Despite deaths and infections, dirty scopes get used even more

olympus-logo-300x64Undeterred by disclosures about the disastrous results of their growing use of dirty medical scopes, doctors, hospitals, and manufacturers have failed to figure how better to sanitize many of the devices. They, instead, may be taking short cuts that ensure the devices stay unsanitary when used in invasive procedures.

Chad Terhune, a reporter now with the independent Kaiser Health News service, deserves credit for staying with the story that he first started to break several years ago at the Los Angeles Times. He reported that tainted medical scopes, used for gastrointestinal exams and made by Olympus Corp. of Japan, were tied to at least 35 deaths since 2013,and had sickened dozens of other patients.

Medical safety experts revisited a key question raised by Terhune’s reporting and investigations by staffers with a U.S. Senate subcommittee: Can medical scopes, with their many and complex components, effectively be sanitized and what must be done?

Researchers visited three, unnamed major hospitals before reaching their findings: 3 out of 4 scopes they examined tested positive for bacteria. “The study found problems in scopes used for colonoscopies, lung procedures, kidney stone removal and other routine operations,” Terhune reported in a KHN story published in the Washington Post and Los Angeles Times.

It gets more worrisome. The researchers didn’t find scopes contaminated with “superbugs,” infections that are tough to put down because the bacteria that cause them to have become resistant to most antibiotics. But they said conditions they found easily could allow superbugs to flourish, and, effectively, to be planted deep in the body via contaminated scopes.

Medical staff at two of the hospitals visited also committed big breaches of protocols to ensure scope hygiene, as Terhune reported:

Among the safety issues: Hospital technicians wore the same gloves for handling soiled scopes fresh after a procedure and later, when they were disinfected, and employees wiped down scopes with reused towels. Storage cabinets for scopes were visibly dirty and dripping wet scopes were hung up to dry, which is a known risk because bacteria thrive on the moisture left inside. The two hospitals also turned off a cleaning cycle on a commonly used ‘washing machine,’ known as an automated endoscope reprocessor, to save time.

These negative practices, by the way, weren’t undertaken covertly in some hidden backroom. They occurred right in front of the safety researchers.

In my practice, I see the significant harms that patients suffer while seeking medical services, and the huge damage that can be inflicted on them by dangerous and defective products, including medical devices. The published results of this medical scope follow-up study show an unacceptable nonchalance about patients’ safety and well-being at all too many levels, from the folks who poke at cleaning these devices all the way up to their makers and their reluctance to fix them, by redesign or otherwise, so they don’t imperil all too many of us. Practitioners, among other options, also could demand and use disposable scopes that lessen infection chances but may add to costs.

As this story also makes clear, doctors and hospitals promote the use of medical scopes in increasing fashion because they say, rightly, that the minimally invasive procedures they’re used in can be less risky to patients than major surgeries. But what’s the point of “keyhole” convenience if patients acquire major infections due to tainted scopes?

Hospital acquired infections have become an all too common part of a tsunami of medical errors, which, researchers say, claim the lives of roughly 685 Americans per day ─ more people than die of respiratory disease, accidents, stroke and Alzheimer’s. The dirty scopes have been addressed in civil and regulatory proceedings and actions, as well as by parts of the U.S. Senate. The federal Food and Drug Administration has just said it plans big improvements to its oversight of medical devices. But what more will it take to remedy serious, much publicized problems with medical scopes?

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