Taiwanese doctors / hospital caught REUSING DISPOSABLE medical devices to save $$$$! Bastards!

[obama.bin.laden]

Only Ah Neh & Chow Ang Moh were caught before doing this now Taiwanese!

https://tw.news.yahoo.com/調查報導-醫界再爆黑幕-次性手術器械遭重複使用-091524494.html

調查報導／醫界再爆黑幕 一次性手術器械遭重複使用

聯合新聞網

12.1k 人追蹤

記者李樹人、陳雨鑫、鄧桂芬、簡浩正、魏忻忻／調查報導
2019年5月9日 下午5:15

檢視相片
可重覆使用的手術器械。
為了切除外痔的50幾歲李姓婦人，術前趴在手術檯上，醫護人員當場拆掉「雙極電外科器械」塑膠封套，意味著這是全新的，為此，她自費兩、三萬元支付此醫材費用，但果真如此嗎？

檢視相片
一次性手術器械包裝上有註明只能供一位病人使用。
手術室裡不能說的祕密

檢視相片
原應該一次性使用的手術器械，部分醫院重複使用。
「你開刀耗材是幾手貨？」
手術室裡不能說的祕密--「你開刀耗材是幾手貨？」，繼揭發達文西手術A健保數億元黑幕之後，聯合報系再次挖掘到國內自費醫療的大黑洞，眾多醫院竟不顧法令，私下重複使用一次性手術耗材，擬定消毒SOP。
儘管醫師、醫院均認為，「這為了病人著想」，但眾多手術患者卻在不知情狀況下，用了第二手、第三手，甚至第四手的醫材，除了承受感染風險，長久以來，病人信任醫師的醫病關係也遭受重大挑戰。
俗稱「雙極電外科器械」屬於一次性使用手術耗材，在食藥署藥證中，清楚寫著「單次使用器械」，但許多醫療院所卻在消毒殺菌後重複使用，記者深入追查，在健保署「醫材比價網」中可看出端倪。
一套「雙極電外科器械」費用近3萬元，但在77家提供該項自費醫材的醫療院所中，卻有32家售價低於2.5萬元，其中八家醫院低於8,000元，台大醫院僅需6875元，位居低價排行榜的第九名。
最便宜的是委託彰化秀傳醫療體系所經營的台南市立醫院，患者僅需自費3,000元，而價格最高的是桃園敏盛綜合醫院，自費價格高達4.75萬元，價格幾乎為台南市立醫院的16倍。
同樣醫材自費價差距大
醫院重複用可能高達10次
先不探究同樣醫材在不同醫院自費售價差距如此懸殊，低於出廠售價的醫院幾可認定重複使用此一次性手術耗材，只是各醫院重複使用的次數不一，有些五次，有些則可能高達十次。
大醫院：幫病患省錢
重複使用竟有消毒SOP
記者親訪台大醫院大腸直腸科主任梁金銅，他不諱言地表示，台大確實重複使用「雙極電外科器械」，出發點是為了幫患者省錢，此醫材單價約3萬，依照院內手術管理委員會所討論出來消毒SOP規範，徹底消毒後，使用次數最高五次。
梁金銅說，就他所了解，在相關能量器械的重複使用上，台大醫院在使用一次性手術耗材時，重複使用機率僅約一成，但有些醫院甚至超過三成以上。
由秀傳醫療體系委託經營的台南市立醫院創下全台「雙極電外科器械」最低價紀錄，病人僅需自費3000元，秀傳醫療體系副總裁牟聯瑞說，基於病人省錢的出發點，平均使用八至十次，價格才能壓到如此之低，讓每個病友都用得起。
牟聯瑞說，「重複使用一次性耗材，這是無可奈何的事」，站在醫院及醫師的立場，當然希望讓病人使用全新的手術耗材，但並非每個病家都能夠負擔得起，因此，才會消毒後重複使用。
大部分病患不知用二手貨
一次性手術醫材大多再使用
在北部某區域醫院手術室任職多年的陳姓護理師透露，除了骨丁、骨板、骨水泥等無法回收的醫材，以及凝血劑、止血用品等醫材，不會重複使用之外，其餘原本僅限一次使用的手術醫材，大都在消毒後多次使用。
大部分患者不知道自己使用「二手醫材」，陳姓護理師說，患者術前接受麻醉，披上手術被單，推至手術台，術後醒來怎會知道自己用過了哪些器械，而這也是部分醫院重複使用一次性手術耗材的主因。
對於部分醫院執行外科手術重複使用一次性器械，台灣內視鏡外科理事長、高雄榮總一般外科主任陳以書表示，站在學會立場，希望醫院遵守規範，單一使用一次性耗材。
陳以書坦言，好幾年前，就爆發過類似弊端，就有醫院訂出令人啼笑皆非的收費標準，第一個使用器材的患者收取50%的費用，第二名則收30%，以此類推，最後一名使用者因為感染風險最高，當然收費就最便宜。
面對醫界這項陋習，陳以書無奈地說，如果易地而處，換他是病人，當然希望醫師坦然告知細節，而不是在不知情的情況下，被迫使用二手醫材，「這樣才公平吧。」。
衛福部：只能單一使用
可開罰50萬 嚴重者停業
健保署年初審閱「醫材比價網」資料，就發現部分醫院價格低得離譜，曾派人致電這些醫院，瞭解低價原因，原因就是重複使用。不過，這並非健保署業務，並未進一步督導究責，而只是打電話「瞭解瞭解」。
對於這項醫界不能說的秘密，衛福部醫事司司長石崇良說，如果醫材耗材仿單上寫著「single use」，就只能做單一使用，不得重消再用，若醫師未依照仿單操作，等同違反醫師法可開罰10萬元以上、50萬元以下罰鍰，嚴重者可要求停業。
延伸閱讀》
醫界不能說的祕密？重複使用手術耗材 衛部把關嚴重失職
醫界器械風暴脫身 北榮、中醫「感控模範生」
陷醫界器械風暴 台大、秀傳：為病患省錢「逼不得已」使用重複器械？
更多udn報導



Investigation report/medical circles re-sharpening Disposable surgical instruments are being reused
[Joint News Network]
United News Network
12.1k person tracking
Reporter Li Shuren, Chen Yuxin, Deng Guifen, Jian Haozheng, Wei Wei/Investigation Report
May 9, 2019 5:15 PM
Reusable surgical instruments.
View photos
Reusable surgical instruments.

In order to remove the 50-year-old woman named Li, she was on the operating table before surgery. The medical staff removed the plastic cover of the "bipolar electrosurgical instrument" on the spot, which means that this is brand new. For this reason, she paid two or three thousand at her own expense. Yuan pays for this medical material, but is this really true?
Disposable surgical instruments are marked on the package for use by only one patient.
View photos
Disposable surgical instruments are marked on the package for use by only one patient.

Secrets that cannot be said in the operating room
Surgical instruments that should have been used once and used in some hospitals.
View photos
Surgical instruments that should have been used once and used in some hospitals.

"How much is your supply of supplies?"

The secret that can't be said in the operating room--"What is your hand-selling consumables?" After the cover of the developed Wenxi surgery A health insurance billions of dollars, the joint newspapers once again tapped into the big black hole of domestic self-funded medical care, many hospitals ignored Decree, private use of disposable surgical supplies, draft disinfection SOP.

Although doctors and hospitals all believe that "this is for the sake of patients", many surgical patients have used second-hand, third-hand, and even fourth-hand medical materials without knowing the situation. In addition to the risk of infection, they have long been The patient's trust in the doctor's medical relationship has also been a major challenge.

Commonly known as "bipolar electrosurgical instrument" is a disposable surgical consumable. In the drug administration certificate, the "single use device" is clearly written. However, many medical institutions have repeatedly used it after disinfection and sterilization. In the "Medical Materials Comparison Network" of the Health Insurance Department, we can see the clues.

A set of "bipolar electrosurgical instruments" costs nearly 30,000 yuan, but among the 77 medical institutions that provide the self-funded medical materials, 32 have sold for less than 25,000 yuan, of which eight hospitals are under 8,000. Yuan, the National Taiwan University Hospital only needs 6875 yuan, ranking ninth in the low-cost list.

The cheapest is Tainan City Hospital, which is commissioned by Changhua Xiuchuan Medical System. The patient only needs to pay 3,000 yuan at his own expense, and the highest price is Taoyuan Minsheng General Hospital. The self-funded price is as high as 47,500 yuan, and the price is almost 16 for Tainan Municipal Hospital. Times.

The same medical materials have a large gap in self-cost

Repeated use of hospitals up to 10 times

We will not explore the disparity in the price of the same medical materials in different hospitals. The hospitals below the factory price can be considered to reuse the disposable surgical consumables. However, the number of repeated use in hospitals varies, some five times, and some It can be up to ten times.

Big hospital: help patients save money

Repeated use has a disinfection SOP

The reporter visited Liang Jintong, director of the large intestine and rectal department of the National Taiwan University Hospital. He said without hesitation that the National Taiwan University has repeatedly used the "bipolar electrosurgical instrument". The starting point is to help the patient save money. The unit price of this medical material is about 30,000, according to the operation management in the hospital. The committee discussed the disinfection of the SOP specification and disinfected it up to five times.

Liang Jintong said that as far as he knows, in the repeated use of related energy devices, the use of disposable surgical consumables in National Taiwan University Hospital is only about 10%, but some hospitals even exceed 30%.

Tainan City Hospital, commissioned by Xiuchuan Medical System, set a record for the lowest price of "bipolar electrosurgical instruments" in Taiwan. Patients only need to pay 3,000 yuan at their own expense. Yan Lianrui, vice president of Xiuchuan Medical System, said that based on the patient's money-saving starting point, the average use Eight to ten times, the price can be so low that every patient can afford it.

Yan Lianrui said, "Reuse of disposable consumables is a helpless thing." From the standpoint of hospitals and physicians, of course, I hope that patients can use new surgical supplies, but not every patient can afford it. Will be reused after disinfection.

Most patients do not know the use of second-hand goods

Most of the disposable surgical materials are reused.

Chen surnamed nurse, who has worked in the operating room of a regional hospital in the north for many years, revealed that except for boneless vegetables, bone plates, bone cement and other medical materials that cannot be recycled, as well as medical materials such as blood coagulation agents and hemostasis supplies, they will not be reused. Originally used only for one-time use of surgical materials, mostly used after disinfection.

Most patients don't know that they use "second-hand medical materials." Chen surnamed nurse said that the patient received anesthesia before surgery, put on the surgical quilt, pushed it to the operating table, and how to know what equipment he had used after waking up. This is also the main reason for the repeated use of disposable surgical supplies in some hospitals.

For some hospitals to perform surgical re-use of disposable devices, Taiwan's endoscope surgery director, Gao Xiongrong general general surgery director Chen Yishu said that standing in the academic position, I hope the hospital to comply with the norms, the single use of disposable supplies.

Chen Yishu said frankly that several years ago, there were similar drawbacks. Some hospitals set a ridiculous charging standard. The first patient who used the equipment charged 50%, the second received 30%, and so on. The last user has the highest risk of infection, and of course the cheapest is the cheapest.

In the face of the bad habits of the medical profession, Chen Yishu said helplessly that if he is easy to change, he is a patient. Of course, he hopes that the doctor can tell the details calmly, instead of being forced to use second-hand medical materials without knowing it. Fair.".

Wei Fu Department: can only be used alone

Can be fined 500,000. Seriously closed

The Health Insurance Department reviewed the "Medical Materials Comparison Network" information at the beginning of the year and found that some hospitals were outrageously low. They were sent to call these hospitals to understand the reasons for the low price. The reason was repeated use. However, this is not the health care business. It has not further supervised the responsibility. It is just a call to "know it."

For this secret that the medical profession can't say, Shi Chongliang, director of the Department of Medical Affairs of the Department of Health and Welfare, said that if the medical consumables are written with "single use", they can only be used for a single use, and should not be reused. According to the imitation single operation, it is equivalent to a penalty of more than 100,000 yuan and less than 500,000 yuan in violation of the doctor's law. In severe cases, it may be required to suspend business.

Extended reading

The secret that the medical profession can't say? Reuse of surgical consumables

Medical equipment storms come out Beirong, Chinese medicine "sensory model students"

Trapped in the medical equipment storm Taida, Xiu Chuan: saving money for patients "forced to use" repeated equipment?

More udn reports

 

[obama.bin.laden]

https://www.wsj.com/articles/SB120588469924246975

Hospitals Reuse Medical Devices To Lower Costs

By
Laura Landro
Updated March 19, 2008 12:01 a.m. ET


In a bid to save costs and stem a rising tide of medical waste, hospitals are recycling a growing number of medical devices labeled as single-use, from scissors and scrubs to the sharp blades surgeons use to saw through bones.

Recycling medical devices labeled for single use is legal as long as certain Food and Drug Administration guidelines are followed. But the practice, which involves shipping devices to reprocessing facilities to be cleaned, sterilized and tested for reuse, has raised concerns about safety. Medical device...


https://www.nytimes.com/1999/11/10/us/single-use-medical-devices-are-often-used-several-times.html


'Single Use' Medical Devices Are Often Used Several Times

By GINA KOLATANOV. 10, 1999

Continue reading the main story Share This Page

• Share
• Tweet
• Email
• More
• Save

When patients come to the University of Virginia Health System to have an abnormal heart rhythm diagnosed or treated, they are told that doctors will be threading thin wires through their veins directly into their heart. They learn that they run a slight risk of infection, or of damage to the heart, lungs or blood vessels from the very nature of the invasive procedure.
But there is one thing they are not told: although the catheters and wires are labeled ''single use only,'' they may have been used before. They have been cleaned and sterilized, but they have spent time in someone else's blood vessels and heart.
In hospitals and clinics around the nation, these devices and others -- biopsy needles used to extract tissue, tiny scissors used to cut out tissue in patients' gastrointestinal tracts, wires or balloons that go into the coronary arteries or the heart itself -- are being reused more and more often despite their labeling.
The practice of reusing devices that are approved only for one-time use is not necessarily dangerous, experts say, but it generally violates federal regulations. So far, the government has declined to ask the companies that reprocess the devices to submit evidence that they are safe and effective but under pressure from device makers it is now reconsidering its approach.
''We have used what we call enforcement discretion not to go after them,'' said Dr. Larry Kessler, who is director of the office of surveillance and biometrics at the Food and Drug Administration.
Continue reading the main story





One reason is that the agency has little evidence of a safety problem, Dr. Kessler said, although everyone admits that research is urgently needed.
''There's a big yuck factor to reusing devices,'' Dr. Kessler said. But he added that ''there are no products where we have significant evidence that there is immediate harm to public health.''
Some doctors and federal officials say the issue is more about economics than safety. Device makers make less money when single-use devices are cleaned, sterilized and used again.
Hospitals and medical centers save money, in some cases tens of thousands of dollars a year, when they reuse the devices.
Doctors say that manufacturers charge so much that they often cannot afford to use devices just once; nor can they pass the cost along to patients, because in many cases the rates have been set in advance by insurance companies or Medicare. And, they say, many expensive devices that are labeled ''single use only'' can safely be used repeatedly.
Device makers reply that the hospitals are putting patients at grave risk to save money.
''The real issue is patient safety,'' said Josephine Torrente, president of the Association of Disposable Device Manufacturers. ''Until you prove otherwise, these devices are safe and effective for one use. After that, they're garbage.''
The F.D.A., caught in the middle, is considering regulating those who reprocess devices in the same way it regulates the original device makers. They would have to get approval -- showing the reprocessed devices were safe and effective -- before they could sell them. The only exception would be devices, like surgical saw blades, that are considered to pose a very low risk after being cleaned and sterilized. At the same time, the agency is suggesting that the device makers explain on their labels what the risks would be if the devices were processed.
The agency is posting the proposal on its Web site (www.fda.gov -- follow the links to ''Medical Devices,'' then ''Recent Federal Register Notices''). Today the agency will hold a satellite teleconference in which the device makers, the companies that reprocess devices, doctors, hospitals, and ethicists can comment. And on Dec. 14, the agency will hold a public meeting on its proposal.
From all accounts, the business of reprocessing medical devices is booming, with commercial companies springing up to clean and sterilize devices and to take on the liability if their processes fail.
Mark Salomon, the senior vice president of corporate development at Vanguard Medical Concepts, a reprocessing company in Lakeland, Fla., said that when he joined Vanguard in 1995, it had just 12 employees. Now, 220 people work there and the plant has grown to 50,000 square feet from 2,000 square feet.
Used devices are cleaned and disinfected. Then the company tests them to make sure they still function the way they are supposed to. Finally, the devices are packaged and sterilized with ethylene oxide gas, the same method that the device makers use. The question is: Are the devices really as good as new?
One way to keep track of device problems is through the F.D.A.'s device surveillance system. When medical devices fail or injure patients, manufacturers, hospitals, and doctors are supposed to notify the agency. Of the 100,000 such reports to the agency each year, virtually all are from devices that were used just once, Dr. Kessler said. Of course, if a reused device does fail, the agency may not get a report.
''Can you imagine a hospital that discovers a problem and the manufacturer had said, 'Don't reuse that device'? '' Dr. Kessler said. ''Do you think the hospital would want to tell anyone? They are worried that they will be in court and in serious trouble.''
The Centers for Disease Control and Prevention tracks outbreaks of infections, which would occur if devices were not sterile. ''To date, there is no strong evidence in this country that reprocessing medical devices leads to more adverse events than single use,'' said Dr. William Jarvis, who heads the infections and prevention branch in the hospital infections program at the centers.

Some ask why take a chance. Dr. Philip Grossman, a gastroenterologist in Miami who is a consultant to the device manufacturers group, says he has challenged defenders of reuse in public forums. ''I said, 'You look me in the eye in front of this group and tell me you do it because you think it's better for your patients,' '' he said.
But others say that the debate can best be advanced by actual data on safety. Some medical groups, as well as a device maker, have done their own studies, asking whether medical devices can be safely cleaned, sterilized, and reused.
Patricia Davis, an electrical engineer and senior patent attorney at Boston Scientific, a leading device maker, says her company has evidence that devices often are contaminated and degraded when they are re-processed.
The company takes reprocessed devices off hospital shelves and sends them to independent labs for testing, Ms. Davis said. ''In all cases,'' she said, ''at least 45 percent of the devices have come back contaminated.'' In one instance the F.D.A. and Vanguard said they independently tested devices from a lot that Boston Scientific had said was contaminated. But the F.D.A. and Vanguard tests found that the devices were sterile.
Larry Spears, a director of enforcement at the F.D.A., says the agency is still investigating. ''We have a number of different lab results for the same product,'' he said. ''We need to find out what happened -- and we will.''
Ms. Davis, who said the company was working on getting its studies published in the United States, also says Boston Scientific's tests indicate that reprocessed devices can have subtle changes in their functions that could be devastating to patients.
Other safety studies were published in leading medical journals. In one, Dr. Richard A. Kozarek, who is chief of gastroenterology at Virginia Mason Medical Center in Seattle, examined the reuse of an argon beam plasma coagulation probe, a $190 device that is used to stop bleeding in the gastrointestinal tract. If used 10 times, it would cost $24 per procedure, even with the cost of cleaning and sterilizing; if used five times, it would cost $42. The device was first introduced in Europe and Asia, labeled for multiple use. It even came with instructions for cleaning, Dr. Kozarek said. A few years ago, it was introduced in the United States, labeled for single use only.
Dr. Kozarek and his colleagues put the device through a rigorous test, contaminating it with spores from the bacterium Bacillus subtilis, among the most difficult organisms to kill. ''We found organisms too numerous to count throughout the device,'' Dr. Kozarek said. But after he cleaned it and sterilized it, they were gone. The investigators also asked if the device still functioned and found that it did.
''The long and short of it was that it was reusable for up to 10 times and we didn't test it more than 10 times,'' said Dr. Kozarek, who published his results in the American Journal of Gastroenterology in May 1998.
Dr. Kozarek also tested sphincterotomes, which are used to cut open abnormal sphincter muscles in the bile duct. His group again found that the devices could safely be cleaned, sterilized, and reused, publishing their data in Gastrointestinal Endoscopy in 1997.
Dr. Kozarek's group began reprocessing the devices and, among 1,000 patients treated, found two who had become infected. They checked, fearing the infections had arisen from improperly sterilized devices. But ''they were brand-new devices,'' Dr. Kozarek said. The infections turned out to be unrelated to the devices.
Now Dr. Kozarek and his colleagues routinely reuse gastroenterology devices. ''We saved this institution about $65,000 in medical costs,'' he said.
Some, like Dr. James T. Frakes, a gastroenterologist in Rockford, Ill., say they do not reuse devices because of liability concerns. But Dr. Frakes says such caution has a cost. ''We cannot afford to use some single-use accessories in our unit,'' he said.
At the University of Virginia Health System, where electrocardiologists routinely reuse devices that can cost $1,000 or more per patient but far less if they are reused, there have been no safety problems, said Dr. David E. Haines, a professor of internal medicine there. Several groups have published papers reporting that it is safe to reuse the devices. And Dr. Haines says the economics of medicine leaves him little choice.
''The cost of single use is prohibitive,'' he said. ''If we were forced to have single use on catheters we would shift from being marginally profitable to probably losing $600,000 a year.''
But Ms. Torrente said that those who reuse devices that are designed for single use are playing a risky game. ''If this is so safe and so O.K., why don't we tell the patients?'' Ms. Torrente asked.
Dr. Haines said there was no reason to bring it up. ''Why force the issue?'' he said. ''Show us the data that says this is exposing the patient to increased risk.''
What if patients started insisting that Dr. Haines use new devices, fresh out of the package?
''If we found that a lot of patients were starting to demand that we use brand new equipment,'' Dr. Haines said, ''we would probably decline to take their cases and refer them elsewhere.''

 

[obama.bin.laden]

https://www.forbes.com/sites/brucel...priately-reusing-anal-catheters/#12449f231625

70,586 viewsDec 30, 2017, 11:32am
Doctor Accused Of Inappropriately Reusing Anal Catheters





Bruce Y. Lee
Contributor


Pharma & Healthcare

Not all medical devices and equipment can be adequately cleaned between uses. (Photo: Shutterstock)

If you ask your doctor where a single-use anal catheter has been before the doctor uses it on you, there should be only one answer: in the packaging. Any other answer should be unacceptable. Single-use anal catheters are not like bowling shoes. They are not meant to be re-used.

Unfortunately, according to Spencer Kent reporting for NJ.com, Dr. Sanjiv K. Patankar, a colorectal surgeon based in East Brunswick, NJ, may have overlooked the "single-use" portion of the name. The New Jersey Board of Medical Examiners has suspended the medial license of Patankar for allegedly reusing disposable single-use anal catheters on multiple patients. (Note: Attempts to leave a message at two offices for Dr. Patankar were unsuccessful, and an email address for him could not be located.) Anal catheters include tubes that are inserted into a patient's rectum to either inject fluids or obtain fecal matter samples. As you can imagine, anal catheters can get quite dirty while being used, hence the reason for single-use disposable ones.

However, from January 1 to November 30 this year, Dr. Patankar's office reportedly performed 82 procedures requiring the catheters but only ordered five catheters over that time period. Do the math and you'll realize that this would mean that a given catheter was used on at least 16 different patients. Apparently, rather than disposing the catheters after a single use, Dr. Patankar and his staff washed the catheters between uses.





That can be a bit like washing and then reusing used toilet paper. Neither toilet paper nor single-use catheters are designed to be washed, making them difficult to adequately clean and disinfect. Microbes such as bacteria and viruses can hide out in the various cracks, crevices, and pores in the catheter. Besides sounding rather disgusting, such unacceptable re-use can help transmit infectious diseases from one patient to another. Moreover, washing can significantly damage any device, equipment, or material that is not designed to be washed. This can not only impair the functioning of the catheter but also create more cracks, tears, and other places for microbes to hide.

Hospitals and clinics are resuing certain medical devices labelled as single-use to help save money. (Photo by Theo Heimann/Getty Images)

YOU MAY ALSO LIKE



Reusing medical devices that are labelled as single-use devices can be an attempt to save costs. In 2008, Laura Landro wrote a piece for the Wall Street Journal on how hospitals were employing such a practice for a variety of medical devices such as scrubs, scissors, and surgical knives. An article in CMAJ by Roger Collier claimed that a quarter of hospitals in Canada and the U.S. do so. Beyond saving money, proponents argue that reuse is better for the environment by reducing medical waste and that medical device companies are trying to make more money by selling devices as single-use when they could safely be multi-use devices. Multi-use may be appropriate if there is a proper amount and degree of scientific evidence that reuse and washing of that particular device will not compromise safety and performance. Moreover, well-documented and well-monitored cleaning and testing processes have to be in place. Just because one hospital or one person can thoroughly clean a device one time doesn't mean others will do so other times. Finally, clinics and hospitals must be transparent about their reuse policies and procedures. No device can be reused indefinitely. There's a difference between reusing a pair of scissors 3 times versus 1,783,347 times.

While there may be appropriate reuse of certain medical devices, no one wants to be victim of inappropriate reuse such as what allegedly occurred with anal catheters. So here are some precautions that you may want to take:

• Choose your doctors, clinics, and hospitals carefully. If possible, don't sacrifice quality by trying to save money. Do your research. Make sure that your doctor has the appropriate background, training, and qualifications. Get a sense of whether the clinic or hospital is in cost-cutting mode and how that may affect quality of care and patient safety.
• Scan the surroundings: Are the office space, examining room, procedure rooms, and surrounding environment clean? Pay attention to places that don't immediately catch the public eye and may be overlooked such as the trash cans, the bathrooms, the back offices, and under furniture. Dirty and poor upkeep may be a sign that the clinic or hospital is trying to cut costs by cutting corners and skimping on hygiene.
• Familiarize yourself with every procedure you will receive. Know what equipment will be used, including what can and cannot be reused.
• Inquire about procedures used to clean and check equipment. The spray that is used on bowling shoes at bowling alleys is not an acceptable means to clean medical devices.
• Watch the equipment being taken out of their packaging. A common practice is opening the packaging in front of you so that it is clear that new equipment is being used. Be wary of packaging that looks like it has been re-sealed, re-taped, or re-anything.
• Be wary of any signs of damage, wear and tear, or hygiene issues. Brown spots may be a fashion statement in some situations but don't belong on many medical devices.
• Ask to see and read the packaging: Check whether the device is labelled as single-use. Reading the packaging will also help ensure that they are employing the proper equipment.
• Ask how the devices and equipment are handled. You have a right to know how everything is cleaned and stored. Also, inquire about the clinic's or hospital's reuse policy. If you are told that a single-use device is being reused, check or ask for the evidence that such a practice is safe.

Any reluctance to answer such inquires should raise red flags. Anything that may affect patient safety should be as transparent as clear plastic packaging. After all, medical devices aren't the same as bowling shoes in many, many different ways.

Follow me on Twitter @bruce_y_lee and visit our Global Obesity Prevention Center (GOPC) at the Johns Hopkins Bloomberg School of Public Health. Read my other Forbes pieces here.