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Medical Scopes and ‘Superbugs’: Infection Risk Greater Than Previously Thought

Scopes used for stomach, lung, colon exams can cause deadly infections, reporter finds

Injury reports in a federal database detail how the risk of serious infections from contaminated medical scopes is far broader than previously believed, according to an article in the Los Angeles Times.

During the last 3 years, patients have been exposed to bacteria — and to human tissue and dried blood — left inside a variety of scopes commonly used to examine the lungs, colon, bladder, and stomach, reporter Melody Petersen writes.

Infection experts have been warning for years in speeches and research papers that many types of endoscopes can remain dirty after cleaning — only to have their concerns mostly ignored by doctors performing the procedures, according to Petersen.

Last year, Cori Ofstead, a Minneapolis epidemiologist warned a national group of infection-control professionals that she and her colleagues were finding scopes that were still contaminated after they were disinfected according to guidelines. Another researcher in Manitoba, Canada, tested scopes that had been cleaned at a Canadian hospital for traces of blood and protein. She found that 9% of gastroscopes, 7% of colonoscopies, and 4% of bronchoscopes still had traces of potentially infectious material.

Federal regulators say they don’t know how many patients have been sickened by the scopes, which as a group are used tens of millions of times each year, Petersen writes. There are no numbers to quantify the risk because few scope-caused infections get reported. The government's injury reporting system, which keeps names of hospitals and clinics secret, is mostly voluntary.

The cases reported to the FDA show a repeated story: The scope transferred bacteria among patients even though medical staff believed it had been disinfected, Petersen reports. And in many cases, multiple patients were sickened before doctors recognized that the scope harbored bacteria inside its long narrow channel or delicate mechanisms.

Mistakes by a hospital's cleaning staff can go unnoticed for months.

In 2010, the Palomar Health system in San Diego County notified 3,400 patients that they may have been exposed to tainted scopes after workers continued for months to use a disinfectant that was past its expiration date.

Scope manufacturers have said they often find that hospitals reporting infections did not properly clean or maintain the device

Jennifer Dooren, an FDA spokeswoman, told Petersen that the agency believes the scopes currently on the market are safe.

“The risk of acquiring an infection from an inadequately reprocessed medical device is relatively low given the large number of such devices in use,” Dooren said.

She added that the agency had warned hospitals about improperly cleaned scopes in 2009.

In May 2015, some members of an expert panel created to advise the FDA on improving the safety of duodenoscopes expressed alarm about the even broader danger from the other types of scopes.

Source: Los Angeles Times; August 2, 2015.

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