By Al Brander, RN BSN BSW MBA/HCM FACHE HCAP, SVP of Clinical Services
A few months ago, a Med Device customer asked me a straightforward question.
They were updating their Policy and Procedure for disposing of pacemakers and implantable cardiac defibrillators in California and wanted to make sure they were doing it right. These devices contain bio-debris. They contain lithium batteries. They fall under hazardous waste guidelines. The hospital wanted clarity and compliance.
That request sent me down a path I hadn’t really expected.
As part of that work, I came across Project My Heart Your Heart, a nonprofit based at the University of Michigan that refurbishes explanted cardiac devices for humanitarian use in parts of the world where access to cardiac care is extremely limited. Devices that cannot be reused in the U.S. are tested, sterilized, and implanted by trained physicians abroad.
What struck me wasn’t just the mission. It was the gap it exposed.
Hospitals are very good at managing explanted devices that are still under warranty. There are clear processes. Clear ownership. Clear financial incentives. But once a device is no longer eligible for warranty recovery, the path forward gets murky.
Many of those devices still have years of battery life left. And yet, in most cases, they’re treated as medical waste.
Not long after that initial research, one of our existing customers, Baptist Health in Little Rock, reached out with a related concern. They wanted to send non-warranty pacemakers and ICDs to Project My Heart Your Heart, but they were worried about something very real and very reasonable: they did not want to mess up their warranty workflows with SpendMend.
That concern matters. Warranty recovery is tightly regulated. It’s audited. It’s high-risk if done incorrectly. Hospitals should be cautious about introducing anything that could interfere with that process.
So instead of jumping to a solution, we slowed down and asked a different question:
Is there a way to do both?
Can you preserve clean, compliant warranty workflows and still offer a responsible option for devices that fall outside of warranty?
That question led to a pilot.
SpendMend worked with Baptist Health and Project My Heart Your Heart to put clear guardrails in place. Warranty-eligible devices would continue to follow existing processes, unchanged. Only devices that were clearly non-warranty eligible would be routed through the humanitarian program. Roles were defined. Compliance considerations were addressed up front.
And then we watched to see what would happen.
What we found was refreshingly simple.
From an operational standpoint, the process fits naturally into existing workflows. Staff didn’t need new systems. They didn’t need new training programs. They didn’t need to slow down or add steps that created friction. As one clinician put it, instead of throwing the device in the trash, they wiped it down and put it in a different bag.
That was it.
From a compliance standpoint, warranty recovery stayed intact. There was no crossover. No confusion. No disruption.
And from a broader perspective, devices that would have been discarded were instead tested, sterilized, and used to help patients in parts of the world where cardiac care is simply not accessible.
Even devices that couldn’t be reused were handled responsibly and recycled. Shipping materials were reused whenever possible. Nothing about the process felt wasteful or careless.
Two months in, it was clear this wasn’t a heavy lift. It wasn’t a risky experiment. It was a small, thoughtful change that closed a gap hospitals have lived with for a long time.
What stood out to me most wasn’t the volume of devices or the operational metrics. It was the alignment.
Clinical teams felt better about what was happening after a device came out. Supply chain teams didn’t have to manage another exception process. Compliance teams didn’t have to worry about unintended consequences. And warranty recovery continued exactly as it should.
At SpendMend, we spend a lot of time talking about visibility, compliance, and protecting our clients. This experience reinforced something important for me: sometimes the most meaningful improvements aren’t about adding more technology or more rules. They’re about recognizing where a process ends too early and asking whether it can be completed responsibly.
Based on the success at Baptist Health, we plan to make this option available to other hospitals we work with. Each organization will make its own decision, register directly with Project My Heart Your Heart, and move at its own pace. That’s how it should be.
But I do think this is a reminder worth sharing.
Hospitals deal with countless decisions every day that feel small in isolation. What happens to a device after it’s explanted can feel like one of those details. But when you step back, those details add up.
Sometimes, doing the right thing isn’t complicated. It just requires someone to notice the gap and be willing to ask a better question.