Friday, June 8, 2012

Local Endoscopy Center's Patients Exposed To Partially Cleaned Endoscopes

A local Pittsburgh resident received this unsettling letter from South Hills Endoscopy Center. The individual had gone to the Endoscopy Center for a colonoscopy. The procedure went fine. But a few days later the individual received this letter indicating that the endoscope used during the procedure had not undergone a final step in the disinfection process.


An endoscope consists of a flexible tube, which is passed into the body. Within the tube are electronics necessary to obtain a video image, cables that allow control of the flexible tip, and channels that permit the passage of the device to sample tissue, stop bleeding, or remove polyps.

The endoscope is a complex but durable instrument and is safe for use in thousands of procedures including colonoscopies. In all areas of medicine and surgery, complex medical devices are generally not discarded after use in one patient but rather are reused in subsequent patients. This practice is very safe, provided that the devices are properly cleaned, or reprocessed, before each procedure. Proper reprocessing eliminates the risk that an infection could be transmitted from one patient to another.

Before a procedure, an endoscope must be carefully cleaned and disinfected according to guidelines published by the American Society for Gastrointestinal Endoscopy, which, as far as the author can find, have been endorsed by every major medical and nursing association dealing with endoscopy and infection control.

The standard reprocessing steps are as follows:

1.  Mechanical cleaning: The operating channels and external portions of the endoscope are washed thoroughly, wiped with special detergents that contain enzymes, and brushed with special cleaning instruments. Studies have shown that these steps alone can eliminate potentially harmful viruses and other microbes from an endoscope. However, much more is done before the endoscope is considered ready for use.

2.  Disinfection: Next, the endoscope is soaked continuously for an appropriate time period with one of several FDA-approved liquid chemicals that destroy microorganisms which can cause infections in humans, including the AIDS virus, hepatitis viruses, and potentially harmful bacteria.

3.  Post-processing: The instrument is rinsed with water to remove residual chemicals, subjected to a final alcohol rinse, and the internal channels dried with forced air.

It appears that in this case, a final disinfectant soak did not occur. If you received one of these letters from South Hills Endoscopy or underwent an endoscopic procedure at that facility between February 8, 2012 and March 9, 2012 feel free to contact me to learn more about what may have happened. Share this post :
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