Untitled

Hayes, John J.

doi:10.1023/a:1023695124312

Cited by 9 publications

(1 citation statement)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While many cardiologists perfectly implant these devices, they usually remain in the background during the follow-up due to limited time or inadequate experience and knowledge. Hayes (16) stated that management of CIEDs has proceeded to a technologically more complex stage at a pace that is difficult for most medical doctors to keep up with. Therefore, this condition forces medical doctors to rely on industry representatives for their technical expertise regarding follow-up.…”

Section: Discussionmentioning

confidence: 99%

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up)

Üreyen

Baş²,

Yüksel³

et al. 2017

Anatol J Cardiol

View full text Add to dashboard Cite

Objective:This retrospective study sought to research the adequacy of the follow-up and optimization of cardiac implantable electronic devices (CIEDs) performed by industry representatives.Methods:A total of 403 consecutive patients (35% females; median age, 67 years; age range 18–97 years) with either pacemakers (n=246), implantable cardioverter-defibrillators (ICDs), (n=117) or cardiac resynchronization therapy with defibrillator (CRT-D) (n=40) applied to our hospital’s outpatient pacemaker clinic for follow-up. These patients had been followed up by industry representatives alone until September 2013 and then by a cardiologist who is dealing with cardiac electrophysiology and has a knowledge of CIED follow-up.Results:It was ascertained that 117 (47.6%) of 246 patients with pacemakers had a programming error. Forty-three (36.8%) of 117 patients were symptomatic, and after reprogramming, all symptoms diminished partially or completely during the follow-up. Moreover, 30 (25.6%) of 117 patients with ICDs had a programming error. Furthermore, 6 (15%) of 40 patients with CRT-Ds had a programming error. To conclude, when all patients with CIEDs were assessed together, it was ascertained that 153 (38%) of 403 patients had programming errors.Conclusion:The prevalence of inappropriate programming of CIEDs by industry representatives was quite higher than expected. Therefore, our study strongly demonstrates that CIED follow-up should not be allowed to be performed entirely by manufacturers’ representatives alone.

show abstract

Section: Discussionmentioning

confidence: 99%

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up)

Üreyen

Baş²,

Yüksel³

et al. 2017

Anatol J Cardiol

View full text Add to dashboard Cite

show abstract

Industry Technicians Embedded in Clinical Teams: Impacts on Medical Knowledge

Hutchinson¹

2022

Hastings Center Report

View full text Add to dashboard Cite

Advances in implantable medical devices have increased the role for industry‐employed allied professionals (IEAPs) in providing training and support during surgical procedures and follow‐up care. The effect of these changes on the organization of medical knowledge and the sharing of information remains largely unexplored. Recent work in social epistemology and the conceptualizing of implantable medical device companies as part of a knowledge‐based industry provide a framework for engaging with this issue. In this article, we argue that the insertion of industry technicians into hospitals diminishes epistemically valuable knowledge‐sharing practices. This is in part a result of health care professionals’ increased dependence on IEAPs, who control access to knowledge about devices, limiting opportunities both for independent learning and for dialogic education practices through which participants work toward a common goal. Ultimately, we claim that overdependence on the IEAP as expert undermines a basic social value regarding knowledge sharing for everyone’s benefit.

show abstract

What Pacemakers Can Teach Us about the Ethics of Maintaining Artificial Organs

Hutchison

Sparrow

2016

Hastings Center Report

View full text Add to dashboard Cite

One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs. We briefly outline the nature and history of cardiac pacemakers, with a particular focus on the need for technical support, maintenance, and replacement of these devices. Drawing on the existing medical literature and on our conversations and correspondence with cardiologists, regulators, and manufacturers, we describe five sources of ethical issues associated with pacemaker maintenance: the location of the devices inside the human body, such that maintenance generates surgical risks; the complexity of the devices, which increases the risk of harms to patients as well as introducing potential injustices in access to treatment; the role of software-particularly software that can be remotely accessed-in the functioning of the devices, which generates privacy and security issues; the impact of continual development and improvement of the device; and the influence of commercial interests in the context of a medical device market in which there are several competing products. Finally, we offer some initial suggestions as to how these questions should be answered.

show abstract

Untitled

Cited by 9 publications

References 4 publications

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up)

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up)

Industry Technicians Embedded in Clinical Teams: Impacts on Medical Knowledge

What Pacemakers Can Teach Us about the Ethics of Maintaining Artificial Organs

Contact Info

Product

Resources

About