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Health Highlights: Feb. 23, 2015

Endoscope Cleaning Problems Known by FDA Since Late 2013 One Patient Dead in Superbug Outbreak in North Carolina Nursing Home Quality Website Tightens Standards

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Endoscope Cleaning Problems Known by FDA Since Late 2013

Cleaning problems with endoscopes implicated in a number patient infections with deadly drug-resistant bacteria have been known to the U.S. Food and Drug Administration for more than a year, the agency said.

Seven people became infected with a superbug called CRE after undergoing endoscopy procedures at Ronald Reagan UCLA Medical Center, and CRE may have played a role in two of the patients' deaths, according to hospital officials. They added that 179 people were exposed to CRE during endoscopy.

Similar infections and deaths involving the devices -- called duodenoscopes -- have occurred across the country in recent years, ABC News reported. Duodenoscopes are inserted into the mouth to access the small intestines, pancreas and liver.

UCLA Medical Center officials said they traced the bacteria back to two endoscopes made by Olympus Corporation of the Americas. The scopes had only been in use since June and were cleaned according to the manufacturer's guidelines.

The FDA told ABC News it has known about cleaning issues and bacterial infections associated with duodenoscopes for more than a year.

"The CDC first alerted the FDA to a potential association of multi-drug resistant bacteria and duodenoscopes in fall 2013," an agency spokesperson said. "The FDA has been actively working with federal partners, manufacturers, and other stakeholders to better understand the issues that contribute to the infections and what can be done to mitigate them."

Late last week, the FDA issued a safety communication about duodenoscopes, which are used in about 500,000 procedures a year. The agency said meticulous cleaning and disinfection "may not entirely eliminate" the risk of patients contracting bacteria, ABC News reported.

The FDA said it received reports of suspected cases of patients contracting germs from reprocessed duodenoscopes between January 2012 and December 2014.

While there may be cleaning problems with duodenoscopes, it would be a "major, major step back for patient care" if doctors stopped using the devices, Dr. Michael Kochman, chair of the American Gastroenterological Association's Center for GI Innovation and Technology, told ABC News.

He said the scopes enable doctors to treat patients with deadly diseases and infections without surgery, and using other methods would actually result in more deaths.

"The value of the procedures performed utilizing these devices far outweighs the unfortunate events that have occurred," Kochman said.

A March 21 meeting to discuss the issue has been scheduled by the AGA. It will include the FDA, the Centers for Disease Control and Prevention, infectious disease specialists, gastroenterologists, endoscope makers and others, ABC News reported.


One Patient Dead in Superbug Outbreak in North Carolina

A superbug linked to two deaths in California has killed a patient in North Carolina.

So far this year, 18 people have contracted carbapenem-resistant Enterobacteriaceae (CRE), Carolinas HealthCare System spokesman Kevin McCarthy told CNN.

Of those 18 patients, 15 had CRE when they were admitted to the hospital in Charlotte and three acquired it while in the hospital. The cause of the infections is unclear, as is the cause of death of the patient who died, McCarthy said.

Seven people in Los Angeles contracted CRE after routine endoscopic procedures and two of them died, the Ronald Reagan UCLA Medical Center said last week. CRE was a contributing factor in those deaths, but the exact cause of death wasn't disclosed, CNN reported.

The patients in Los Angeles were infected by two medical scopes that were contaminated with CRE despite being disinfected according to guidelines.

The UCLA medical center is contacting 179 other patients who had endoscopic procedures between October and January, and is offering those patients home tests to screen for the deadly bacteria, CNN reported.


Nursing Home Quality Website Tightens Standards

Nearly one-third of nursing homes in the United States had their quality ratings lowered Friday by federal government.

It's the result of changes to one of three major criteria used to rate nursing homes on the Nursing Home Compare website, which uses a one-to-five star system to rank more than 15,000 nursing homes, The New York Times reported.

Federal officials adjusted the curve for the quality-measures rating, which uses data collected about every nursing home patient. The adjustment was made due to criticism that the rating was artificially inflated and inaccurate.

The changes will make it easier for consumers to see differences between nursing homes, as well as prompt nursing homes to make improvements, according to federal officials.

"You do need to raise the bar," Dr. Patrick Conway, chief medical officer at the Centers for Medicare and Medicaid Services, said at a news conference, The Times reported.

When it's fairly easy to achieve a high rating, "that's not going to incentivize the same level of improvement," Conway said.

Nursing home industry representatives claim the changes will frustrate, rather than help, consumers. Advocates for nursing home residents said the changes were long overdue.

"We think that rescaling the quality measures will result in improved reporting of the quality of care a nursing home may provide," Robyn Grant, director of public policy and advocacy at the group Consumer Voice, told The Times.

The Nursing Home Compare website receives 1.4 million visits a year, according to government officials.

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