Recently there have been countless stories in the news centered around the deadly Superbug that is believed to be transmitted via contaminated endoscopes. Due to the complex nature of duodenoscopes/ERCP endoscopes, it can be extremely difficult to adequately disinfect an endoscope following the existing reprocessing guidelines and standards. As a response to this issue, industry experts have provided recommendations for preventing the spread of this deadly bacteria, many of which focus on the importance of the cleaning that occurs prior to reprocessing. Endoscope reprocessing expert Lawrence F Muscarella (PhD) states that the difficulty with reprocessing endoscopes can be traced back to shortcuts and skipped steps in the tedious reprocessing procedure.  

Dr. Muscarella points out that this extremely scrupulous task is often performed by workers making as little as $13 an hour. It has been recommended that these technicians be certified to ensure that everyone undergoes the training required to properly perform the steps. However, at this time, certification of reprocessing technicians is only required in New Jersey & New York in the United States. On top of the laborious job and often modest salaries, technicians are faced with enormous pressure to reprocess endoscopes quickly and work towards increasing scope throughput in their facility. 

Often because of the countless factors working against technicians, steps in the critical cleaning process are not performed as thoroughly as required, or steps can be missed altogether. Without effective cleaning to remove organic material from the endoscope, the disinfection process will not be as effective in high-level disinfecting the endoscope. 

Each year, the ECRI institute releases a list of the top patient safety hazards as a reference for Healthcare Organizations. Inadequate reprocessing was included on last year's list in the #10 spot, and has moved up to #8 on this year's list. This issue has also been included for 6 years in a row on ECRI's top 10 list of Health Technology Hazards. The issue of inadequate reprocessing continues to be a critical health issue due to the continued occurrence of infection outbreaks resulting from infectious agents remaining on medical devices such as endoscopes. Because there are multiple steps involved in the process, there is a lot of room for error when it comes to reprocessing an endoscope. ECRI states that if organisms are not removed from an endoscope during the cleaning process, the disinfection process may not affect the organisms adequately. Additionally, endoscopes that are not thoroughly dried create an environment that allows organisms to grow even after reprocessing. ECRI notes that because there are so many variables that are critical to the process, even one small change to the process can impact the quality of disinfection. Because of the highly manual process and detailed steps involved, there is a lot of potential for scopes to go through the process without being adequately disinfection which can result in patient harm, or in serious cases, death.