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2014, involving approximately 135 patients, but it seems that concrete steps to
address problems related to dirty scopes began in earnest this year. In late
March, Olympus issued new reprocessing instructions for its TJF-Q180V duo-
denoscope. That's also when the American Society for Gastrointestinal
Endoscopy (ASGE) gathered 60 experts for a duodenoscope infection control
summit and the American Gastroenterological Association (AGA) convened a
"Getting to Zero" meeting to figure out how to stop device-associated infections.
Instruments manufactured by Fujifilm, Olympus and Pentax have been linked
to the outbreak; the 3 companies said earlier this year that they will cooper-
ate fully with the FDA to address concerns surrounding duodenoscopes
and CRE infection.
Why didn't anyone act sooner? The answer, whether you choose to
accept it or not, lies in striking a delicate balance between the undeni-
able benefit of using the scopes and the true risk of infection.
'A tough spot'
Patients who undergo ERCP are very sick,
points out Stuart Gordon, MD, director
of gastrointestinal endoscopy at
Dartmouth-Hitchcock Medical
Center in Lebanon, N.H.
Duodenoscopes let physicians
access the bile duct with
minimal invasiveness dur-
ing what are often outpa-
tient procedures, says
Dr. Gordon, who
adds that major
surgery is the only
