Happy Holidays! ... Home of "The Q-Net Monthly."

1. Just in!  Q-Net: "Annual Quiz 2010." (2011 Nov-Dec;17[11,12]:21-24S)
2. The "Answer Box and Key" for Q-Net's annual 2011 quiz.

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3. Also:  Q-Net: "A discussion of 5 contrverisal reprocessing topics." (2011 Aug-Sept-Oct;17[8-10]:15-20)

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4. Incident in Ottawa: 4 patients test positive for the hepatitis C virus. YourOttawa Region.com November 17, 2011.
5. Tracing the path of infection. Ottawa Citizen November 12, 2011.
6. Farazli clinic’s former patients may learn lessons from tainted blood scandal. Ottawa Citizen November 7, 2011.
7. EndoNurse:  Risk factors for infection with hepatitis during GI endoscopy.

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8. Health scare in Ottawa:  6,800 former patients of an Ottawa GI endoscopy clinic may have been exposed to HIV or hepatitis:  Article 1 (Toronto Sun);  Article 2 (Ottawa Public Health);  Article 3 (Ottawa Citizen);  Article 4 (The Star.com);  Article 5 (The Digital Journal);  Article 6 ( The City of Ottawa);  Article 7 (The Ottawa Citizen);  Article 8 (Vancouver Sun);  Article 9 (CTV News);  Article 10 (Vancouver Sun);  Patient notification letter (Oct 17, 2011);  Opinion: An argument for patient disclosure (Ottawa Citizen).

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9. Some of my lectures this fall:   (1) Kansas - Overland Park, KS <Brochure> Nov 5th, 2011. (2) Minnesota - SGNA's Fall Conference: Brooklyn Park, MN <Brochure> Oct 7-9, 2011. (3) Arkansas - SGNA's Fall Conference: North Little Rock, AR <Brochure> Oct 15th, 2011.

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10. Q-Net:  "Review of a CDC Report about Healthcare-Associated Infections."

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11. My comments in reply to the FDA's request in the Federal Register for the public’s perspectives on the reprocessing of reusable medical devices.
12. The FDA notice entitled “Reprocessing of Reusable Medical Devices,â€Â published recently in the Federal Register (Document Number: FDA-2011-N-0294)
13. A simple electronic method for sending your own comments to the FDA.
14. Also see:  the FDA's “Draft Guidance for Industry and FDA Staff: Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling.â€Â

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15. Cocke S. Hawaii Public Kept in Dark about Hospital Infections. Honolulu's Civil Beat 08/30/2011
16. My comments in reply to this newspaper article.

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17. Also, Q-Net: "Published Central Line-associated Bloodstream Infections: More Conjectural than Scientific?"

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18. Also new:  "Study of a Contaminated Colonoscope":  How to Prevent Infection.

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19. Q-Net:  "Recommendations to Prevent Healthcare-Acquired Infections."
20. Q-Net:   How to reprocess the Olympus MAJ-855 water tube.
21. Q-Net:  "Published Infection Rates: More Conjectural than Scientific?"
22. Q-Net:  "Three Facts and Myths about Published Infection Rates."

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23. Ryan C. Court allows civil suit in hepatitis C outbreak to proceed. Las Vegas Sun July 28, 2011.
24.  AP. Nurse in Las Vegas hepatitis c trials can't testify as expert witness regarding cause. The Republic July 28, 2011.
25. Southerm Nevada Health District. Outbreak of hepatitis C at outpatient surgical centers. Public health investigation report. (Las Vegas, Nevada) December, 2009.

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26. Is colonoscopy a risk factor for transmission of hepatitis C virus?  Review following articles:  Bronowicki et al. (1997);   Gonzalez-Candelas et al. (2010);  Bruguera et al. (2002).  Also see: Yonat Shemer-Avni et al. (2007);  Krause et al. (2003); Gutelius et al. (2010);  Q-Net (December 2007); Muscarella (2001).

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27. "The Seattle Times" (OP/ED): "Getting at the truth behind hospitals' published infection rates."  (December 5, 2010; by: Lawrence F. Muscarella, PhD)
28. "The Kitsap Sun" (special column): "MY TURN | Infection Rate Data: Science or Conjecture?" (December 12, 2010; by Lawrence F. Muscarella PhD).

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29. CDC. Vital Signs: Central Line--Associated Blood Stream Infections --- United States, 2001, 2008, and 2009. MMWR March 4, 2011 / 60(08);243-248.
30. CDC. First State-Specific Healthcare-Associated Infections Summary Data Report (January-June, 2009).
31. CDC: Methicillin-Resistant Staphylococcus aureus Central Line–Associated Bloodstream Infections in US Intensive Care Units, 1997-2007. JAMA 2009;301(7):727-736.

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32. NHS patient dies, 150 at risk from Hepatitis B infection linked to contaminated equipment. The Telegraph July 22, 2011.
33. More than 150 patients warned over exposure to hepatitis B at Swansea's Morriston hospital. Wales On-line July 22, 2011.

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34. Muscarella LF. Published reductions in infection rates: Valid data or optimistic thinking?  British Medical Journal  [Letter] (March 2010).
35. Q-Net: "Dear Consumer Reports." (From Q-Net's Jan-Feb-Mar, 2010, issue)

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36. Dr. Muscarella, discussed or quoted on the front page of the:  <"Wall Street Journal">; <"Investor's Business Daily">; <"San Juan Weekly">; <"USA Today">, among others.
37. Dr. Muscarella:  One of the industry's "100 Notable People."

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38. Automated endoscope reprocessors. Gastrointest Endosc 2010;72(4):675-80.

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39. A study:  Multidrug-resistant Klebsiella pneumoniae outbreak after ERCP.
40. An editorial about this study by Dr. Muscarella in Endoscopy (Nov 2010).

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41. Infection-control breaches and patient safety concerns in Puerto Rico. (Muscarella LF. The Q-Net Monthly Apr-May-June 2010.)
42. Patient disclosures - A contrast in cultures?   Canada notifies patients of lapses associated with a low risk of infection (article #1 or article #2), whereas the U.S. does not (click here).
43. Patient notification letter (December 2, 2010. (Royal Inland Hospital in Kamloops)
44. The Disclosure Dilemma — Large-Scale Adverse Events. Dudzinski et al. (2010).

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45. "Infection Control's Growing Weeds"? (Muscarella LF. The Q-Net Monthly)

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46. A "<correction>: EVOTECH(R) endoscope cleaner and reprocessor (ECR) simulated-use and clinical-use evaluation of cleaning efficacy. (By: Alfa et al.)
47. Dr. Muscarella’s 3-PART review of an article about ASP's EVOTECH reprocessing device:  <Part 1>;  <Part 2>;  <Part 3>.

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48. An article about biofilms: "Modeling microbial survival in buildup biofilm for complex medical devices." (Alfa and Howie; BMC Infectious Diseases 2009)
49. A 3-part review of this paper by Lawrence F Muscarella PhD: <Part 1>;  <Part 2>;  <Part 3>.

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50. Muscarella LF. Evaluation of the risk of transmission of bacterial biofilms and Clostridium difficile during gastrointestinal endoscopy. Gastroenterol Nurs. 2010 Jan-Feb;33(1):28-35.
51. Muscarella LF. Study of a contaminated colonoscope. Clin Gastroenterol Hepatol. 2010 Jul;8(7):577-80.

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52. Dr. Muscarella’s 3-PART article on the safe use of CIDEX OPA or Metricide OPA Plus: <Part 1> ("A Tale of Three Labels");  <Part 2>;   <Part 3>.

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53. How to reprocess ... rigid (their blades and handles) and flexible laryngoscopes.
    
54. A State of California recommendation for reprocessing flexible laryngoscopes.

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55. Instrument-reprocessing mishaps in Murfreesboro (TN), Augusta (GA), and Miami (FL):  Report of the Department of VA Office of Inspector General June 16, 2009 entitled "Healthcare Inspection - Use and Reprocessing of Flexible Fiberoptic Endoscopes at VA Medical Facilities." (A follow-up, dated September 17, 2009.)
56. NBC-WSMV (Murfreesboro, TN): Videos, A Root Cause Analysis, and other documents discussing the VA mishap in Tennessee.
57. VA Safety Alert (12-22-2008):  Improper reprocessing of flexible endoscope tubing.
58. Olympus "Important Safety Notice" regarding this VA incident, dated January 26, 2009.
59. Woman sues Augusta (GA) VA claiming that improper disinfection of a flexible laryngoscope infected her with the hepatitis C virus. Augusta Chronicle (7-6-10).

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60. "Healthcare Inspection - Patient Safety Issues. VA Caribbean Healthcare System, San Juan, Puerto Rico" (3-26-2010) Patient risk is deemed by the VA to be "negligible."
61. The San Juan Weekly:  Exclusive: Infection Control Breaches Unveiled. 6-24-10.
62. Dr. Muscarella concludes the risk of infection associated with these infection-control breaches confirmed by the VHA in the Caribbean is *not* negligible.
63. Corwin T. Warning of VA patients' risk was discounted. 9-12-2010 Augusta Chronicle

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64. Liquid Chemical Sterilization - A scientific or hopeful claim?
65. A juxtaposition of perspectives: The FDA's perspectives and Dr. Alfa's "anthology" of the STERIS System 1, compared and in contrast to some of Dr. Muscarella's conclusions, and more reprocessing conclusions, about "liquid chemical sterilization."
66. Filtered and extensively treated rinse water : the Achilles' heel of liquid-based instrument reprocessing systems.

Welcome to the new MyEndoSite.com - the home of The Q-Net^TM Monthly newsletter.  ... Your interactive and comprehensive infection control site.

MyEndoSite is committed to publishing information, including The Q-Net^TM Monthly - downloadable newsletters that focus on infection control and the prevention of healthcare-acquired infections and disease transmission during endoscopic, both flexible and rigid, and other types of surgical (invasive) and non-invasive medical procedures.

Each month this website is visited and read by thousands of healthcare practitioners. This website (MyEndoSite), its newsletters (The Q-Net^TM Monthly), and all of its content are offered free to the public.  Subscribe today using this <Subscribe to this website's newsletter> link.

MyEndoSite seeks to raise the standard of infection control and health care by forging evidence-based alliances between patients, medical device manufacturers, hospitals and other healthcare facilities, and federal agencies ... one published paper at a time.

Moreover, the main goal of Q-Net -- the idea behind the newsletter "The Q-Net Monthly" whose home is MyEndoSite.com and which is a technology assessment infection control-based network of questions, answers, viewpoints, and perspectives, -- is to encourage the infection control, endoscopy, and operating room communities to imrpove patient care not only by asking good questions, but also demanding well-referenced, evidence-based answers.

MyEndoSite.com is the home and website of Q-Net™, providing access to its educational and "required reading" newsletter, "The Q-Net™ Monthly," <Click here> for more about Q-Net.

• This site offers you the quality you would and have come to expect ... and much, much more.

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• Most unique and comprehensive, MyEndoSite.com features unique perspectives, editorials, reviews, commentatry, and position statements about such varying topics as <how to clean a flexible laryngoscope used in a doctor's office> to <how to prevent bloodstream infecitons in a hospital's intensive care units>.

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• Most of these are available as free, downloadable PDF newsletters - search for them using this website's "seach by topic" or "search by date" links.

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• This website also provides a list of important media reports that discuss instrument reprocessing mishaps, infection control breaches, and infectious outbreak investigations.

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• It discusses recent FDA public health advisories, device recalls and safety alerts.

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• It also provides discussions about and instructions for reprocessing a number of different types of reusable instruments.

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• And, it lists links to: important medical articles and other important educational material; to methods for sampling endoscopes, automated reprocessors, and rinse water; to published infection-control and instrument-reprocessing guidelines, FDA guidance documents, and CDC recommendations; and discussions of aseptic technique and operating room procedures.

Each of the articles published in this newsletter and available through this website were written by this website's and newsletter's founder, Lawrence F. Muscarella Ph.D.

MyEndoSite(TM) uses a powerful search and indexing feature that provides access to almost all of the back issues of The Q-Net™ Monthly, from 1996 - 2005. For your convenience, each back issue is indexed and categorized by its topic and date of publication. <Click here> to learn more about Q-Net™.

All of this website's published articles can be conveniently emailed to a colleague. Just visit the "Seach Q-Net by Topic" link and activate the "envelope" next to the article.

Participation, comments, and suggestions by the public are important to ensure that MyEndoSite(TM) is the most comprehensive, accurate, up-to-date, and unique website in these healthcare fields. Contact this website's moderator by <clicking here> to have additional information added to this site. Also refer to the <Feedback> and <Contact Us> links. 

All articles published in The Q-Net™ Monthly (unless stated otherwise) are written by:

Lawrence F Muscarella, Ph.D. 
Editor-in-Chief, The Q-Net Monthly
Chief, Infection Control
Director, Research and Development
Founder, Myendosite(TM): www.myendosite.com

Custom Ultrasonics, Inc.
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This website is designed, developed, maintained, and updated by:
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Send comments to: editor@myendosite.com

This website, MyEndoSite(TM), and Q-Net(TM) are supported by:

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© Custom Ultrasonics, Inc. 2008.

Disinfection, sterilization, Are all sterilization processes alike?, Inherent shortcomings of liquid chemical sterilants, Liquid chemical sterilization, High-level disifnection or "sterilization" of flexible endoscopes?, Sterilizing dental equipment, FDA labeling of liquid sterilants,  "Sterile" filtered rinse water, infection control, Endoscope reprocessing, Instrument reprocessing, Flexible endoscopes, Bronchoscope reprocessing Part 1 and Part 2, Flexible and rigid laryngoscope reprocessing, Serratia infections in neonatal intensive care units (NICUs) Part 1 and Part 2, Soaking endoscopes for 20 minutes at 20 degrees Celsius?, Hospital infections, contamination, bioburden, Published infection rates, Muscarella, MyEndoSite.com, q-net, risk management,  Instrument design and cross infection, Intensive care units (ICUs), MRSA, Clostridium difficile and biofilms, Study of a bronchoscope recall, TASS or toxic anterior segment syndrome, Lapses in ambulatory surgical centers, Automated endoscope reprocessors, Propofol, aseptic technique, glutaraldehyde, ortho-phthalaldehyde, Cidex OPA Revisited, Cidex OPA: Part 1 and Part 2 and Part 3, peracetic acid, Butterfly Effect, A risk analysis, Infection control's growing weeds?, Central processing, materials management, Double standards in infection control, Patient safety concerns in Puerto Rico, Steris System 1, Steris System 1E, Dear AORN Part 1 and Part 2, Importance of Endoscope Drying, To dry ort not to dry the endoscope?,  Deja vu .. all over again?,  Dear Newsweek, CJD, A case study: potential errors during end, Endoscope storge, CLABSI or central line infections, Risk and prevention of disese tranmission during GI endocopy: Part 1 and Part 2 and Part 3, Potential conflcits of interest in infection control, Study of a contamiated colonocsope, Are devices labeled to be reprocessed by an adulterated or misbranded "sterilizer" themsevels adulterated, misrbanded? Endoscope shuffling Part 1 and Part 2, Biological indicators: Part 1 and Part 2 (to monitor rinse water?), A proposal to prevention healthcare-acquried infections, Let sleeping dogs lie?, Endoscope damage Part 1 and Part 2, Steris Reliance EPS, ECRI Institute, Dear Consumer Reports, Dear CDC and HICPAC,  Adulterated and moisbranded medical devices, Antibiotic resistant Pseudomonas aeruginosa, Investigation and prevention of infections during ERCP, Sheathed flexible endoscopes, Adminisitration of IV medications and propofol during GI endoscopy, Contribution of tap water to healthcare-acquired infections of antibiotic-resistant Pseudomonas aeruginosa, Prevention of transmission of SARS and Whipple's disease and anthrax during GI endoscopy, Inconsistent endoscope-reprocessing guidelines, Leading a horse to water, The San Juan Weekly: Infection control breaches unveiled at Veterans Medical Center, An OP/ED article Part 1 (Kitsap Sun) and Part 2 (Seattle Times) and Part 3 by L.F. Muscarella about published infeciton rates: more conjectural than scientific?, The Steris System 1's rinse water is not sterile:  The Wall Street Journal and Invesotrs Business Daily.