Patient Recall in Maryland Continues Recent Spat of Endoscope-Related Issues

Kaiser Permanente’s Largo Medical Center in Maryland has issued a notice to 23 patients that they should undergo testing following the use of an improperly disinfected flexible endoscope in their cases.  This recall, coupled with the recent issue at an armed forces facility in Qatar, continues to remind us of the risks that improperly reprocessed scopes represent to our patients. 

While the facility believes the “risk of illness in this situation is minimal,” they are nonetheless asking the patients to come in for screening – creating a substantial time commitment and unnecessary anxiety for the affected patients.  The patients in question underwent an upper-region endoscopy or colonoscopy at Largo Medical Center. Kaiser Permanente issued a statement regarding the issue:

“We are reaching out to 23 patients to let them know that a piece of endoscopy equipment at our Largo Medical Center in suburban Maryland had a defect that might have kept it from being thoroughly disinfected. Kaiser Permanente follows nationally recommended protocols for the cleaning and disinfection of all equipment used during procedures to ensure the safety of our patients and that all potentially transmissible infectious agents have been removed. The scope in question was disinfected following the recommended protocols before its use. However, after discovering the defect and conducting subsequent analysis, we determined that we cannot guarantee that the sterilization process was fully effective.

Even though our physicians believe the risk of illness in this situation is minimal, gastroenterologists are contacting the 23 members who underwent a colonoscopy/upper endoscopy at the Largo Endoscopy Unit to explain the situation and ask them to come in for some screening tests. Each member’s primary care physician will work closely with them to ensure appropriate care is provided. All members will also receive a letter from Kaiser Permanente.

At Kaiser Permanente, the health and safety of our members is our absolute top priority. We are committed to ensuring that this does not happen again.”.”

Read the entire article by WJLA in Washington D.C. here: Officials reach out to 23 Md. medical center patients after equipment improperly cleaned

Rapid outbreaks call for rapid responses – Kaiser Permanente seems to have caught this issue before it created issues for even more patients.  Make sure your facility is prepared to do the same by having well-documented procedures and inspecting that they are being followed as designed. If you believe your hospital could use some help thoroughly documenting its procedures, automated systems such as iRIScope can make the capture and reporting of such steps seamless while reducing the amount of time sterile processing staff spend documenting their work.