Product News and Recalls

How Clean is that Endoscope?

“I’m [making] $13 an hour, and I’ve got the surgeon who built the hospital screaming at me. What am I going to do?”

When most people think about the staff that keeps them off death’s door during a visit to the hospital or doctor’s office, they think of doctors, nurses, and other well-compensated medical professionals. We take solace in knowing that our doctors went to school for years and have incomes well into six- or seven-figures. Their high incomes are, in our eyes, a direct reflection of the quality of care we are receiving.

What we don’t think of, however, is that at some point our lives will be in the hands of someone who makes considerably less than a manager at McDonald’s.

The average McDonald’s store manager makes about $44,000 per year. Yet, the person who cleans the medical devices that will be used inside your body to test, remove, and diagnose tissues and other samples may make a fraction of that.

Contaminated duodenoscopes have been in the news recently as a possible cause of the spread of deadly drug-resistant bacteria known as CRE. Multiple deaths have been attributed to these infections and everyone from the FDA to the makers of the devices are working to slow the rate of new infections.

Far less attention, however, has been paid to the medical staff charged with keeping these, and other critical medical instruments, clean. Some scopes used in common medical procedures can cost upwards of $40,000. Since a new scope can’t be purchased for every new procedure, the instruments are cleaned between uses in a process known as reprocessing. During reprocessing, a scope is cleaned, disinfected, and dried according to strict standards. When completed according to these standards, a scope should pose no danger to the next patient.

These standards are met less than you would think. In one test, 1 in 3 duodenoscopes failed to meet critical standards for disinfection. Other types of scopes received similar failing marks for cleanliness. Blood, tissue, and other materials were found to have survived the cleaning process and been found on devices thought to be ready for use in the next patient.

Those tasked with cleaning the devices cite multiple causes for the lapses. These include the complicated nature of the cleaning process as well as pressure from physicians and surgeons to clean the devices faster in order to keep up with the surgeon’s schedule. One might argue that a process that takes 116 pages to explain, the length of the cleaning manual for an Olympus duodenoscope, is something that can not and should not be rushed.

As the spotlight shines on those who make the least, yet at some point will also hold a patient’s life in their hands, hospitals should consider clearing the way for education, certification, better pay, and a higher level of understanding between surgeons and those who clean their instruments.