Damage Prevention

Leakage from the Bending Rubber Sheath

• Indication

  During dry leak test the needle in the gauge may fall During wet leak test a trail of bubbles may emerge from the scope's distal bending section Failure to immediately detect a leak could result in optics malfunction (Charge-coupled Device [CCD] blackout, image distortion, etc.) or other fluid damage

• Common Causes

  Inadvertent contact with sharp-edged objects such as needles, forceps, fingernails, bed frames, etc. Accessories that are reprocessed in the same container as the scope Scraping insertion tube against storage cabinets or wire mesh filters inside automatic scope reprocessors Scraping of insertion against a patient's teeth The weight of metal connectors or fittings from multiple scopes placed on top of the distal bending section

• Prevention

  Check for sharp edges on all surfaces of an automated cleaning/reprocessing unit Store endoscopes in a dedicated, well-ventilated cabinet with no sharp protrusions Do not grasp, carry or pull the scope by the distal bending rubber Avoid placing heavy parts or accessories on top of the scope

Cracked Objective Lens/Light Guide Cover Glass

• Indication

  Shadow or distortion of the endoscopic image

• Common Causes

  Impact to the tip of the scope against a table, wall, storage cabinet, metal sink, etc.

• Prevention

  Avoid any impact of the distal tip or the light guide prong of the endoscope with any hard surface during handling, storage or reprocessing of the scope Properly align the PVE connector when inserting the scope into the processor

Fluid (Water, Detergent, Disinfectant, or Sterilant) Invasion into Endoscope

• Indication

  Distorted or cloudy images Color degradation and image black out Multiple bumps or wrinkles along the scope insertion tube or umbilical cable Corrosion of metal components and damage to the insertion tubes, flexible parts, fiber optic cables and Charge-coupled Device (CCD) chips

• Common Causes

  Scope immersed without the soaking cap attached Scope immersed with the venting cap on Puncture of an internal channel due to improper use of an accessory or other sharp-edged device Puncture or leak of distal bending rubber with subsequent immersion without prior leak test Disconnecting the leakage tester while the scope is immersed Wet connection of the leakage tester Watertight integrity of the scope is compromised

• Prevention

  Carefully perform a leak test using the PENTAX leakage tester before any immersion, even if you use a fully automated cleaning device Electrical contacts and pins must be covered with the cap Never immerse the scope with the RED venting cap on. RED caps: OFF; soaking caps: ON during immersion Never insert a needle or wire into the air or water nozzle in an attempt to unblock a clogged channel Examine accessories and scope parts prior to every procedure. Never use forceps with misaligned or protruding cups or spikes, and never use non-retractable needles Take the entire leakage tester out of the water before disconnecting it from the plastic (PVE) connector Ensure that the connector is completely dry prior to any leakage testing If you use pressurized air or water pistols for cleaning, the pressure must be limited to a maximum of 24 PSI

Damage (buckles, bumps, kinks, or wrinkles) to the insertion tube and/or umbilical cable

• Indication

  Raised or depressed areas along the circumference of the insertion tube or umbilical cable

• Common Causes

  Acute bending of the scope during cleaning and handling Use of or prolonged exposure to harsh chemical or antimicrobial agents Being rolled over or stepped on Excessive heat Being trapped in the cabinet door Patient bite

• Prevention

  Avoid acutely bending the scope at any point, particularly where the flexible portion is connected to a rigid portion. Use only PENTAX compatible cleaning solutions. Do not overexpose scope to solution (check manufacturer specifications) Avoid tightly looping the scope while cleaning in a basin or sink Avoid grasping onto the umbilical cable while pulling the scope out from the processor. Instead hold onto the plastic (PVE) connector housing Never autoclave an endoscope Avoid over-coiling an endoscope in the sink Ensure proper handling of the scope

Clogged Air or Water Channels and Nozzles

• Indication

  Minimal or no air or water delivery

• Common Causes

  Improper or incomplete pre-cleaning and cleaning procedures resulting in the accumulation of patient debris within the air or water channels and nozzles; solidification of debris occludes the channels and nozzles and blocks the flow of air or water Chipped O-rings

• Prevention

  Immediately after removing the endoscope from the patient, wipe down the scope, turn the air pump switch on the light source processor to its highest pressure setting, set the level on the air/water bottle to the "drain" position, force air through the scope, in effect purging the air and water channels of the endoscope Immerse the scope in enzymatic detergent Inject enzymatic detergent through all channels of the scope (using the channel-cleaning adapters provided) If the distal nozzles of the scope are blocked, the scope tip should be soaked in an enzymatic detergent for approximately 10-15 minutes. Immediately after soaking, the distal nozzles should be cleaned with a lint-free cleaning cloth Complete a visual check of the O-rings and replace any chipped ones