How to Reprocess the MAJ-855 Water Tube and the GI Endoscope’s Auxiliary Water Channel

Initial remarks: This blog is to be read in conjunction with the comprehensive article entitled “Recommendations to Prevent Healthcare-Acquired Infections,” which is referred to below as the “main article” and can be downloaded in PDF format by clicking here.

Introduction: As much as any other lesson, the reprocessing breaches identified at the three Veterans Administration Medical Centers (VAMCs) in Murfreesboro (TN), Augusta (FL), and Miami (FL) (refer to the main article‘s “case 3,” p. 2) teach the importance of proper use and reprocessing of both the Olympus MAJ-855 auxiliary water tube and the colonoscope, including its auxiliary water channel.13,20

A diagram showing the MAJ-855 auxiliary water tube connected to the GI endoscope to flush water through its auxiliary water channel is provided in another of Dr. Muscarella’s articles entitled “Faulty Use of a GI Endoscope’s Auxiliary Water Channel”, which can be downloaded by clicking here.

Purpose: The MAJ-855 tube has two purposes:27 

  • First, it may be used to supply the GI endoscope’s auxiliary water channel with (sterile) water for flushing the GI tract’s mucosa, which may be required to enhance visibility during the clinical exam.20 (Flushing may be achieved manually via a syringe or using an automated water pump.27
  • Second, the MAJ-855 tube may be used as an adapter to reprocess the GI endoscope’s auxiliary water channel.

Recommendations: The following recommendations provide guidance to reprocess the MAJ-855 auxiliary water tube and auxiliary water channel both manually and using an automated endoscope reprocessor (AER). (Refer to the operator’s manual of the GI endoscope for more detailed instructions.)

I. Initial quality-assurance verifications:

A. Verify whether any GI endoscopes in inventory feature an auxiliary water channel that uses a MAJ-855 tube for flushing (i.e., Olympus 160 and 180 series: 3 models of gastroscopes, 13 models of colonoscopes).20

B. Confirm that the MAJ-855 water tube and the GI endoscope’s auxiliary water channel are both being reprocessed after each clinical case, in accordance with their manufacturer’s instructions.20

Caution: If it was connected to the GI endoscope’s auxiliary water channel during the clinical case, the MAJ-855 auxiliary tube requires reprocessing, regardless of whether this channel (and tube) was used or flushed with water.20

C. Prior to GI endoscopy, visually verify that the MAJ-855 tube is fitted with the correct green, double-winged (one-way flow) valve (with which the MAJ-855 tube was originally manufactured and shipped).13,20

Caution #1: Do not remove this green, double-winged valve from the MAJ-855 tube. This valve is crucial to the MAJ-855 tube’s safe and effective use.13,20

Caution #2: Do not use the MAJ-855 tube if it is fitted with a similarly-shaped, green, single-winged (two-way flow) connector, which is intended for use only with the Olympus MH-974 washing tube. Use of the MAJ-855 tube fitted with the MH-974 tube’s single-winged connector is contraindicated.13,20

II. Manual reprocessing of the MAJ-855 tube and the auxiliary water channel using a syringe:

A. Use a (30 ml) syringe to clean and high-level disinfect (and water rinse and forced-air dry), manually and simultaneously, the MAJ-855 tube and the GI endoscope’s auxiliary water channel (to which this tube is connected; see: main article) in accordance with the GI endoscope manufacturer’s instructions.13,20

Note: The manufacturer’s procedure and set-up for manually reprocessing the auxiliary water channel via the MAJ-855 tube are similar to those of the same manufacturer for manually flushing this channel with water during the exam via the MAJ-855 tube. 

This entry was posted in Auxiliary Water Channel, Colonoscopes, Disease Transmission, Disposable Irrigation Tubing, Gastrointestinal Endoscopy, GI Endoscopes, High-Level Disinfection, Infection Control, MAJ-855 Water Tube, Risk Management. Bookmark the permalink.

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