The asterisked papers reflect safety and efficacy studies of single-use devices (SUDs) that have been cleaned or reprocessed by the hospitals themselves. While these papers may demonstrate the safety of reusing select single-use devices, “in-hospital reuse lacks the rigor of ­highly regulated, commercial SUD reprocessing, which is done outside of hospitals.  AMDR works to create harmonized, regulated markets for reprocessed SUDs, where all reprocessors are held to the same safety and efficacy requirements as applied to original medical device manufacturers.