After a wonderful Thanksgiving dinner at Aunt Silvia's house, my family and I were sitting around the dinner table having desert. There were many wonderful deserts to choose from, I decided to go with my family traditional favorite, lemon pie. As I reached for my fork to take my first bite I noticed a spot of some sort on my silverware. As I left the dinning table to enter the kitchen to look for a new fork I began to think to myself about how Aunt Silvia had washed her dishes. Did she overload the dishwasher? Use too little dish soap? How did the rest of the silverware look clean while my fork seem to be dirty? I wanted to call the CPD Guy to come over with a protein test to help me to get to the bottom of my silverware mystery. Of course the CDP Guy wasn't available, he was busy celebrating Thanksgiving with his own family, but it sparked an interesting office discussion when we came back from vacation. We talked about how there are many different factors that can prevent surgical instruments from being properly cleaned. How unlike the household dishwasher, hospitals use tests to ensure water is at the appropriate temperature to clean surgical instruments. Special equipment that is used to dispense the right amount of detergent per cleaning cycle. There are even tests, such as the TOSI that will even measure the quality of automatic washers. After this discussion my mind was at ease knowing that modern tests provide quality assurance that makes sure that a surgeons scalpel won't end up like my Aunt Silvia's silverware.