not a new build, not a full O.R. redesign.

Step 1: Define what 'emergency' actually means

This sounds like a meeting question, but it's not. Ask the team: is this a capacity problem or a capability problem? If your only issue is that the current washer-disinfector is down for a repair that will take three weeks, you might be able to rent a temporary device. If the team needs a different cycle chemistry or a larger chamber, a rental won't help.

For a fluoroscopy system, the difference matters even more. A tube failure with unacceptable image quality is a replacement. 'We'd like to do more hybrid cases' is a project. Treating a project like a replacement is how you end up buying a machine that doesn't fit the O.R. workflow and then paying rush freight for the privilege.

Step 2: List every constraint before you call—or click

Before you open the STERIS Shop or ask a rep for a quote, write down what must be true. I do not mean a wish list. I mean the non-negotiables: dimensions, voltage, phase, steam pressure, water quality, ventilation, floor drain, network connection, and cycle time. Also include the workflow, such as how many loads per day, whether the sterilizer needs a separate aeration room, and what your GPO agreement requires.

If you're buying an energy device in surgery, list the existing generators and instruments you need it to work with. If you're replacing a surgical stapler line, list the reloads already in your inventory. I've seen surgical stapler reloads purchased in bulk that did not fit the new stapler handle because no one listed the generation. That is an expensive and entirely avoidable mistake.

The vendor can't tell you what's actually fast if you haven't told them what's actually possible.

Step 3: Verify installation requirements before the PO hits the system

Get the installation spec sheet from STERIS or the original equipment manufacturer. Check the door opening, corridor width, ceiling height, floor load, clearance for service access, and every utility connection. Do not trust 'it's the same as the old one.' The old one might have been installed with a chain hoist through a roof hatch. You do not want to learn that after the unit is at your loading dock.

In March 2024, I had a client need a new ETO sterilizer in 12 weeks. We found one, rushed the quote, placed the order, and then realized the electrical panel had no spare breakers for the new unit. The unit sat in its shipping crate for nine days while the hospital paid an electrician to add a separate feed. If I had made the site survey a condition of the PO, we would have caught it before the order was placed.

For a fluoroscopy system, verify ceiling joists and floor reinforcement, too. Imaging systems are heavy, and the manufacturer's installation manual is not a suggestion.

Step 4: Put consumables and accessories on the same purchase order

This is the step most people skip, and it comes back in the worst way: the capital item arrives on time, but it's not usable.

For a STERIS ETO sterilizer, that means aeration storage, biological indicators, chemical indicators, the correct gas supply, and staff PPE. For a fluoroscopy system, it means the QA phantom, license keys, and a DICOM interface. For an energy device in surgery, it means the compatible cables and handpieces. For a surgical stapler, it means the reload sizes and generations that match the handles you actually have.

I was once asked to rush a 'full energy device in surgery' replacement. The new generator showed up with the right console but the wrong foot pedal connector. The vendor said, 'we didn't know you had the older instruments.' They didn't ask. I didn't send a list. Both of us got to apologize.

Step 5: Get a written lead time and a written escalation path

Verbal promises are not a contract. I knew I should get written confirmation on the delivery date, but thought 'we've worked together for years.' That was the one time the verbal agreement got forgotten. The equipment appeared a week after the surgeon was scheduled to return, and the schedule had to be shifted.

Ask for two dates in writing: the ship date and the installed and operational date. 'Shipping on June 1' is not the same as 'ready for patient use on June 1.' If the vendor won't commit to an installed date, that's a sign they don't control the freight or the install crew. You need to know that before you approve the order.

Per FDA guidance (fda.gov), the intended use and instructions for use are part of a device's cleared labeling. That matters in an emergency order too—if you're switching models within the same product category, your clinical staff needs to train on the new IFU before they use it. A rushed order doesn't remove that step.

Step 6: Plan the day after delivery before you order

The crate arriving is the middle of the project, not the end. If you're installing a STERIS ETO sterilizer, the sterile processing team needs to run biological and chemical validation before you put it into routine service. If you're replacing a fluoroscopy system, the medical physicist needs to be booked for acceptance testing. If you're bringing in new energy devices in surgery or a different surgical stapler platform, the O.R. staff needs hands-on training before the first scheduled case.

I've seen a fluoroscopy system sit unused for a week because no one scheduled the medical physicist. It wasn't the vendor's fault; the hospital approved the purchase without telling the physics team. You can avoid that in exactly thirty seconds: before you sign the PO, check the calendar of whoever has to install, validate, or train.

What most people overlook

Two things. One: deinstallation. People budget for the new device but not for removing the old one. An old ETO sterilizer doesn't walk out on its own. A used fluoroscopy system isn't a piece of office furniture. Rigging, disposal, and any radiation-source or chemical-container removal can add days to your timeline. Put deinstallation in the same contract.

Two: the order number is not a tracking number. When you buy through the STERIS Shop, the confirmation page is satisfying. It means the order was received. It does not mean it's on a truck. I want to say I learned this after one delay, but don't quote me on that—it might have been two.

When this checklist won't help you

In my experience, this checklist works for 80% of urgent replacement requests. If you're designing a new operating room, starting a sterile processing department from zero, or converting an entire installed base from another manufacturer to STERIS, you're in the other 20%. You need a project plan, not a rush list. I recommend this only when the infrastructure already exists and the clock is the biggest problem.

Also, this is not a guide to whether STERIS is 'better' than another brand. I don't think that's useful. I have my preferences, but a procurement decision is about your utility, your staff, and your volume. What I can give you is a way to avoid the mistakes that make a good choice look like a bad one.

Look, I don't have a perfect record. In March 2024, a client called at 6 a.m. needing a replacement surgical table for a two-room outpatient surgery center. Normal turnaround was four weeks. We found one, paid a rush freight fee—$2,200, if I remember correctly—and got it installed two days before the first case. The alternative was canceling surgery for two days, which would have cost more than the purchase. That one worked. The ones that didn't work were the ones where I skipped a step because I was confident. So now I use the checklist. You should too.