title: Reprocessing and reuse of single-use medical devices used during hemodynamic procedures in Brazil: a widespread and largely overlooked problem.
abstract: BACKGROUND
  Several medical devices used during hemodynamic procedures, particularly angiographic diagnostic and therapeutic cardiac catheters, are manufactured for single use only. However, reprocessing and reuse of these devices has been reported, to determine the frequency of reuse and reprocessing of single-use medical devices used during hemodynamic procedures in Brazil and to evaluate how reprocessing is performed.
  
  
  METHODS
  National survey, conducted from December 1999 to July 2001.
  
  
  METHODS
  Most of the institutions affiliated with the Brazilian Society of Hemodynamic and Interventional Cardiology were surveyed by use of a questionnaire sent in the mail.
  
  
  RESULTS
  The questionnaire response rate was 50% (119 of 240 institutions). Of the 119 institutions that responded, 116 (97%) reported reuse of single-use devices used during hemodynamic procedures, and only 26 (22%) reported use of a standardized reprocessing protocol. Cleaning, flushing, rinsing, drying, sterilizing and packaging methods varied greatly and were mostly inadequate. Criteria for discarding reused devices varied widely. Of the 119 institutions that responded, 80 (67%) reported having a surveillance system for adverse events associated with the reuse of medical devices, although most of these institutions did not routinely review the data, and only 38 (32%) described a training program for the personnel who reprocessed single-use devices.
  
  
  CONCLUSIONS
  The reuse of single-use devices used during hemodynamic procedures was very frequent in hospitals in Brazil. Basic guidance on how to reuse and reprocess single-use medical devices is urgently needed, because, despite the lack of studies to support reusing and reprocessing single-use medical devices, such devices are necessary in limited-resource areas in which these practices are current.
authors.affiliation: Hospital Samaritano de São Paulo, Brazil.
authors.forename: Jorge M Buchdid
authors.initials: JM
authors.lastname: Amarante
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Toscano
authors.forename: Michele L
authors.initials: ML
authors.lastname: Pearson
authors.forename: Virginia
authors.initials: V
authors.lastname: Roth
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
authors.forename: Anna S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D001938:Brazil; D006328:Cardiac Catheterization / Q000295:instrumentation*; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control; D004203:Disinfection / Q000379:methods; D004209:Disposable Equipment; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D017743:Equipment Reuse / Q000706:statistics & numerical data*; D004869:Equipment Safety; D019538:Health Care Surveys; D006801:Humans; D013242:Sterilization / Q000379:methods; D011795:Surveys and Questionnaires; D014656:Vascular Surgical Procedures / Q000295:instrumentation*