Jack Iwashyna 🫁

OK, this #JAMA Viewpoint on #PulseOx is amazing

But I think it basically says "It's weird that nobody has sued hospitals for continuing to use racially biased pulse ox's. Like, they seem pretty liable to us. And they don't really have a defense"

It's JAMA, so there's more nuance than that, but also not that much more

Jan 9, 2023 at 11:29pmWeb
Show threadJack Iwashyna 🫁Jan 9, 2023
Cause #Hypoxia is EVERYWHERE during dying. And it would not be hard to strongly suggest that undertreated hypoxia played a role in a lot of deaths.
Show threadJack Iwashyna 🫁Jan 9, 2023

Ok, I missed this sentence at first:

"The absence of any tort law cases is surprising"

Show threadJack Iwashyna 🫁Jan 9, 2023

. @dynarski

They literally say "The absence of any tort law cases is surprising"

Source:

https://jamanetwork.com/journals/jama/fullarticle/2800468

Pulse Oximeters and Violation of Federal Antidiscrimination Law

This Viewpoint discusses how some pulse oximeters can provide incorrect oxygen saturation data for dark-skinned patients compared with light-skinned patients, describes the reasons that biased oximeters remained in use, and highlights why a rule recently proposed by the US Department of Health and...

Show threadJack Iwashyna 🫁Jan 10, 2023
Hey @bethwilensky @hauschildt, as we were discussing… see above
Show threadKenneth BaillieJan 10, 2023
@dynarski @iwashyna Thanks for sharing. There must be a huge financial incentive now for companies to produce fair and accurate pulse ox, and for hospitals to buy them.
Show threadJack Iwashyna 🫁Jan 10, 2023

@kennethbaillie @dynarski

Maybe? There are certainly growing financial risks

But as https://www.forbes.com/sites/kerryadolan/2022/10/03/meet-the-iranian-immigrant-who-became-a-covid-medtech-billionaire/ showed, the market for med tech to hospitals is really dysfunctional, likely protecting crappy unequal devices

Meet The Iranian Immigrant Who Became A Covid MedTech Billionaire

Joe Kiani surmounted overwhelming personal and professional odds to build a better blood oxygen monitoring device. So why should he be afraid to push his scrappy company into consumer electronics, challenging firms 100 times its size?

Forbes
Show threadjsussmanJan 10, 2023
@iwashyna Generally, is there research on disparities in tort/malpractice cases? IE, disparities in people who were harmed by the healthcare system receiving just recompense?
Show threadSarah MelvilleJan 10, 2023
@iwashyna @jsussman key regulatory discussion in this editorial on the topic from last week: https://jamanetwork.com/journals/jama/fullarticle/2800368?guestAccessKey=e5a893e7-10ca-4c03-a27b-92bfc5d1bfb0&utm_content=weekly_highlights&utm_term=010823&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email
Clinical Algorithms, Antidiscrimination Laws, and Medical Device Regulation

This Viewpoint discusses recent legal directives by the DHHS and FDA that could increase health care entities’ liability for possible discriminatory biases of clinical algorithms and the need for additional legal clarity to avoid adverse effects on algorithm development and use.

Show threadJack Iwashyna 🫁Jan 10, 2023
@jsussman I don’t know, could be interesting
Show threadSarah MelvilleJan 10, 2023
@iwashyna yes, & there are 2 other related studies & an editorial on the topic too.
The clinical inaccuracy of these med. devices is in violation of the federal anti-discrimination law. These device inaccuracies have existed for 40 yrs., yet nothing has been done to improve them, 🙄