Endoscope Equipment Often Not Properly Cleaned: Study

New research suggests that about 15% of all endoscopes used by hospitals may be improperly cleaned and could put patients at risk of a blood infection.  

According to a study presented at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC) on June 9, researchers found evidence of “biological dirt” on about one out of every 7 reusable tools, which includes cells and other matter that remained on the equipment from prior patients.

The findings come on the heels of a number of other cases and studies into the risk of infections caused by endoscopes that were not properly cleaned.

Researchers looked at 275 medical instruments used in endoscopy at five hospitals in the United States. The researchers were looking for adenosine triphosphate; a sign of biological contamination. The tools, including flexible duodenoscopes, gastroscopes and colonoscopes, were checked after they were reportedly cleaned by hospital personnel.

The study found that 15% of the endoscopes were not clean enough, including about 30% of the duodenoscopes, 24% of gastroscopes and 3% of colonoscopes.

An estimated 15 to 20 million endoscopy procedures are conducted each year with these types of instruments.

As a result of improper cleaning, patients could face risk for a number of serious bloodborne infections from other patients, including HIV, hepatitis B and hepatitis C.

In 2008 and 2009, thousands of veterans were notified that they may have been exposed to contaminated blood during colonoscopy procedures at several Veterans Affairs hospitals, after it was discovered that the staff was not properly cleaning the endoscope equipment.

In November 2012, an Air Force veteran, Robert Metzler, was awarded $1.25 million after suing the VA for contracting hepatitis C from allegedly contaminated endoscopy tools.

The VA endoscopy contamination problems were discovered in December 2008 at the Alvin C. York Medical Center in Murfreesboro, Tennessee. A subsequent review of the procedures at all VA clinics led to the discovery of additional VA health center problems at the Charlie Norwood VA Medical Center in Augusta, Georgia, and the Miami Veterans Affairs Healthcare System in Florida.

The potential exposures, caused by improper cleaning and use of endoscopic equipment, required the VA to notify 11,000 former patients that they should get tested for HIV and hepatitis.

According to another study published in JAMA Internal Medicine in March 2013, researchers found that many older patients may be unnecessarily exposed to risks associated with colonoscopies, indicating that nearly a quarter of all procedures on older patients may be unnecessary.

Risks associated with a colonoscopy could include bowel perforation, bleeding, incontinence and a false positive diagnosis. A false positive can result in additional unnecessary treatment and added stress to an elderly patient.