Patient safety relies on clinical precision, attention to detail, and adherence to best practices, especially when performing procedures that involve puncturing the skin. One seemingly small decision can carry outsized risk: the type of ultrasound gel used.
In a recent alert, the CDC announced an ongoing multistate investigation into the use of non-sterile ultrasound gel during ultrasound-guided percutaneous procedures. The investigation began after the environmental bacterium Paraburkholderia fungorum was identified in patient blood cultures. Genomic testing linked those isolates to contaminated batches of MediChoice® and ClearImage® gel, both manufactured by NEXT Medical Products Company.
While most patients didn’t develop active infections, P. fungorum was recovered from blood cultures, a strong indicator that these products may have introduced organisms into sterile body sites during procedures such as central line placement, tissue biopsy, or amniocentesis. Even without causing illness, these organisms can lead to false-positive culture results, inappropriate treatment, and unnecessary use of healthcare resources.
Key Reminders for Providers
- Only use single-use, sterile ultrasound gel for procedures involving skin puncture or entry into sterile body areas.
- “Bacteriostatic” or “preservative” labels do not indicate sterility and should not be considered safe for invasive procedures.
- Clinicians should be trained to identify appropriate gel products and understand when sterility is required.
A Broader Clinical Lesson
This situation highlights a broader takeaway: clinical safety isn’t just about technique, it’s about every product and process involved. Even commonly used materials, such as ultrasound gel, can pose a serious risk if not applied correctly.
At Maverick Medical Education, we aim to raise awareness of these risks and integrate safety standards into all aspects of hands-on education. Whether you’re a student or seasoned provider, our continuing education opportunities help you stay informed about safety, improve your techniques, and deliver better patient care.
You can read the full CDC alert here:
🔗Alert: Use Only Sterile Ultrasound Gel for Percutaneous Procedures
