Preventative Maintenance Training
You’ve asked for it. We heard you. Now we are offering it.
By popular demand, starting in March 2012, MER, the world leader in endoscope repair training, will offer a new 2-day Preventative Maintence Inspection Class.
Check back soon for more information!
Cross Contamination from Flexible Endoscopes Makes Top 10 List, Again
For the third year in a row the ECRI Institute has included Cross Contamination from Flexible Endoscopes on their Top 10 Health Technology Hazards List. This year it makes the list in the number 4 position. This is down from the first appearance in 2010 and the number 3 spot last year. While the position of Cross Contamination from Flexible Endoscopes on the hazard list has been reduced, the importance of proper reprocessing should be kept at the top of every endoscopy department and clinical engineering list for patient safety.
In order for a patient safety hazard to be included on the list it must meet one or more of the following factors:
- Occurrences have resulted in death or serious injury.
- Occurrences have been frequent.
- When it occurs there is a high probability that a number of people will be affected.
- Occurrences have been given high profile media coverage.
ECRI has Included Recommendations to make your safety initiatives as effective as possible :
- Ensure that a specific reprocessing protocol exists for each flexible endoscope model in your facility’s inventory.
- Periodically review protocols to ensure that they are clear and comprehensive and that they reflect the current environment.
- When developing or reviewing protocols, ensure that all steps are addressed and documented in adequate detail.
- If your facility reprocesses endoscopy equipment using a reprocessing unit ensure that:
- Endoscopes are compatible with the reprocessor and its disinfecting/sterilizing agent.
- The appropriate channel adapters are available to connect the endoscope to the reprocessor, and staff are familiar with the correct endoscope/ connector combinations.
- Staff are familiar with and adhere to appropriate reprocessor maintenance schedules, including the periodic replacement of particulate and bacterial filters.
- Ensure that documented protocols are readily available to staff and that staff are trained to understand and follow them.
To these MER would also like to add the recommendation to conduct regular visual inspection during reprocessing and preventative maintenance inspections with 10X magnification to identify any manintenance related crevices where bio burden can accumulate and prevent adequate cleaning. Read below for more information…
YIKES! Is It Time For A New Repair Company?
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YIKES! If Your Distal Tips Look Like This, |
 Recessed lenses like those in the above picture create a crevice in which body protein matter collects, making it extremely difficult to adequately clean and disinfect. On this instrument you can actually see the matter collected around the light guide lenses and objective lens. |
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Correctly Sealed Lens Assembly and C-Cover Lenses that are raised slightly above the surface of the c-cover, as shown here, allow for a proper seal and eliminates cleaning and disinfection issues.This slight elevation of the lens assemblies also allows the air water nozzle to properly clear the objective lens during procedures.
With cross contamination from flexible endoscopes holding the number 3 position of risk on the ECRI Institute’s 2011 Top 10 Health Technology Hazards List, the Technical Team at MER encourages you to regularly view your scopes with a 10x magnification as part of your disinfection protocol. If you see something that looks like the top picture or the one down below, it’s time to fire your current repair company and call Matlock Endoscopic.
Other things to look for while conducting a visual inspection with magnification include:
1-800-394-9822
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Flexible Endoscope Preventative Maintenance & Minor Repairs
The new Scope Requirements announced by the Joint Commission a few months ago highlight the trend MER has seen towards the increasing role of Clinical Engineering with regards to inventory management, preventative maintenance schedules and repair cost reduction of flexible endoscope. With this increased responsibility comes an increased need for knowledge.
For decades the OEM and most ISO’s have kept this knowledge shrouded in a cloak of mystery, presuming that no mere mortal BMET could undertake the preventative maintenance and repair of these expensive, delicate instruments.
Recently a well-respected member of the biomed community shared his disdain for the ISO concept of Flexible Endoscope Preventative Maintenance. “At the end of the “PM”, the ISO typically hands the hospital a list of repair recommendations. This is kind of like taking your car to a mechanic, asking him to recommend work that may be needed, with the mechanic knowing that you’re going to pay him to “fix” everything he recommends. If your looking for a PM program to perform in-house, you might want to check your scopes for wear, angulation, o-rings on air/ water buttons, and of course leaks.”
OK, so you’ve checked your scopes for wear, angulation issues, o-rings and leaks. Now what? Send it to the OEM? Send it to an ISO? How about fix it In-House. Whether it is a first call approach or a complete repair depot there is tremendous value in having in-house flexible scope repair capabilities. Everyone benefits – the facility, the doctors, the patients, the departments, and YOU.
With the help of MER’s Flexible Endoscope Repair Training Program, more and more brave biomeds have dared to pull back the curtain and found that scope wizardry is not rocket science. As a result MER has experienced a 125% enrollment increase over the past 3 years. Since 1998 MER has trained technicians from the US, Canada, Europe, and Asia to repair flexible endoscopes. If they can do it, you can too.
With 5 days of training and less than the cost of 1 OEM rebuild, a BMET can perform 60% of repairs in house, and over half of these repairs can be done within 1 hour or less. Scope repairs can be done in any bio-med shop equipped with a 96” x 30” anti-static bench. There are a few specialty tools needed to open the scope, but other than that you use standard bench tools.
Because Olympus® holds 85% of the world market share, parts availability for this brand is greater than Fujion® or Pentax®. In the past 20 years an entire industry has grown around replacement part for Olympus ® endoscopes, but all parts are not created equal. Part of the MER program is using our 20 years of researching the highest quality parts to ensure that your parts meet or exceed OEM standards. With an in-house repair program for Olympus ® flex scopes your Service Value Ratio for these instruments can be 5-8%.
The MER Flexible endoscope repair program is taught in 3 phases that allow you to take it from the level of mastering flexible scope preventative maintenance and performing minor repairs through complete self-sufficiency. It’s all about what makes sense for your facility size, equipment inventory and volume of endoscopic procedures. We can even help you set up your own in-house loaner program.
MER is currently enrolling for our 2011 classes.
Phase 1 – Introduction to Endoscopes, Minor Repairs, and Angulation Rubbers
Phase 2 – Internal Component Replacement
Phase 3 – Major Repairs and Rebuilds
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For more information, scheduling and fees.
Cold Weather Endoscope Care
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Upon receiving a scope back from repair, open the case for about 30 minutes and allow the instrument to reach room temperature before removing it from the case. This simple step can prevent premature breakdown of the light guide tube and insertion tube as well as damage to the internal components. |
The Folly of Fluid Invasion
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Any time a flexible endoscope is immersed in water or a cleaning solution a fluid invasion can occur if a leak is present. Proper leak testing is the easiest way to identify the location of a leak. If a leak remains undiagnosed for any period of time it can result in significant repair costs related to rusted components, damage and corrosion of electronics, and brittle or weak fiberoptic bundles.
The Control Body is made of plastic and metal that is difficult to damage without impact, but even slight impact can cause the o-rings and seals that join the parts together to misalign and leak. Leaks with the Control Knobs can be particularly problematic and tricky. During the leak testing procedure it is important to manipulate the control knobs while the scope is adequately pressurized. Depending on the location of the leak and position of the knobs a leak can be missed or it can become an open floodgate if pressure is not kept on the scope. 
The Electronic Connector has an airtight cap that must be used to cover and seal this delicate part prior to any form of submersion. The seal on the cap should be checked regularly as a damaged seal or crack in the plastic will render the cap leaky. Corrosion in the EC can lead to CCD damage. Replacing a CCD can cost $5000 or more.
Leak Test…Leak Test…Leak Test
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Protecting Your Capital Investment
With the slowing economy resulting in smaller capital budgets for new endoscopy equipment, forging a solid relationship with a reputable repair vendor is more important than ever. Even if you have an OEM service contract on your newer equipment, you still need to maintain your 160, 140 and 100 series scopes.
Never replace your flexible endoscopes prematurely. There is little that cannot be repaired on a flexible scope with today’s advanced repair technologies. At a price of $25,000 and up for new scopes, consulting with a reputable repair vendor before considering replacement is both practical and prudent.
Should you need to replace, taking advantage of refurbished equipment is a wise option. A reputable vendor can help you put together complete systems at a fraction the OEM cost and provide service contract options to help control maintenance and repair cost of these delicate instruments.
The market is flooded with vendors, but there are only a few real professionals. There are vendors with workshops in their garage or basement. There are vendors that will Frankenstein your scope back together with sub-par parts and repair techniques. And then there is Matlock Endoscopic who has specialized in small and large diameter flexible endoscope repair, complete system sales, and facility installation for nearly 20 years.
Not sure about the facility you are using? Request a site visit. We would love to see you.
Common Questions in Flexible Endoscopy
When clinical staff members who have contact with your flexible scope inventory truly understand scope nomenclature, how a scope works and proper handling, your facility or department should have fewer incidents of damage due to improper handling or accidental breakage. But what happens when something does go wrong? Do you understand symptoms of problems and how to prevent a minor problem from becoming an expensive repair?  M.E.R. has the answers you need.
Why is my scope foggy?
The camera lens is broken and needs to be repaired. Fluid invasion is possible. Do not hang the scope; send for repair immediately.
Why is the endoscope beeping on its own?
Possible fluid invasion or loose connection internally on the microswitches. Do not hang the scope; send for repair immediately.
Why does the endoscope angulate in only 3 directions?
Broken angulation cable.
Slipped stopper on angulation cable.
An angulation is needed.
A coil pipe is detached from insertion tube.
What does excessive play mean?
The angulation cables have stretched and need to be adjusted.
What does reduced angulation mean?
Angulation stoppers need to be adjusted; no wires need to be shortened.
Why do I feel bumps when passing a brush or forcep through the channel?
Channel is possibly kinked or bent.
The instrument is damaged or bent.
The channel is obstructed.
What causes a buckle?
Coiling the endoscope in too tight a radius.
Bending or pressing down on insertion tube during the procedure.
Why does the video image slowly turn gray or foggy during procedures, and then turn back to normal?
The camera head seal on the distal tip is broken or cracked.
Possible fluid invasion. Do not hang; send for repair immediately.
Why can I see debris when I look into the light guide connector prong?
Possible broken light guide(s).
The scope has a possible fluid invation. GRAVITY + FLUID= DIRTY PRONG.   (When a scope is hung with fluid trapped inside, the fluid and lubricants automatically flow to the end of the scope).
Should I hang a scope that I know is flooded?
No, it can cause corrosion and further internal damage. Send for repair immediately.
Flexible Endoscope Repairs: Doing It Your Way
Today more than ever hospitals are seeking innovative ways to reduce costs and provide affordable health care. Empowering your Biomedical Engineering team to perform simple repairs on-site can save your facility hundreds of thousands of dollars in repair and shipping costs annually. Some multi facility systems have adopted the repair depot concept through which system wide repairs can be performed.
The November 24 x 7 cover story, Doing It Their Way, features the unique approach to cost containment on equipment repair adopted by Methodist Le Bonheur Healthcare, Memphis, TN.
If you’re interested in learning more about training your Clinical Engineering department to perform repairs on flexible endoscopes, look no further than Matlock Endoscopic’s Endoscope Repair Training Classes.
