Saturday, November 18, 2006

On Schembechler's Death: Explant His Device?

I read the press reports of Mr. Schembechler’s death this morning (WSJ):
Bo Schembechler, who became one of college football's great coaches in two decades at Michigan, died Friday after taping a TV show on the eve of the Wolverines' No. 1 vs. No. 2 showdown with perennial rival Ohio State. He was 77.

Mr. Schembechler collapsed at the studios at WXYZ-TV in the Detroit suburb of Southfield and was taken by ambulance to a nearby hospital. His death at 11:42 a.m. was confirmed by Mike Dowd, chief investigator for the medical examiner's office in Oakland County.

"It was probably not a heart attack; it just stopped working," Shukri David said.

Mr. Schembechler had a heart attack on the eve of his first Rose Bowl in 1970 and another one in 1987. He had two quadruple heart-bypass operations, and doctors implanted a pacemaker to regulate his heartbeat after he became ill during a taping at WXYZ on Oct. 20.
First, let me say that I do not know the type of “pacemaker” device Mr. Schembechler received. Was it a "pacemaker" or "defibrillator?" The press rarely differentiate between these two “pacemaker-like” devices. (Defibrillators detect and treat rapid and slow cardiac rhythms while pacemakers just support slow cardiac rhythms). I don’t consider the age of 77 to be that old anymore and would likely have implanted a “defibrillator” rather than a pacemaker, given the degree of cardiac disease Mr. Schembechler suffered from. But this misses my central point today.

I think his death, like many others that we’re less likely to hear about, illustrates my earlier point about letting people die in peace. The recent call to explant all medical devices (pacemakers and defibrillators), like rushing to a airplane crash to look for the black box flight recorder to see what actually caused the demise of an individual, might not be appropriate in most circumstances. Mr. Schembechler had a long history of cardiac disease. People with severe heart disease die from heart rhythm disturbances and pump failure. Yes, some die from cardiac device malfunctions, but these are decidedly rare. There are those that feel that explanting every device and returning it to the manufacturer will improve quality products in the future. Perhaps. But once we embark on this tract, the potential to exacerbate the liability mess in medicine seems inevitable.

Let’s say (only conjecture here), that Mr. Schembechler’s “pacemaker” device was later explanted. Three months later the manufacturing company concludes that the "root cause" of the device malfunction was cosmic radiation that caused a short-circuit in a chip on his device. Certainly, there might be a later improvement in the manufacturing process to avoid a future problem. But should the family be informed that the reason their loved one died was the device? Who will notify them? Industry? One of Mr. Schembechler’s physicians?

I can hear the lawyers salivating, can’t you?

-Wes

2 comments:

Armond said...

Bo's device was an ICD, according to Jon Duffey of Zaplife.org. Following is his article:

"By now you may have heard: Former Michigan Coach Bo Schembechler died today. My friend Steve Wilson, who won the Emmy for his series of reports on faulty ICD's broke the news to me this morning... he was in the same building as Bo when he passed away and called me with some insider information.

A little background: The old coach was taping his weekly show at Steve's station (WXYZ-TV/7 in Detroit) in October when he had a heart attack. After rushing Bo to the hospital last month, doctors implanted him with an ICD! So today, on the eve of the big game between his beloved Wolverines and the Ohio State Buckeyes... he was back at WXYZ to tape his show to run before the game tomorrow. The crew waited to start the taping session as Coach Schembechler went to the rest room where he collapsed and died. No word yet on whether his implanted device responded in any way. WXYZ Report: Michigan Legend Bo Schembechler Dies at 77

FYI: I can't believe this story: 'I'm a miracle' Bo bounces back after latest heart scare: from last Saturday is STILL online, but it really has great details about the previous episode.

In light of this news... these may be worth your time for reading:
Something to consider in late life planning....
Most defibrillators buried with patients: study

Finally: Need I say more about pressuring Washington to stop blocking stem cell research?
Heart valve grown from amniotic stem cells
Different but related story: New stem cell trial for heart attack patients

Hope this is useful info...
Stay well..
Duffey"

DrWes said...

Armond-
Thanks for the info.