Filthy surgical tools can easily lead to an outbreak of infections that appear many days, weeks or months after undergoing invasive medical procedures and surgeries. Using unsanitary surgical instruments as a part of a surgical procedure often causes cross-contamination of serious life-threatening diseases. This is often a significant problem for patients with compromised immune systems who are susceptible to deadly infections and sepsis.
Many patients of filed civil action against hospitals, surgeons and other health care professionals who use unclean medical tools. The recent outbreak of carbapenem-resistant Enterobacteriaceae (CRE) infections at hospitals in the US appear to be caused by unsanitary endoscopes. The bacterium is highly resistant to every form of available antibiotics.
Endoscopes are considered complex medical tools that are extremely challenging to disinfect and clean. However, the growing cases of cross contamination outbreaks caused by filthy medical equipment raises serious questions about keeping hospitals clean to minimize the risk to patients. Contaminated lab equipment and medical tools used as part of the manufacturing process of prescription medications also seem to be responsible for the spread of serious infections including meningitis and hepatitis.
Patients Dying from Endoscopic Procedures
In February 2015, North Carolina health officials announced that three former Carolina Healthcare System Hospital patients suffered serious infections from the highly resistant bacteria CRE that claimed two of their lives. In the same month, two patients at California’s UCLA Medical Center died after being infected and more than 170 others were likely exposed to the life-threatening bacteria following routine procedures requiring the use of endoscopes.
The serious problem with unsanitary medical instruments is not unique to North Carolina or California. The pattern of deadly illnesses first emerged in hospitals back in 2012 in major cities including Pittsburgh, Seattle and Chicago. CRE, the culprit in every case, was transmitted through specialized endoscopes and duodenoscopes used in various procedures treating digestive disorders, cancers and gallstones. The equipment accumulates bacteria that is often difficult to remove using conventional cleaning methods, allowing the infection to pass between patients.
FDA Slow to Respond
Until now, the FDA (Food and Drug Administration) who approves the scope uses, nor the manufacturers, offered any guidance on resolving the problem nor publicized their concerns. Many health care professionals who use the scopes and many of the patients treated for specific conditions requiring the use of endoscopes are unaware of the inherent risks of infection.
Though life-threatening, the infection can go unnoticed in many cases. Many of the deaths caused by CRE outbreaks are not attributed solely to the life-threatening bacteria. This is because many of these patients already suffered from other serious health issues. While any outbreak of CRA is likely to garner attention, more common bacteria usually does not send up a red flag because it can easily be treated with prescription antibiotics.
In early 2015, the FDA made a public announcement that they were “aware of and closely monitoring” the risks of infections directly associated with the use of endoscopes. However, the agency added “Some parts of the scopes may be extremely difficult to access and thoroughly cleaning a duodenoscope may not be possible.”
Filthy Scopes Equals Dead Patients
Many of the patients who lost their lives by CRE had undergone procedures using duodenoscopes including ERCP (endoscopic retrograde cholangiopancreatography). The medical tool in these procedures is used to inject contrast dye into pancreatic and bile ducts to reveal tumors, gallstones, blockages and other conditions through x-rays.
The duodenoscope is threaded down the throat of a patient to provide the doctor control of tiny devices designed to extend from the end of the scope. However, the scope is also used for other procedures including obtaining biopsies, removing stones or installing stents to open blocked ducts.
Minimally invasive surgeries have grown exponentially since the 1990s. Many of the instruments used in numerous surgical procedures have become significantly smaller and more complex with complicated moving parts, narrow channels and tiny holes that can provide a place of harbor for serious life-threatening bacteria.
Fortunately, numerous hospitals that have experienced CRE breakouts associated with endoscopes are not waiting for guidance from scope manufacturers and the FDA on how to proceed. These hospitals have developed more effective safety procedures and advanced cleaning protocols including quarantining the scope after cleaning and testing the device for residual bacteria before reuse.