someone has actually died as a result of a dirty
device does it need to file a report. (
Manufacturers are supposed to alert the government if
they receive reports of device-related harm.)
If the cases aren’t part of a recognized outbreak, they might escape notice altogether.
Douglas Cooper certainly did notice, however. In 2008, he saw a doctor near his upstate
New York home because he was having problems urinating after an outpatient surgery.
Before the doctor inserted a catheter, he slid a
cystoscope—an endoscope for urology—into
Cooper’s penis. Two weeks later, Cooper was
suddenly seized by a fever and chills. He was
diagnosed with a severe bladder infection, his
first in all his 65 years. Even more unusual, it
was caused by pseudomonas, a pathogen often
blamed for infections associated with health
care. (And the diagnosis was not far-fetched
for cystoscopy patients. In early 2007, at least
seven men in New Mexico picked up
pseudomonas infections from a dirty cystoscope after
a urologist had probed their bladders.)
That turned out not to be Cooper’s biggest
problem. A week after his bladder infection,
Cooper noticed “a very painful something on
the tip of my penis, just below the opening.”
He had contracted genital herpes, which he
believes came from the cystoscope. His doctor
disagreed. “You cannot possibly prove that for
25 years you were faithful to your wife,” says
Cooper, “but for 25 years I have been.”
Perhaps the most high-profile endoscope-
cleaning breakdown came in 2009, when the
U. S. Department of Veterans Affairs notified
more than 11,000 patients about improperly
cleaned endoscopes. They’d had appointments
at four VA medical centers. One man who
received the news was Robert Metzler of
Coral Gables, Florida; he now has hepatitis C.
It’s up to a judge to decide whether Metzler
has enough evidence to show that his illness
came from the colonoscopy he underwent
in 2007, at his physician’s urging. (“She was
so nice, I just didn’t want to disappoint her,”
he stated in court documents.)
Metzler had had a negative hepatitis C test
the year before the colonoscopy, which attor-
ney Ervin Gonzalez hopes will convince the
judge that the virus came from the endoscope.
The VA cases were unusual, Gonzalez says, in
that administrators notified all patients who
could have been at risk; this is something a pri-
vate hospital may be less inclined to do. “A lot
of times people who develop injuries or dis-
eases are not able to relate them to the scoping
event,” Gonzalez says, “not knowing that the
instrument wasn’t properly cleaned.”
Given the many high-profile cleaning
screwups, reprocessing is finally getting its
due. The FDA is working with manufacturers
of arthroscopic shavers to address the debris
problem. And last year, the FDA and the Asso-
ciation for the Advancement of Medical
Instrumentation held a summit to discuss
RECUPERATING IN THE HOT ZONE
Even if your surgeon cuts like Michelangelo, you could still check out of the hospital with
a nasty infection. The scary part: Some of the biggest bacterial breeding grounds are right
in your room. Here’s how to shield yourself from a sneaky onslaught of germs.
staff. “When the cleaning
is outsourced, the crew’s
goal is to get in, get out,”
says Dr. Hooker. “They’re
being paid by the room—
not to drive down infec-
tion rates.” 3 THE TV
REMOTE The channel
changer in your room
may be dirtier than the
toilet handle, University
of Arizona research
found. “It’s a piece of
electronic equipment, so
they can’t spray it with
disinfectant,” says study
author Charles Gerba,
Ph. D. The solution is
simple: Pack some disin-
fecting wipes (Clorox
makes good ones) and
s wab your remote at least
once a day, says Gerba.
4 THE PRIVACY CUR TAIN
Sure, a curtain shields
you from a wkwardness—
but it also invites un welcome bacterial visitors.
A new University of Iowa
study found that 95 per-
cent of hospital privacy
curtains were contami-
nated with bacteria;
some were even coated in
MRSA. “Doctors and
nurses may wash their
hands before they touch
the curtain but not again
before they touch you,”
says study author Michael
Ohl, M.D. Research sug-
gests that men hesitate
to ask nurses if they’ve
scrubbed up; but remem-
ber, it’s your health at
stake. Try taking a non-
confrontational approach:
“I’m a little paranoid.
Would you mind washing
your hands again?”
5 NURSE-CALL BU TTON
Press this to complain
and it could mean trouble too. —L.R.
1 THE MAT TRESS
Three out of four hospitals don’t scrub mat-tresses before dousing
them with disinfectants,
a new Xavier University
study reveals. “They slop
the chemical onto the
bed, wipe it around, and
let it dry. They’re not
removing blood and infection,” says study author
Edmond Hooker, M. D.
“Contamination comes
right through the sheets.”
2 BED ADJUSTMENT
PANEL Look for a hospital
with an in-house cleaning
improvements in reprocessing. The International Association of Healthcare Central
Service Materiel Management, which represents reprocessing professionals, wants
more states to require certification for techs.
(Only New Jersey now has such a requirement; legislation is pending elsewhere.) Both
organizations are working with the government and industry to establish some kind of
consistency in cleaning instructions.
Major manufacturers, such as Olympus
America, which sells 70 percent of the coun-
try’s endoscopes, say they are engineering
devices to be easier to clean, with fewer
chances for human error in reprocessing. “In
the past, reprocessing was not a focus of the
design process,” says Mary Ann Drosnock, M. S.,
who heads infection control for the company.
“That’s not true any longer.”
Adam Higman, from Soyring, urges anyone
planning to go in for any kind of procedure to
do some homework. Ask how the equipment is
cleaned, and check on the infection rates. It
may take time, and the doctor may be sur-
prised that you’re even asking.
