Doctors, Hospitals Should Share Blame For Recalled Medical Devices

Cheryl Clark, for HealthLeaders Media , February 17, 2011

"The conflict of interest for physicians in the device world is even worse than in the pharma world," he says. "They promote them, get royalties from them and become advocates for these devices that they're involved with and earn equity from. In the orthopedic world, they're out there writing guidelines when they actually own equity in the devices they're recommending their colleagues use," Nissen tells me.

Nissen says the problem is especially acute in his own field of cardiology, which is why he got involved. "A single group of cardiologists dominate device-related research, and it's an enormous problem in orthopedics where there are so many entrepreneurs and investors," he says.

Other surgeons and interventionalists flock to use them without thinking about how new they are. "It's imprudent. Instead of looking at these devices as unproven, they flock to them as the 'latest and greatest,' when the devices that have a long-term track record might be a better choice."

Nissen says hospitals share some blame as well because they stock the devices that doctors want. "It's harder to put the blame on them, but they certainly should be asking more questions."

Healthcare reform may help mitigate the problem, because it is putting the squeeze on hospitals to reduce costs. That may result in hospitals buying fewer brands that are older and more "tried and true," enabling them to get volume discounts rather than purchasing dozens of brands to meet each physician's preference.

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2 comments on "Doctors, Hospitals Should Share Blame For Recalled Medical Devices"

Mary Potter (2/18/2011 at 1:40 PM)
How presumptuous to suggest that hospitals and most physicians fail to report device failures. My experience is that physicians and clinicians consistently report device failures and offer recommendations for improved functionality. The majority of manufacturers thank us for our interest and advise that no one else has reported the issue and no one else has requested functional change. Instead of attemping to assign blame, maybe we should devote our energies to improving the reporting structure and making it transparent.

Linda Ollis FACHE (2/17/2011 at 3:12 PM)
Hospital leaders are generally very cautious of clinical trials and should have a solid, tested IRB Committee and process in place for research protocols. Once a device has been approved for use, hospitals still have the responsibility of reporting incidents and/or poor outcomes that include the use of a medical device, allowing trends to be tracked. We also rely on outside experts from such organizations as Sg2 and ECRI to warn of issues. We cannot make independent medical judgements as to the causes of any problems. There are a number of patient safety organizations in existence now who should be reviewing the system and issues and making recommendations for improvement that hospitals can support.




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