Dr. Wes posted a really interesting entry today pointing to a Chicago Sun-Times article, “Used pacemaker could keep someone else ticking: But most aren’t removed from patients who die.” He writes of the article:

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.

It turns out that many such devices are simply buried with the deceased who first used them. Only in the case of cremations are they removed to avoid an explosion. But whether buried or returned, better things can be done with these devices. According to the Chicago Sun-Times report:

An organization affiliated with the Archdiocese of Chicago has donated several hundred recycled pacemakers to poor patients in Bolivia.

The patients have Chagas disease, which can cause slow heart rate and other cardiac problems. Patients typically are 30 to 60 years old, and many become bedridden.

The devices are tested, sterilized and recalibrated before they are donated to Bolivian clinics.

“It’s a wonderful high-tech instrument that makes a lot of difference in people’s lives,” said Juan Hinojosa of Solidarity Bridge, which distributes the devices in Bolivia.

Heart to Heart, a nonprofit group in Billings, Mont., collects pacemakers and defibrillators from funeral homes and families, and gives them to Solidarity Bridge and other groups for use in Third World countries. Only devices that retain at least 80 percent of their original battery life are used.

Recycled devices have been implanted in about 1,400 people and have worked well, said Heart to Heart founder Bill Daem.

Why is this not done and encouraged more often? It seems there is a medmal issue standing in the way.

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.”

Dr. Wes says this statement “fell flat to me,” and asks,

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?

In fact, Medtronic has given devices away, though not used ones. That is too bad because there are probably many more people, here and abroad, that would prefer an affordable means of treatment to none at all due to medical malpractice concerns.