Tuesday, August 07, 2007

Recycling Defibrillators and Pacemakers

"So, does your husband have any devices that might damage the crematory?"

"He has two artifical hips," she said.

"No, I mean like pacemakers or defibrillators that might explode when incinerated."

"No," she said.

And the conversation continued today. I could have done without it, but was fascinated by the fact that our funeral home asked this question. So I had to ask:

"So you remove them?"

"Yep, and now the manufacturers want them sent back to them, but a patient brought an article describing how some of these are recycled for poor countries. It was in the Sun Times."

"Do you have that article?"

"Sure. Here it is."

I looked and saw my colleague at University of Chicago, Brad Knight, MD who researched the fact that most people would want their loved one's device donated, if it could be, and realized this is in opposition to the new Heart Rhythm Society's mandate to return all defibrillators to the manufacturer for "analysis" to assure "quality" devices are manufactured. This new mandate must make it tough for groups like Heart to Heart, a nonprofit group in Billings, Montana that collects pacemakers and defibrillators from funeral homes and families to gives them to Solidarity Bridge and other groups for use in Third World countries.

If it were me, I'd want to donate my Dad's, too, if he had had one.

These are remarkably expensive devices, costing between $20,000 and $35,000. Sadly, some of them are used for a remarkably short time. Should we just dispose of a device with the potential to save someone else?

Somehow, the "official" take by Medtronic in the article fell flat to me:
But Medtronic, a leading manufacturer, opposes reusing the devices in people. A spokeswoman said the company cannot ensure recycled devices are as safe and reliable as new devices. The complex devices might be hard to sterilize, and cleaning and reprocessing could have a "debilitating effect on the durability of the materials."
What if Medtronic could be absolved of the liability, in such a case? There's a lawyer somewhere who could make that happen, isn't there? Also, consider that re-sterilization could use a variant of a cleansing agent and water, followed by exposure to ethylene oxide, the same technique used to sterilize the original device. Perhaps Medtronic could add this to their philanthropic efforts already under way?

They should.

But in the meantime, here's the flier with the address if you want to donate your loved one's device.

And Brad and company? Sorry I didn't about know this sooner. Keep up the good work.

-Wes

09:12 AM CST Update: This from Solidarity Bridge's website:
One of the most serious medical issues facing Bolivia today is Chagas, a parasitic heart disease, which affects 1.8 million Bolivians, mostly those who live in poverty or rural areas. In 2004, Solidarity Bridge forged a partnership with the Medtronic Corporation who committed to donating hundreds of thousands of dollars worth of pacemakers and other related heart surgical supplies to save the lives of poor Bolivians afflicted with Chagas. These devices cost upwards of $8,000. The average wage in Bolivia is between $50 and $100 a month, making it impossible for the poor to receive the medical aid they need without our help. Since 2001, we have sent 685 pacemakers to Bolivia. This program functions in three cities: La Paz, Cochabamba and Santa Cruz and draws on patients from the entire country.
It is my understanding that these are "expired devices" that Medtronic has donated - not used devices.

1 comment:

Elaine said...

My Father age 80 is on his second Medtronic ICD, recycling it was something that never crossed my mind. To be honest I am not sure how I feel about this, should I talk to him about it? I've met his cardiologist many times, in and out of the hospital and it's never been mentioned. Since I am the durable health care power of attorney it's up to me to make these decisions and I want to do the right thing, for my Dad and for society. Glad I found this post Dr.Wes, thanks!