Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Scott Adams
    Scott Adams

    Nearly Two out of Three GI Endoscopes Contaminated with Retained Biopsy Samples

    Reviewed and edited by a celiac disease expert.

    Nearly two out of three endoscopes used to perform biopsies are contaminated with retained tissue, according to a new study.

    Nearly Two out of Three GI Endoscopes Contaminated with Retained Biopsy Samples - Image: CC BY 2.0--RinzeWind
    Caption: Image: CC BY 2.0--RinzeWind

    Celiac.com 08/24/2021 - We've written about high rates of tissue contamination in reprocessed duodenoscopes, and the FDA has warned about the deadly potential for infection in such cases, and encouraged the transition to disposable duodenoscopes.

    We also know about similar problems with endoscopes, but the latest news shows that the problem with contaminated biopsy endoscopes is much more severe than previously understood. 

    Celiac.com Sponsor (A12):
    The most recent study shows that nearly two in three endoscopes used for colonoscopy and esophagogastroduodenoscopy (EGD) procedures show a "startlingly high" rate of contamination from retained biopsy samples in the endoscope accessory channel or cap. This is a huge problem with potentially serious consequences for patients undergoing biopsy, as contaminated endoscopes can cause infection in many cases.

    In the study, conducted by Gregory Toy, MD, and colleagues at University of Utah Health, in Salt Lake City. investigators found 64% of 105 total endoscopies featured retained matter from biopsy samples, including more than three out of four EGDs and 50% of colonoscopies.

    When University of Utah Health polled its own endoscopists, they estimated the rate of contaminated scopes to be 10% to 15% of all scopes, far below the actual number of 64%, Gregory Toy, MD, told reporters. "The take-home message would be that retained biopsies are much more common than most endoscopists would think," adds Dr. Toy.

    Also worrying in the data was the high rate of retained biopsies found in EGDs compared to colonoscopies, said Dr. Toy. Increasing awareness about the high rate of retained biopsy samples in endoscopes, Dr. Toy suggests, may help clinicians to "change behavior to make this happen less often." Dr. Toy presented the findings during the Digestive Disease Week (DDW) 2021 virtual meeting.

    "Very Surprising" Results

    Calling the results "very surprising," session moderator Serge Sorser, MD, told reporters that "The study is very important as it points out a significant rate of tissue retention in the biopsy channel at the conclusion of endoscopic procedures."

    From the 2021 Digestive Disease Week (DDW) virtual meeting. [PAYWALL]


    User Feedback

    Recommended Comments

    Distressed

    Five years ago the FDA mandated manufacturers to redesign scopes for this very reason. I refused to undergo EGD for this very reason, waiting patiently for invention of single-use scopes.  Now its time for the physicians & hospitals & OP clinics to make the necessary purchase.  Although the out-of-pocket expense will likely increase, it will be well worth the cost in order to prevent transfer of blood borne pathogens and neoplastic tissue.

    "FDA clears first fully disposable duodenoscope, eliminating the potential for infections caused by ineffective reprocessing | FDA"

    Link to comment
    Share on other sites
    Guest Bob
    3 hours ago, Distressed said:

    Five years ago the FDA mandated manufacturers to redesign scopes for this very reason. I refused to undergo EGD for this very reason, waiting patiently for invention of single-use scopes.  Now its time for the physicians & hospitals & OP clinics to make the necessary purchase.  Although the out-of-pocket expense will likely increase, it will be well worth the cost in order to prevent transfer of blood borne pathogens and neoplastic tissue.

    "FDA clears first fully disposable duodenoscope, eliminating the potential for infections caused by ineffective reprocessing | FDA"

    I have scheduled both an endoscopy and colonoscopy for the end of the year.  I will be inquiring if they use disposable instruments.  If they don't, I don't see how delaying or canceling the procedure is of much help.  You need to weigh the risks.  You're kind of stuck.  The procedure was a success, biopsies were benign but the resulting infection killed the patient.  

    Link to comment
    Share on other sites
    trents

    It also makes me wonder if when a biopsy sample is sent to a lab for analysis of potential celiac disease, whos tissue is being evaluated? Yours or the person who was scoped before you?

    Link to comment
    Share on other sites
    Distressed
    1 hour ago, trents said:

    It also makes me wonder if when a biopsy sample is sent to a lab for analysis of potential celiac disease, whos tissue is being evaluated? Yours or the person who was scoped before you?

    That depends.  When a tissue is biopsied it is held by a "pincer" and withdrawn from the scope.  If there is a "washing" then the fluid is aspirated along with any material (fluid or solid material) into a suction trap.  That collection could lead to false diagnostic results. 

    HIV, Hepatitis B&C and MRSA are dangerous blood borne pathogens. Cancer cells transferred to a healthy patient are typically not a risk, but celiac disease patients have "immunological" disorders (often multiple problems). 

    The disposable scope was approved in 2019, but I have yet to hear of its wide-range use. Facilities are often "resistant" to spending money on these items. I remember one hospital chain used "disposable" intubation scopes.  That was a "safe" move, but no one else perceived of the "risk management".  As it regards EGD/colonoscopy scopes: in 1994 a new washer was patented.  That machine thoroughly cleaned scopes.  Again dollar investment is the issue.  Typically, it is the radiology department that makes the most revenue and is the division that receives most of the upgraded equipment.

    Link to comment
    Share on other sites


    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Jefferson Adams
    Surprising Number of Endoscopes Contaminated and Pose Infection Risk
    Celiac.com 03/30/2015 - Researchers are calling for an overhaul of cleaning and decontamination procedures in the face of a study showing that three out of 20 flexible gastrointestinal (GI) endoscopes (15%) pose an infection risk, because they are contaminated with unacceptable levels of human biological matter.
    The researchers are part of the 3M Infection Prevention Division, which recently conducted an assessment of endoscopes at five major hospitals.
    For their study, the researchers analyzed 275 flexible duodenoscopes, gastroscopes, and colonoscopes and found that 30 percent, 24 percent, and 3 percent respectively harbored unacceptable levels of human biological matter.
    The results surprised the team, as 15% constitutes an "unexpectedly high number of endoscopes...


    Jefferson Adams
    FDA Issues Warning Over 24-Hour Multipatient Endoscope Connectors
    Celiac.com 05/08/2018 - The US Food and Drug Administration (FDA) has issued an alert to healthcare providers about the risk of cross-contamination with certain endoscope connectors used in gastrointestinal endoscopy. 
    The FDA warns that ”24-hour multi-patient use endoscope connectors,” carry cross-contamination risks. To help reduce the risk of cross-contamination and possible infection between patients, the FDA recommends that providers use connectors with backflow prevention features that prevent patient fluids from flowing back into the endoscope. 
    The FDA warns that these connectors carry cross-contamination risks. "To date, the FDA has not received acceptable testing to demonstrate the safe use of these products, and recommends against their use," the FDA said.
    ...


    Jefferson Adams
    FDA Warns of Deadly Duodenoscope Contamination Rates
    Celiac.com 06/03/2019 - In 2015, the FDA ordered duodenoscope makers Olympus, Fujifilm, and Pentax to conduct post-market surveillance studies to determine how infections were being transmitted, and to assess the factors that may be contributing to the problem. Interim results from those FDA–mandated studies show unacceptably high contamination rates after reprocessing, with deaths and infections as a result, the FDA said today.
    The agency said three deaths in the United States in 2018 were likely due to contaminated duodenoscopes. "That's three deaths too many," Jeff Shuren, MD, director of the Center for Devices and Radiological Health, said in a statement.
    The problem first surfaced in 2013, when the FDA became aware that reprocessed duodenoscopes were transmitting multidrug-re...


    Jefferson Adams
    FDA Urges Transition to Disposable Duodenoscopes
    Celiac.com 09/10/2019 - The US Food and Drug Administration (FDA) is recommending that manufacturers of duodenoscopes, along with health care facilities, switch to duodenoscopes with disposable parts to help reduce the risk of patient infection.
    Post-market surveillance studies ordered by the FDA reveal that contamination rates for reusable duodenoscopes remain unacceptably high after reprocessing, with avoidable deaths and infections still occurring.
    As a result, the agency is now recommending the elimination of duodenoscopes with fixed endcaps in favor of those with either disposable components, including disposable endcaps, or fully disposable duodenoscopes as they become available.
    By simplifying or eliminating the need for reprocessing, disposable duodenoscopes...


  • Recent Activity

    1. - Wheatwacked replied to CeliacPsycho246's topic in Gluten-Free Foods, Products, Shopping & Medications
      5

      GLUTEN FREE OCD MEDICATION

    2. - Wheatwacked replied to CatLady15's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      3

      Toddler Diagnosis?

    3. - Wheatwacked replied to More2Learn's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      9

      Celiac Maybe a Possibility?

    4. - BoiseNic posted a topic in Dermatitis Herpetiformis
      0

      Skinesa

    5. - Wheatwacked replied to llisa's topic in Gluten-Free Foods, Products, Shopping & Medications
      20

      Gluten free vitamins


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      126,241
    • Most Online (within 30 mins)
      7,748

    katherine west
    Newest Member
    katherine west
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.9k
    • Total Posts
      69.3k

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Popular Now

    • llisa
      20
    • More2Learn
      9
    • ellanataliw
      6
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...