(Philadelphia Inquirer:  Published 04/12/2015, Avril, Tom, Web)

A few years ago, researchers from 3M Co. tested 245 endoscopes – long tubes used to look inside the colon and other organs – to see whether the devices had been properly scrubbed of blood, tissue, and other human debris.  The results of the tests, conducted at five U.S. hospitals, were not what anyone would want to hear before going in for an exam.  The scientists gave a failing grade to 10 out of 30 complex devices called duodenoscopes, which have been in the spotlight this year after federal officials linked them to multiple outbreaks of dangerous, drug-resistant infections.  The 3M researchers also detected evidence of debris inside other more commonly used kinds of endoscopes. In a 2013 issue of the American Journal of Infection Control, the scientists reported that 24 percent of gastroscopes and 3 percent of colonoscopes had not been adequately cleaned.

In practice, those scopes would then have been given a liquid germicide bath intended to kill bacteria harbored by the lingering debris.  But infection-control experts say breakdowns at any point in the “reprocessing” of scopes – cleaning, disinfecting, and thorough drying – are cause for concern, especially with the increasing emergence of bacteria that can survive treatment with antibiotics.

Reprocessing endoscopes is a tedious, multistep task performed by workers making as little as $13 an hour who are required to be certified by just two states, New Jersey and New York. The devices are far too expensive to use just once – duodenoscopes can run $40,000 – so the only option is cleaning with relentless attention to detail.  “You can’t cut a corner,” said Joseph Charleman, chair of the surgical processing program at Berkeley College, a career-training school with nine locations in those two states.

The how-to manual for cleaning and disinfecting one duodenoscope made by Olympus, with U.S. headquarters in Center Valley, Pa., runs 106 pages. In March, the company issued a 10-page supplement after scrutiny from the Food and Drug Administration.  Aside from the difficulty of the task, there is a more basic reason scopes are not always cleaned thoroughly. Hospitals often are not checking the work, said Michelle J. Alfa, a clinical microbiologist at St. Boniface Research Centre in Winnipeg, Manitoba.  “Most of the health-care facilities in the U.S. and Canada don’t actually monitor how well the cleaning is done by the staff,” said Alfa, who validated the testing method used in the 3M study. “They don’t really know.”

Meanwhile, the best that hospitals and workers can do is maintain constant vigilance and recognize that these complex devices can’t be rushed back into service, Charleman said.

“It’s tedious, but attention to detail needs to be maintained,” he said.

The lawyers at Liever, Hyman & Potter, P.C., are concerned for the safety of families in Reading, Berks County, PA, Pottsville, Schuylkill County, PA, and throughout Eastern and Central PA.  The lawyers there handle personal injury claims, including claims for injuries or death caused by unsafe or dangerous products.

From the desk of Adam K. Levin, Esquire.

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