Becker's Hospital Review

85 FINANCE CMO / CARE DELIVERY Study: 71% of endoscopes still contain bacterial growth after reprocessing By Mackenzie Bean C urrent reprocessing methods do not effectively sterilize flexible endoscopes, which may pose an infection risk to patients, suggest the findings of two new studies. Here are four things to know. 1. In the first study, published in the American Journal of Infection Control, researchers assessed endoscope repro- cessing, drying and storing practices at three multispecial- ty hospitals in the U.S. Researchers took samples of fully reprocessed endoscopes stored for at least 24 hours and sent them to FDA-registered microbiology laboratories. 2. Twenty-two percent of endoscopes had signs of organ- ic contamination and 71 percent still contained micro- bial growth. Researchers also found retained moisture in 49 percent of endoscopes, showing no hospital's drying methods successfully eliminated residual fluid or water- borne pathogens from the devices. All three hospitals had damaged endoscopes in use, and two followed substan- dard reprocessing and drying practices. "We were surprised to find that two hospitals accredited by The Joint Commission were skipping so many steps or do- ing them poorly, but we were even more surprised to find that reprocessing failed about half the time, even in a hos- pital that had very good practices," Cori Ofstead, lead re- searcher and president and CEO of the independent research organization Ofstead & Associates, told Reuters via email. 3. The reprocessing issues did not just apply to gastrointes- tinal endoscopes, according to Ms. Ofstead. "This study identified problems with reprocessing effec- tiveness for all types of flexible endoscope, not just the complex gastrointestinal endoscopes with elevators," she told Reuters. "We believe the risk for patients may be high- est for bronchoscopes and urology scopes." 4. Researchers in the Netherlands also assessed endo- scope reprocessing in a second study published in the journal Gut. They found at least one reprocessed duodeno- scope contaminated with detectable microbes in 39 per- cent of all Dutch health centers performing an endoscopic procedure to diagnose pancreas and liver diseases. About 15 percent of duodenoscopes tested positive for microorgan- isms with gastrointestinal or oral origins from previous patients. "These results suggest that the present reprocessing and process control procedures are not adequate and safe," the researchers concluded. n New Jersey court rules physician board, hospital can be sued separately: 4 notes By Alyssa Rege A U.S. District Court of New Jersey judge issued a ruling April 27 noting a hospital's medical executive com- mittee can be sued separately from the hospi- tal it serves, according to the New Jersey Law Journal. e decision stemmed from the case of a New Jersey surgeon seeking to reclaim his medical privileges at Somers Point, N.J.-based Shore Medical Center. Here are four things to know about the case and the judge's decision. 1. In 2002, Frederick Nahas, MD, pleaded guilty in federal court to a charge of prevent- ing, obstructing, misleading and delaying the communication of information and records relating to a healthcare investigation, ac- cording to court documents cited by the New Jersey Law Journal. He was sentenced to one month in prison, three months of home con- finement, 100 hours of community service and three years of probation and was fined $20,000. 2. Following his conviction, Shore Medical Center rescinded his vascular surgical privi- leges in 2003 for three years. In 2005, the State Board of Medical Examiners suspended Dr. Nahas' medical license for nine months. 3. While Dr. Nahas' medical license was re- stored in 2006, Shore Medical Center has not reinstated all of his surgical privileges. e hospital's medical executive committee, which comprises department chairs, at-large members and other physicians, restored only some of his privileges. Dr. Nahas proceeded to sue the committee. However, the commit- tee argued it could not be sued because it was not an entity subject to litigation, according to the report. 4. U.S. District Judge Robert Kugler sided with Dr. Nahas in his April 27 ruling, stating the committee "has the capacity to sue or be sued" because it is a "decision-making entity." "When an association is sufficiently distinct and its membership is distinguishable from the entity, it can be found to be an unincor- porated association with the capacity to be sued," Mr. Kugler wrote in the ruling. "Al- though this court has misgivings about the analytical rigor of treating a group of people on a committee as a singular committee for purposes of legal capacity, the clear trend un- der New Jersey law is to regard such groups as unincorporated associations." n

• Cover