Patients shocked, burned by spinal cord stimulators touted to treat pain
apnews.com
apnews.com
Unlike drugs, implants don’t need to go through clinical trials in most cases.
Furthermore, there is no central registry for aggregating problems that patients experience with particular devices.
[1] https://www.theguardian.com/society/2018/nov/25/revealed-fau...
Edit: Summarized main problems from The Guardian article.
The artical says "surgical innovations" which probably means instruments and procedures. Also "some implants" are exempt from showing efficacy in clinical trials under HDE for cases in which the patient would have died anyway (e.g. pacemakers).
All medical devices of Class 2 and 3 must go through clinical trials to prove safety and efficacy as part of the FDA IDE. Spinal implants would certainly be Class 3.
Edit: clarification
How about if the implant kills the patient?
There was a local story today about a pacemaker where the electrode had failed and he was defibrilated 47 times during 3 hours before the battery ran out.
I assume/hope they have saved much more lives than that but regardless the types of failures seems to indicate that a lot more could be demanded of these products.
http://www.tellerreport.com/news/---83-000-deaths-in-unsafe-...
> “The few devices that get attention at any time in the press is fewer than the devices we may put on the market in a single business day. That to me doesn’t say that the system is failing. It’s remarkable that the system is working as it does.”
The bigger problem seems to be responding quickly (or responding at all) to real life injuries/issues with medical devices than the approval process.
That’s a gross oversimplification. Yes, certain devices don’t need to go through clinical trials since their approval is based on a “predicate device” and only involves minimal changes not expected to greatly change the risk-benefit offered.
If you’re developing a brand new, never seen before device, you will have to conduct clinical trials.
At the time I was pretty stunned that the rep was talking the docs through the operation but the procedure was successful and I learned that when new devices are introduced it is very often the company that trains surgeons in its use.
> Although there are roughly 4,000 types of medical devices in the FDA’s data, just six of them accounted for a quarter of device injury reports since 2008. (Francois Duckett/AP) But the stimulators — devices that use electrical currents to block pain signals before they reach the brain — are more dangerous than many patients know, an Associated Press investigation found. They account for the third-highest number of medical device injury reports to the U.S. Food and Drug Administration, with more than 80,000 incidents flagged since 2008.
This is shocking (pun not intended). I understand the desire and rush to get us off of opioids, but I think this is a horrific reminder that we still need to approach things cautiously and not get swept up in excitement and the promise of a "panacea"
Especially considering that the “panacea” of OxyContin’s “impossible to abuse” marketing is kinda what got us into this mess in the first place.
New medical technologies should be avoided during the de-bugging stages. Guinea pigs are underpaid.
I have done this several times in the UK - oh and one of the most serious ones was 1/5000 chance of death :-)