THE REUSE OF SINGLE-USE CARDIAC CATHETERS - SAFETY, ECONOMICAL ETHICAL AND LEGAL ISSUES

OBJECTIVE: To evaluate the risks, economic benefits, and ethical and l egal aspects of reuse of diagnostic and angioplasty catheters intended for single use only. METHODS: Four approaches were used: first, a com prehensive review of the literature relating to risks of infection, py rogen reactions, toxicity, particulate contamination and catheter brea kage; second, experimental studies involving deliberate bacterial cont amination and resterilization of catheters; third, experimental studie s of the mechanical properties of catheters; and fourth, acquisition o f legal opinions. CONCLUSIONS: Diagnostic and angioplasty catheters in tended for single use can be reused without putting patients or person nel at increased risk if effective cleaning, sterilizing and quality c ontrol procedures are adhered to. An average of five uses for each dia gnostic catheter and three uses for each angioplasty catheter may save approximately $5000 and $100,000 respectively, per 100 procedures. Th e measures necessary to achieve safe reuse, including the steps to ass ure adequate training of the responsible personnel, should be precisel y identified and formally approved by any institution before catheters are reused. Evidence that this has been done and that protocols are f ollowed should be kept updated and available.