Wednesday, November 18, 2015

Blind science

Thanks to Brian Klepper for alerting me to this:

Here's a poignant personal story about modern medicine from my friend Michael Millenson. Michael is a journalist who has played a significant role in ushering in the quality and safety movements in American health care.

The lede:

When I was a newborn — a preemie struggling to survive in a hospital nursery’s incubator — an article deep inside The Washington Post saved me from becoming blind.

The article — on Page A22 — discussed research showing that too much oxygen in an incubator could cause babies to lose their sight. When my worried parents phoned the hospital, they were told doctors had also seen the piece and promptly adjusted the incubator’s air mixture. What none of them knew was that the sight in my right eye had already been destroyed by what is now called retinopathy of prematurity, or ROP. Fortunately, the vision in my left eye remained intact, saving me from a lifetime in the dark.

That was way back in 1953. Yet just a few months ago, a federal judge dismissed a lawsuit involving premature babies enrolled in a study of what incubator oxygen level was best. The infants’ parents said they hadn’t been fully informed of all the risks to their infants. I was stunned. In 2015, how can the oxygen level in incubators still be endangering babies?


Dr.Theresa Willett said...

The reason studies are still being conducted is because it's complicated. The standard O2 saturation of preemie air has been lower than 100% for a long time, but finding the sweet spot for retinal protection vs brain development is tricky. In utero, a fetus is perpetually hypoxic, but once delivered preterm, the organ development is altered, so just maintaining placental levels would not be appropriate.

Carole said...

Dr. Willet
Complicated yes, but you'd think after what 50 plus years of studies and experiments the sweet spot or thin line between
Retinal protection vs. brain development would of been figured out long before now, or at least enough learned to give the parents
complete and total discloser of all risks that they should of been informed of. Any class action lawsuit filed (period) says "everything".
The fact the case was thrown out means nothing!!! but another person in a position of trust failing the precious boo-boo's and their
parents all over again. Surely brilliant minds will figure this out sooner than later, if not - but meanwhile inform, inform inform!
I know firsthand about not being informed of the risk of a procedure and the price from that was my mothers precious life. Because
the very risk that could happen, did happen.