Each year, the Emergency Care Research Institute (ECRI) releases a list of the top 10 most noteworthy medical technology hazards, and this year is no exception. Recently, ECRI released its 2016 Top 10 Medical Technology Hazards List. At the top of the list is the issue of flexible endoscope infections, followed closely by warning negligence and opioid-related deaths. Incomplete Cleaning of Flexible Endoscopes Prior to Sterilization Can Transmit Deadly Pathogens The use of contaminated surgical instruments that have not been thoroughly processed (i.e., cleaned, disinfected or sterilized) can transmit deadly pathogens. The key to effective handling of surgical instruments is to adequately remove biological debris and other foreign matter from them prior to disinfection or sterilization, and if pre-cleaning is not thorough, subsequent disinfection or sterilization may not be effective. Flexible endoscopes (especially duodenoscopes), which are difficult to clean because of their complex design and long, narrow tubes, should be handled with particular care.A series of fatal carbapenem-resistant antibiotic Enterobacteriaceae (CRE)-induced infections received widespread attention in 2014, and a 2015 report on hazards of healthcare technology elucidated the relationship: patient deaths were associated with the use of duodenoscopes that were not thoroughly disinfected or sterilized.