Air / Water Channels
Why Do These Problems Occur? 2014-10-12_115643 Scope is not cleaned and flushed immediately following the procedure allowing debris to collect and harden. Also, if the scope is not properly flushed out after disinfecting the disinfectant will crystallize causing obstruction. Kinked or collapsed channels are a result of excessive bending of the insertion tube and / or universal cord.

Preventive Solution: Clean and flush scope immediately following each procedure. Periodically utilize the air/water functions during the procedure to keep any surgical Residue from backing up into the scope.
Avoid excessively bending the scope. Generally the radius of curvature Should not be tighter than that exhibited in its scope case.
Air /Water Nozzle
Problem: Air/Water Nozzle flattened or crushed. How it occurs? 1. Scope's distal tip has received direct impact to nozzle from another instrument or a hard surface. Preventive Solution: 1. Do not disinfect scope with loose instruments. 2. Pay close attention when handling the scope to protect the distal tip from impact. Angulation System Problem: Reduced angulation or deflection of the bending section as compared to manufacturers specifications. How does it occur? 1. Over time the angulation control wires stretch or elongate. When this elongation occurs the result is a reduction in deflection of the bending section. Preventive Solution: Regular Maintenance is the best preventative measure for this deficiency. Normally, it is suggested that the angulation be adjusted when the reduction is 20 degrees or greater from manufacturers specifications. Please note however, an angulation adjustment is also recommended when the physician feels a reduction in the angulation and / or play in the control knobs. Problem: The scope will not angulate in any one direction when manipulating the angulation control knobs the cause could be a detached stopper or a snapped cable. How does it occur? 1. Stressing the angulation control wires may result in snapping the cable or causing stopper to pull way from the cable. 2. A poor solder job on the stopper from a previous angulation adjustment is also a possibility for why a stopper may detach. 3. A damaged coil pipe could also cause excessive wear to the angulation cable causing it to snap. Preventive Solution: 1. Having the angulation adjustment performed when the angulation is reduced will help to alleviate the stress placed on the angulation stoppers and angulation wires. 2. Make sure the service company you choose is proficient on your specific equipment because what they do to your scope today will either extend the life or shorten the life of your scope.
Angulation System
Problem: Reduced angulation or deflection of the bending section as compared to manufacturers specifications. How does it occur? 1. Over time the angulation control wires stretch or elongate. When this elongation occurs the result is a reduction in deflection of the bending section. Preventive Solution: Regular Maintenance is the best preventative measure for this deficiency. Normally, it is suggested that the angulation be adjusted when the reduction is 20 degrees or greater from manufacturers specifications. Please note however, an angulation adjustment is also recommended when the physician feels a reduction in the angulation and / or play in the control knobs. Problem: The scope will not angulate in any one direction when manipulating the angulation control knobs the cause could be a detached stopper or a snapped cable. How does it occur? 1. Stressing the angulation control wires may result in snapping the cable or causing stopper to pull way from the cable. 2. A poor solder job on the stopper from a previous angulation adjustment is also a possibility for why a stopper may detach. 3. A damaged coil pipe could also cause excessive wear to the angulation cable causing it to snap. Preventive Solution: 1. Having the angulation adjustment performed when the angulation is reduced will help to alleviate the stress placed on the angulation stoppers and angulation wires. 2. Make sure the service company you choose is proficient on your specific equipment because what they do to your scope today will either extend the life or shorten the life of your scope.
Insertion Tube
Problem: A buckle or fold has developed in the insertion tube at the control body boot. Buckling occurs as the outer insulation separates from the underlying wire mesh. Cause: This buckle is a result of excessive bending of the insertion tube in relation to the control body. It is often referred to as a 90 degree or right angle bend. It generally occurs during the procedure when the physician sometime uses the bed to support the scope by lying the insertion tube on the bed and has the control body at a 90 degree angle. Preventive Solution: 1. Avoid repeatedly bending the insertion to a 90 degree angle during the procedure and /or transporting. Problem: Multiple buckles have developed throughout the length of the insertion tube. Cause: If the insertion tube is repeatedly coiled too tight this can cause the outer insulation to separate from the underlying mesh resulting in buckling. Preventive Solution: 1. Do not allow the insertion tube to be coiled too tightly. Problem: A hole or tear develops in one or more of the severe buckles. This problem can also lead to further damage because of the possibility of fluid invasion.
Bending Sheath/ Bending Rubber
Problem: Bending sheath is worn and stretched allowing it to overlap. Cause: Over time, normal wear or over inflation can cause stretching or looseness of the bending sheath. Preventive Solution: 1. Visually inspect the bending sheath for excessive wear and/ or overlapping. If the bending sheath shows excessive wear or overlapping the bending sheath should be replaced. Note: As the bending sheath becomes worn it is more prone to punctures and tears. 2. Do not over inflate when leak testing, always follow manufactures recommended pressure. 3. Follow manufacturers recommendation for installation of ETO caps when gas sterilizing, storage and shipping. This will protect the scope during pressure changes. Problem: A hole or tear has developed in the bending sheath which also could result in fluid invasion if not caught immediately. Cause: Contact with any sharp object i.e., fingernails, instruments, or bites can cause tears or holes in the bending sheath. As well, if the underlying wire mesh becomes frayed the loose wires can puncture the sheath. Preventive Solution: 1. Leak testing the scope after every procedure will enable you to detect holes or tears prior to soaking thus preventing fluid invasion. 2. Never place more than one scope at a time in the reprocessing container. 3. Do not place accessories together with scope when disinfecting. 4. Always use a bite block during upper G.I. procedures. 5. Never allow the insertion tube to swing freely allowing the bending rubber to impact hard surfaces i.e., counter tops, endo-cart, sink, cabinet… 6. Never use the scope once a leak or hole is detected. Send scope in for service. Problem: The glue bands or ties located at each end of the bending sheath are lifting, chipped, brittle, and/or peeling away. This deficiency has the potential of not only causing patient irritation because of sharp edges but, can also harbor biocontaminates. Cause: Use of inferior adhesive, direct impact to glue bands, and extended normal wear. Preventive Solution: 1. Visually inspect bending sheath glue bands for separation and replace when necessary. 2. Track repairs, if bands habitually are lifting your current service company could be using an inferior adhesive.
Biopsy Channel / Instrument Channel
Problem: Difficulty passing instruments through the biopsy channel. Cause: Kinked or damaged forceps may make passage difficult, but primarily it is a result of a kinked or collapsed channel. When an insertion tube buckles it reduces protection for the biopsy channel allowing the biopsy channel to buckle in the same fashion. Preventive Solution: 1. Do not allow the insertion tube to be deflected at a 90 degree angle causing buckles to form. 2. If a buckle does form on the insertion tube at the control body boot, have this repaired before further damage occurs, i.e., buckling in the biopsy channel, hole in the biopsy channel leading to fluid invasion. 3. If you feel restriction or have difficulty passing instruments through the biopsy channel you should send the scope in for evaluation of the biopsy channel. 4. Ensure that your service company is using a quality non-kink safe biopsy channel and also that they do not splice channels together. Problem: Hole or tear has developed in the biopsy channel resulting in a leak, and possible fluid invasion. Cause: Kinked, damaged, or open forceps can cause tears in the channel material. Also, continuing to use the channel after restriction is felt will repeatedly wear the channel at the point of restriction leading to a hole. Preventive Solution: 1. When passing the forceps through and restriction is felt do not force or jab the forceps in an attempt to make passage possible. Scope should be sent in for service 2. Ensure that the jaws are closed on the forceps by holding the handle in the closed position. Inspect all instruments before use. Do not use damaged instruments as this may cause damage to the channel. 3. When using a forcep that has a needle inside its cups check that the needle is not bent or protruding outside the jaws. 4. Never use a scope once a leak is detected in the biopsy channel as this will lead to fluid invasion.
Suction Channel
Problem: A kink has developed in the suction channel at the base of the control body boot or at the base of the light guide connector boot. This kink is usually discovered when resistance is felt while passing the cleaning brush. Cause: Excessively deflecting the universal cord will cause buckles and kinks in the suction channel. Preventive Solution: 1. Avoid bending the universal cord at a sharp angle.
CCD Chip ( Charge Coupled Devise )
Problem: Intermittent image and / or loss of image. Cause: Loss of or an intermittent image can be the result of repeated impact to the distal tip or fluid invasion. Impact to the distal tip can damage the CCD directly or indirectly by damaging CCD board and connections. Fluid invasion will damage the image signal by attacking the CCD and its’ electrical connections. Another common cause we see causing an intermittent image signal is a break in the CCD wires or a loose wire connection at the CCD board. Preventive Solution: 1. Avoid contact of distal tip with hard surfaces. Hang scopes where impacts can be avoided. Leak test, leak test, leak test to avoid fluid invasion.
Objective Lens Damage
Problem: Chipped or cracked objective lens. Cause: Damage to the objective lens is a direct result of impact outside the patient. Preventive Solution: 1. Avoid contact with distal tip when handling and/ or storing. Do not allow insertion tube to swing freely when handling or transporting endoscope. Fluid Invasion Problem: Fluid and / or moisture has entered into the endoscope resulting in one or more of the following; distorted, cloudy, or no image, electrical button malfunction, and possible stiffness in the steering system. Cause: Fluid ( water, detergent, disinfectant / sterilant) has entered the endoscope as a result of a leak in the water-tight design. Leaking could be due to a variety of failures i.e., puncture in the bending sheath or internal channels, leak from one of the endoscope seals, leak from puncture or damage to one of the endoscopes other components. Additionally, immersing a video scope without the electrical connector soaking cap on will allow fluid to invade the scope. As well, soaking the scope with the ventilating (ETO) cap on will flood the endoscope with fluid. Preventive Solution: 1. To avoid fluid invasion, “always” leak test the scope prior to reprocessing 2. Leak test the endoscope checking for punctures and leaks before exposing the scope to any fluid. 3. Always install soaking cap over the electrical connector before immersing into fluid. 4. Never soak the endoscope with ETO ventilation cap on. Note: Fluid invasion is one of the most common and costly reasons for repair, the good news is that it is also the easiest one to control and avoid.
C-Cover Leak and Damage
Problem: Distal tip c-cover leaking, cracked or chipped. Cause: C-Cover leaks are due to a break down and / or deterioration of the underlying sealant and physical damage of the C-Cover. This damage is a result of direct impact at the distal tip. Some impacts aren’t enough to crack or break the c-cover ,but they can compromise the seal allowing fluid to break down the adhesive resulting in a leak or total separation of the c-cover. More severe impacts can crack or break the c-cover resulting in leaks and possible harm to the patient. Preventive Solutions: 1. Guard against any impacts to distal tip. Do not allow the insertion tube to swing freely during handling, transport, and reprocessing.