Duodenoscopes are medical instruments used to perform a diagnostic procedure called endoscopic retrograde cholangio-pancreatography (ERCP). While complications from ERCP are rare, a number of hospitals have recently reported dangerous multidrug-resistant bacterial infections that likely originated with contaminated duodenoscopes.
Every year, some half a million U.S. patients undergo duodenoscope -assisted ERCP to examine and detect diseases of the liver, bile ducts and pancreas. These long, flexible, instruments are about the diameter of a pen, and are equipped with a tiny light and camera at one end. Three device manufacturers currently market duodenoscopes in the U.S.:
During ERCP, a duodenoscope is inserted into a patient’s mouth and guided through the esophagus, stomach and duodenum. It then transmits digital video images to a TV screen. Contras dye is injected through an open channel of the scope and X-rays are taken of the bile ducts and the pancreatic duct. The duodenoscope’s open channel also allows instruments to be passed through in order to perform biopsies, relieve obstructions of the bile ducts or pancreas, and to create incisions via electrocautery.
For best results, ERCP should be performed on an empty stomach. Prior to the procedure, the patient will be administered IV medications to cause relaxation and sleepiness, and possibly a local anesthetic to decrease the gag reflex. During ERCP, the patient will be in a semi-conscious state, and will still be able to follow instructions to change body position on the X-ray table. The procedure can last anywhere from fifteen minutes to one hour.
While ECRP is generally a safe procedure with a success rate of 75% to 90%, roughly 1 in 5 patients will experience complications. Some of the more serious adverse events include:
Recently, bacterial infections have come to be recognized as serious and potentially deadly duodenoscope complications.
Get the latest news and litigation updates about this case by following us on Facebook. Click the "Like" button below.