A woman who used to work in the sterile processing department at UAB took to TikTok last week to air concerns about safety at the hospital in a video that garnered hundreds of thousands of views.

Alessandra Nicholson worked for Steris, a third-party contractor that provides sterilization services to UAB. She took to the social media platform to say conditions at the hospital created dangers for patients and employees. In emails provided by Nicholson, she discussed injuries to herself and other employees who encountered needles and blades that should have been stored in separate containers.

Nicholson, who travels for work and arrived in Birmingham this spring, said conditions at UAB were more dangerous than other hospitals where she worked. She said sterile processing is an unseen but critical part of patient care.

“Your surgeon can be the greatest surgeon in the world,” Nicholson said. “You can have the best Davinci robots in the world. But if the instruments are dirty, then the whole game is over.”

Tyler Greer, a spokesman for UAB, denied Nicholson’s allegations.

“We are aware of and firmly disagree with assertions made on TikTok by an individual who worked in UAB Hospital for roughly seven weeks through a service provider, and who no longer works in our facility,” Greer said. “UAB Hospital ranks highly among peer academic medical centers in the sophisticated Vizient Quality and Accountability Scorecard.”

UAB scored a B on a recent Leapfrog Hospital Safety Grade with mixed results on infection prevention. The hospital has a low to moderate rate of surgical site infections tracked by the Centers for Medicare and Medicaid Services. Its rate of sepsis infections after surgery is higher than average, according to Leapfrog.

Nicholson shared photos that appeared to show backup in the sterile processing department, with stacks of surgical trays crowded into the room. Other photos appeared to show stains on the floor and equipment that hadn’t been fully cleaned. Nicholson said that can create hazards for patients.

She posted the video after she was terminated from Steris. She said the firing happened in retaliation for going public about her concerns. She said she has worked in six hospitals during her career and felt conditions at UAB required immediate action. Steris did not respond to an email seeking comment.

Greer said the hospital recently purchased $3.4 million in new washing a sterilization equipment and adheres to national standards for cleaning instruments.

Nicholson forwarded emails related to one employee who was injured when she encountered a needle that should not have been mixed in with other instruments. That employee now needs to be monitored and tested for blood borne diseases such as HIV. Nicholson said she hoped the company would discuss safety issues with UAB after the incident, but instead they offered to make a video that could be shown to employees of the operating room.

“Because we’re a third party, we can’t make UAB do anything,” Nicholson said. “We can only recommend it to them. I have to come in here every day and oversee this process that is putting employees and patients at harm.”

Nicholson said she became so frustrated she resigned her position effective September 1. However, her supervisors told her to go home on paid leave instead.

“Honestly it was out of pure frustration,” Nicholson said. “I threw up my hands because I didn’t know what to do.”

Nicholson said former employees in UAB’s sterile processing department and former nurses have reached out in support. In addition to working for Steris, Nicholson also has a consulting company and said she is an advocate of more rigorous training for employees and is involved in a nationwide nonprofit called the Sterile Processing Department Education Fund.

Greer said UAB is committed to reducing workplace injuries, including needle sticks.

“We have processes in place to reduce employee interactions with sharp objects, including using magnets to remove needles and blades from surgical trays,” Greer said. “Employees whose jobs may expose them to the possibility of needle sticks or other work-related risks are thoroughly trained on safety procedures, including how to properly handle sharp objects. We also adhere to protocols to monitor and respond appropriately to any reported needle or sharp object injury.”