Since the death of noted entertainer Joan Rivers almost a year ago, the routine use of endoscopes has come under increased scrutiny. Now, evidence has surfaced that contaminated endoscopes are behind many hospital outbreaks of antibiotic-resistant ‘superbugs,’ and the FDA has known about it for years and done nothing. Some of these outbreaks have killed dozens and made hundreds of others ill. (1)
The use of endoscopes has become the first diagnostic choice by a medical establishment that has literally lost touch with its patients and now relies almost exclusively on technology. Endoscopes are medical devices used to examine everything from the throat down to the colon, making the hands-on examination of the patient obsolete. Very similar devices are used for the popular colonoscopy, suggesting that these too are often highly contaminated with biological debris. (1)
The design of these instruments makes them difficult to clean. Tiny crevices can trap matter that is not released during cleaning or exposed to disinfectant, putting the next patient on whom they are used at risk, even when manufacturer cleaning instructions are followed to the letter. These are the instructions presented to and approved by the FDA during the approval process. (2)
Endoscopy use may be a Death Sentence for the Patient
Superbugs are pathogenic microorganisms, most often bacterium, that have developed resistance to the medications normally used against them. Therefore, there is little or nothing to stop them once they get going.
One such superbug is particularly troubling because it is known to be spread directly by unclean endoscopes. It is known as CRE, (Carbapenem-resistant Enterobacteriaceae), and its kill rate is over 40%. So far there have been 4 major outbreaks of CRE in hospitals in the U.S. Other outcomes from contaminated endoscopes include hepatitis B and C, and HIV. (2)
The Alliance for Natural Health USA recently reported that during an outbreak in Florida in 2009,
“health experts from the CDC together with other epidemiologists warned the FDA that the problem was likely not limited to Florida, and action should be taken to warn hospitals of the danger. Only months later did the FDA issue any warning whatsoever – a measly two sentences buried in the fifty-seventh paragraph in a general advisory on the proper cleaning of medical scopes!” (1)
In the Florida outbreak in 2009, 15 patients were killed and dozens were sickened. It was not until earlier this year that the FDA issued a warning with some meat on its bone. Still, the producers of endoscopes do not have to redesign their products or change their cleaning procedures, the warning being just a heads-up to let patients know what they may be getting into.
There’s more to think about than Superbugs When you Consent to Endoscopy
Joan Rivers was undoubtedly able to recruit the best medical talent available, yet she died of something other than superbugs during a routine endoscopic procedure to assess her throat and vocal chords. This suggests that endoscopic procedures in general are not as safe as they have been advertised to be.
Risks that should be considered but are not always explained to the patient ahead of time include bleeding, perforation, infection, reaction to sedatives, and complications from heart and lung disease.
Researchers are finding that gastrointestinal (GI) endoscopy, during which a doctor examines a patient’s digestive tract with an endoscope, may be more common than we know. They are recommending changes to current reporting processes to make sure emergency department visits and unexpected hospital admissions following endoscopic procedures be investigated.
Dr. Daniel A. Leffler and his colleagues from Deaconess Medical Center in Boston have concluded that complications from endoscopy of the GI could be 3 times or more than is currently reported. During their study, they found that 419 emergency department visits and 266 hospitalizations occurred within 14 days of having a procedure involving an endoscope. This compares to a total of only 31 complications recorded through physician reporting.
It may be a good idea to forego any medical fishing expeditions involving endoscopes. Save such procedures for use only when there is truly no other choice.