Multiple common endoscopic procedures have been linked to contaminated scope infections. From ERCP to colonoscopy to bronchoscopy, patients undergoing routine diagnostic and therapeutic procedures have been exposed to dangerous pathogens through reusable scopes that cannot be adequately cleaned between patients.
If you developed an infection after any endoscopic procedure, you may have been harmed by a contaminated scope. Understanding which procedures carry the greatest risk is the first step toward protecting your rights.
Endoscopic Retrograde Cholangiopancreatography, or ERCP, is a specialized endoscopic procedure used to diagnose and treat conditions of the bile ducts and pancreas. Physicians perform ERCP to address gallstones lodged in the bile duct, biliary blockages, pancreatic duct strictures, tumors affecting the biliary system, and chronic pancreatitis. Approximately 700,000 ERCP procedures are performed in the United States each year.
During the procedure, a specialized endoscope called a duodenoscope is passed through the patient's mouth, down the esophagus, through the stomach, and into the duodenum (the first part of the small intestine). The physician then uses the scope to access the bile ducts and pancreatic ducts for diagnosis, imaging, or treatment. What distinguishes a duodenoscope from other endoscopes is a small, mechanical component at the tip of the scope known as the elevator mechanism.
The elevator mechanism is a tiny, movable lever at the distal end of the duodenoscope that allows the physician to control the direction of wires, catheters, and other instruments passed through the scope's working channel. While this component is essential for the procedure, it is also the primary design defect identified in contaminated Olympus scopes.
The elevator mechanism creates a small, enclosed channel with tight crevices, seams, and moving parts that are nearly impossible to clean and disinfect using standard reprocessing methods. Biological material — including blood, tissue, bile, and bacteria — becomes trapped in and around the elevator mechanism during the procedure. Even when hospitals follow Olympus's own reprocessing instructions to the letter, research has shown that dangerous pathogens can survive within the elevator channel and be transmitted to subsequent patients.
ERCP carries the highest infection risk of any endoscopic procedure. The duodenoscope's elevator mechanism creates a persistent reservoir for dangerous bacteria, including carbapenem-resistant Enterobacteriaceae (CRE) — superbugs that are resistant to nearly all available antibiotics and carry mortality rates as high as 50%.
Multiple hospitals across the United States have traced CRE outbreaks directly to contaminated ERCP duodenoscopes. In several of these outbreaks, patients died after contracting superbug infections from scopes that had been cleaned according to the manufacturer's instructions. These outbreaks ultimately contributed to the FDA's decision to take action against Olympus endoscopes.
The connection between contaminated duodenoscopes and patient infections is not theoretical — it has been documented at major hospitals nationwide. These outbreaks involved antibiotic-resistant bacteria transmitted between patients through scopes that had undergone standard reprocessing. Investigations revealed that the design of the scopes themselves, not hospital negligence in cleaning, was the root cause.
The elevator channel's design meant that even meticulous cleaning could not eliminate all biological material, leaving a pathway for cross-contamination between patients. Each time a contaminated duodenoscope was used, the patient undergoing the ERCP was unknowingly exposed to whatever pathogens the previous patient carried.
Colonoscopy is the most common endoscopic procedure performed in the United States, with approximately 20 million procedures conducted every year. It is the gold-standard screening tool for colon cancer and is recommended for all adults beginning at age 45. During the procedure, a long, flexible instrument called a colonoscope is inserted through the rectum and advanced through the entire length of the large intestine (colon).
Colonoscopy allows physicians to visually examine the lining of the colon, identify and remove precancerous polyps, take tissue biopsies, and diagnose conditions such as inflammatory bowel disease, diverticulosis, and colorectal cancer. For most patients, colonoscopy is considered a routine, preventive procedure — which makes the risk of infection from a contaminated scope all the more alarming.
Like all reusable endoscopes, colonoscopes contain internal channels through which instruments are passed during the procedure. These channels must be meticulously cleaned and disinfected between patients to prevent cross-contamination. When the design of the colonoscope prevents adequate reprocessing, bacteria and other pathogens from one patient can be transmitted to the next.
The sheer volume of colonoscopies performed each year means that even a small contamination rate translates to a staggering number of potential infections. If just one-tenth of one percent of colonoscopies resulted in pathogen transmission from a contaminated scope, that would represent 20,000 infections annually in the United States alone.
Studies examining reusable endoscopes after standard reprocessing have found bacterial contamination rates ranging from 1.4% to as high as 35%, depending on the study methodology and the type of organisms tested. These findings suggest that the actual number of patients exposed to contaminated colonoscopes may be far higher than documented outbreak reports indicate.
Because colonoscopy is a screening procedure often performed on otherwise healthy individuals, many patients do not expect complications. When an infection develops days or weeks after the procedure, patients and physicians alike may attribute it to unrelated causes rather than connecting it to the colonoscope itself.
Many patients who develop infections after colonoscopy never connect their illness to the procedure. Symptoms may appear days or even weeks later, by which time the patient may have forgotten about the colonoscopy entirely. If you were hospitalized with an unexplained infection, required IV antibiotics, or developed sepsis within 30 days of a colonoscopy, a contaminated scope may have been the cause. Review your potential infection symptoms and consider whether an endoscopic procedure preceded your illness.
Upper endoscopy, formally known as esophagogastroduodenoscopy (EGD), is an endoscopic procedure that allows a physician to examine the upper portion of the gastrointestinal tract. During the procedure, a flexible scope called a gastroscope is passed through the patient's mouth and advanced through the esophagus, into the stomach, and into the duodenum (the first section of the small intestine). Approximately 12 million upper endoscopies are performed in the United States each year.
Physicians use EGD to evaluate and diagnose a wide range of conditions, including gastroesophageal reflux disease (GERD), esophageal strictures or narrowing, Barrett's esophagus (a precancerous condition), peptic ulcers and gastritis, celiac disease, unexplained abdominal pain or difficulty swallowing, and suspected upper GI tumors. During the procedure, the physician can also take tissue biopsies, remove polyps, dilate strictures, and place stents.
The gastroscope used in EGD procedures shares the same fundamental design challenges as other reusable endoscopes. It contains narrow internal channels for air, water, suction, and instrument passage. These channels must be thoroughly cleaned, brushed, and subjected to high-level disinfection between each patient use.
When the scope's design includes features that trap biological material — such as tight bends in channels, rough internal surfaces, or components that cannot be fully accessed during cleaning — standard reprocessing procedures may fail to eliminate all pathogens. This means that bacteria, viruses, or other infectious material from one patient can remain in the scope and be introduced into the next patient's esophagus, stomach, or small intestine.
Upper endoscopy is one of the most frequently performed endoscopic procedures in the country. Patients undergo EGD for symptoms ranging from chronic heartburn to unexplained weight loss to suspected cancer. The procedure is generally considered safe and well-tolerated, which can create a false sense of security regarding infection risk.
However, any time a reusable scope is inserted into a patient's body, there is a risk that inadequate reprocessing has left behind infectious material. The high volume of EGD procedures means that contaminated gastroscopes have the potential to affect a large number of patients. Infections after EGD may manifest as unexplained fever, abdominal pain, or systemic infection — symptoms that may not immediately prompt an investigation into the endoscope as the source.
Bronchoscopy is an endoscopic procedure that allows a physician to examine the airways and lungs. During the procedure, a thin, flexible instrument called a bronchoscope is passed through the patient's nose or mouth, down the throat, through the vocal cords, and into the trachea (windpipe) and bronchial tubes. This gives the physician a direct view of the airways and allows them to collect samples, perform biopsies, and carry out certain treatments.
Physicians order bronchoscopy to evaluate a persistent or unexplained cough, investigate suspected lung infections or pneumonia, examine abnormal findings on a chest X-ray or CT scan, diagnose suspected lung cancer or other tumors, collect tissue samples (biopsies) from the lungs or airways, remove foreign objects from the airway, and treat airway obstructions or bleeding. Bronchoscopy is performed in both inpatient and outpatient settings and is a critical diagnostic tool for pulmonary medicine.
Contaminated bronchoscopes pose a particularly dangerous threat because they deliver infectious material directly into the lungs — one of the most vulnerable organ systems in the body. Unlike the gastrointestinal tract, which has stomach acid and other natural defenses against pathogens, the lungs are highly susceptible to infection when bacteria are introduced directly into the airways.
Contaminated bronchoscopes have been linked to outbreaks of Pseudomonas aeruginosa, a particularly aggressive and often antibiotic-resistant bacterium that can cause severe pneumonia, respiratory failure, and sepsis. Other pathogens transmitted through contaminated bronchoscopes include Mycobacterium species (including tuberculosis), Klebsiella pneumoniae, and various multidrug-resistant organisms. For patients who are already immunocompromised — such as those undergoing cancer treatment, organ transplant recipients, or elderly patients — a lung infection from a contaminated bronchoscope can be fatal.
Patients who develop respiratory infections after bronchoscopy should consider whether the scope itself may have been the source. Symptoms to watch for include new or worsening fever within days to weeks of the procedure, persistent cough with increasing sputum production, shortness of breath or difficulty breathing, chest pain, and signs of systemic infection such as chills, rapid heart rate, or confusion.
Because many patients undergo bronchoscopy specifically because they already have respiratory symptoms, a post-procedure infection may be mistakenly attributed to the underlying condition rather than to a contaminated scope. If your respiratory symptoms worsened significantly after bronchoscopy, or if you developed a new infection with a different organism than what was initially suspected, a contaminated scope should be investigated as a potential cause. Learn more about infection symptoms to watch for.
Whether you underwent an ERCP, colonoscopy, upper endoscopy, or bronchoscopy, all of these procedures share the same fundamental problem: they rely on reusable endoscopes with complex internal channels that are extraordinarily difficult to clean and disinfect between patients.
The internal architecture of these scopes — narrow lumens, tight bends, suction channels, air and water channels, and in the case of duodenoscopes, the elevator mechanism — creates an environment where biological material can become trapped and resist standard reprocessing. This is not a hospital hygiene problem. It is a product design problem. When manufacturers like Olympus design and sell scopes that cannot be adequately cleaned even when hospitals follow the manufacturer's own instructions, patients are placed at risk regardless of which procedure they undergo or how carefully the facility handles the equipment.
Research has consistently demonstrated that standard high-level disinfection procedures fail to eliminate all pathogens from reusable endoscopes. Studies have found viable bacteria, blood residue, and other biological material remaining inside scopes after they were cleaned according to the manufacturer's reprocessing guidelines. This evidence forms the foundation of product liability claims against Olympus and other endoscope manufacturers.
For a deeper understanding of how endoscope design defects lead to contamination, visit our page on what is endoscope contamination. To learn about the regulatory response to this crisis, see our page on FDA warnings and actions.
If you or a loved one developed a serious infection following a colonoscopy, ERCP, upper endoscopy, bronchoscopy, or any other endoscopic procedure, you may be entitled to compensation. Our team of Board Certified trial lawyers and medical-legal experts can evaluate your case at no cost and with no obligation. We only get paid if you win.
