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Study: catheter re-use safe, economical

by Dick Peterson
Public Relations
Here’s how to make a $1,200, single-use catheter better: Use it again. And again.

Sound outrageous? There’s more.

But first, let’s answer a couple obvious questions: 

Yes, it’s passed the scrutiny of MUSC’s Infection Control. Their concern is patient safety, and they do a good job of keeping patients and sources of nosocomial (hospital-acquired) infection apart. 

And no, the University Counsel’s Office isn’t the least bit worried about university liability should a re-used electrophysiology catheter fail. Because chances are, it won’t. A company whose business it is to prepare and inspect the catheters for re-use has accepted liability and is fully insured.

“We found that the catheters we re-use for treating heart arrhythmias are just as thoroughly cleaned, sterilized and inspected for defects as the new ones,” said Joan Janes, MUSC Pediatric Cardiology manager. Janes was part of an 18-month study that was accepted  as a poster presentation at the American Heart Association annual meeting Nov. 8 through 10 in Atlanta. Barbara J. Knick, a cardiovascular technician in Pediatric Cardiology, presented the study.

An electrophysiology catheter is a solid plastic cable with a mechanism at one end that allows a cardiologist to thread the other end through a major blood vessel in the patient’s groin or arm and steer it into chambers of the heart. The catheter is designed to locate areas of arrhythmia within the heart by transmitting electrical signals to cardiac monitors much the same as an EKG (electrocardiogram). With this information, cardiologists and technicians are able to map the electrical pathways of the heart and pinpoint sources of arrhythmia.

Once a source is located, a special electrophysiology catheter called a radiofrequency ablation catheter is used to deliver controlled energy to ablate (destroy) the defective nerve cells creating the arrhythmia. 

One electrophysiology or ablation catheter can cost anywhere from $400 to $1,200, and often a variety of catheters are used on one patient. A used catheter—cleaned, sterilized and
inspected—will cost from $200 to $500.

A Spartanburg company, Paragon Healthcare, processes the used catheters for re-use and manually inspects each one for sterility and function before releasing it. “New catheters undergo random inspection for quality control, but every one of these is thoroughly examined,” Janes said. She demonstrated how nothing on the solid-core catheter’s surface could harbor organic matter from a previous use.

“These are actually as good, and the quality of  every re-used catheter is ensured just as well, if not better than the new ones,” she said.

Janes’ claims are based on her department’s 18-month study in which re-used catheters were tracked for their performance and for patient outcomes. Bar codes on the packages matched the instruments with the patients for whom they were used.

From April 1, 1998 through Oct. 1, 1999, 130 electrophysiology procedures were performed, requiring the use of 510 of the special catheters. Of these, 311 were reused catheters. The study reports that “... no adverse consequences of catheter re-use occurred during this time period.” 

The study also states that the re-use program realized a savings of $98,759 during the 18-month study.  “The use of re-used catheters is still being tracked,” Janes said, “with no change in their reliability.

“We managed to get the attention of the American Heart Association,” she said. “Cost savings, equipment re-use and safety are all hot topics, and the AHA was interested.” 

Janes said that there is no industry standard on how many times a catheter should be re-used. She has heard of them being used up to 10 times, but five times has been set as a standard at MUSC.

“My goal is to provide high-quality care and save money for the hospital and the patient,” Janes said.

Authors of the study are:
Barbara J. Knick, LPN
Seshadri Balaji, MRCP
Robert B. Leman, M.D.
J. Philip Saul, M.D.
Joan L. Janes, BSRT