Role of Public Health Following Infection Prevention Breaches in Colonoscope Reprocessing at a Rural Hospital

On July 10, 2013, a rural hospital contacted the State Health Department (SHD) to report an infection prevention breach in colonoscope reprocessing. On January 3, 2013, the hospital introduced a new model of colonoscope with an auxiliary water channel not present on previous models; this channel was neither cleaned nor disinfected. Patient notification was performed by the hospital, in coordination with SHD. An investigation into the potential for bloodborne pathogen (BBP) transmission was initiated.