Within the healthcare setting, an endoscope is used multiple times each day. As a result, paying careful attention to every part of the cleaning process is important. And although reprocessing issues have been a concern for years, the more recent and deadly superbug infections (Carbapenem-resistant Enterobacteriaceae) involving duodenoscopes have put a spotlight on effective device cleaning and protecting patients. “The duodenoscope is considered one of the most challenging scopes to clean,” said Chris Lavanchy, engineering director of ECRI Institute’s Health Devices Group. “When a technician is doing the reprocessing, they’re typically using a brush that’s threaded through each of the channels to clean out crud that is left behind.” He adds that the manual nature of the process introduces quite a bit of variability, including how much pressure the technician is under to get the cleaning done—and how fast.

During a recent visit to ECRI (Plymouth Meeting, PA), Lavanchy explained the complex design of the devices and why they can be so difficult to clean. “We’re not doing a great job in reprocessing the scopes,” he said, adding that the elevator feature of the device has been implicated as a proximate cause of the deadly infections. Accessing the area with a brush to get rid of blood and bacteria is a difficult task. More troubling is the fact that patients could be in danger of contracting other infections from duodenoscopes. Watch the video to find out why.