CPR device scrutinized following man's death

[WAS967 97]

http://www.thedesertsun.com/apps/pbcs.dll/...S0804/507230339

CPR device scrutinized following man's death

Marie McCain

The Desert Sun

July 23, 2005

A 77-year-old man died earlier this month after Palm Springs paramedics used

a new automated CPR machine to revive him after he was pulled from a local

pool.

The death, in which the cause is undetermined, is still under investigation.

But it has prompted county officials to suspend use of the device until its

safety can be ensured.

On July 14, Fang Joon Yun was pulled from a pool at a local casino.

In the hopes of reviving him, emergency personnel used the AutoPulse

Non-Invasive Cardiac Support Pump to provide CPR to Yun as he was

transported. But Yun died at the hospital.

Sgt. Earl Quinata, a spokesman with the Riverside County Sheriff's

Department, which also includes the coroner's office, confirmed Friday that

Yun suffered some broken ribs.

He said it is uncertain if the AutoPulse played a role in Yun's death.

Additional tests are planned by the coroner's office.

The device is used in other areas of the state, such as Santa Clara, Alameda

and San Francisco counties, according to Michael Osur, director of Riverside

County's Emergency Medical Services Agency.

Osur stopped use of the device in the wake of Yun's death and warned other

counties across the state.

"We don't know if the device worked properly or if there was some flaw with

the overall design," he said Friday. "The coroner is concerned with (Yun's)

broken ribs."

However, manual CPR also can result in broken ribs, officials said.

Palm Springs became the first jurisdiction in Riverside County to obtain the

device and announced its acquisition earlier this month.

At that time, Fire Chief Blake Goetz said the device improves upon the chest

compressions of manual CPR because it is designed to increase blood flow to

the heart and brain.

"Once a person is in cardiac arrest, every minute counts to get the heart

beating normally again," he said at that time. "For every minute that passes

the chance of survival decreases by 10 percent. Our goal is to protect the

lives of Palm Springs citizens and this piece of equipment is an important

step in helping to achieve that goal."

On Friday, Goetz said he still believes the device is useful, but only if it

proves not to have been a factor in Yun's death.

"I'm as interested as anybody in the continuing investigation," he said. "I

would like to continue to use it provided it's deemed safe."

He said his entire staff of nearly 60 fire personnel underwent training from

the manufacturer.

But, citing advice from the department's attorney, he refused to say how

many times the AutoPulse was used prior to this incident.

The device cost the city $15,000.

Both Goetz and Osur said manual CPR also can result in broken ribs. But it

depends on the age of the patient - whether there is a

preexisting condition that might weaken the bones - and the experience of

the person performing CPR.

Osur said the county was initially skeptical about the device's

effectiveness.

Manufactured by Revivant Corp., based in Sunnyvale, a subsidiary of Zoll

Medical Corp. in Massachusetts, representatives visited county officials

more than a year ago, prior to the device's approval by the Food and Drug

Administration.

"They demonstrated it," Osur said. "It was light and easy to put on and it

helped stimulate blood circulation."

Revivant officials could not be reached for comment Friday.

However, according to the company's Web site, the AutoPulse automatically

adjusts to each patient and provides consistent depth and rate compressions.

Testimonials from medical personnel, also on the Web site, laud the device

for its ability to stimulate blood flow.

Osur said other automated CPR devices have been on the market, but they were

heavy and cumbersome.

"I hope we will be able to use it again," he said. "And I commend Palm

Springs for being the first (department) in the county to try it.

"All any of us want is to be able to better save lives. That's all that

matters."

[WAS967 97]

I really hate the way this article is written. The man's death is undetermined yet they immediatly assume it was the Autopulse. They only pulled the autopulse OOS as a precaution. Chances are his COD was unrelated. Stay tuned.

[Guest]

I agree with was. A "typical" 77 year old cardiac arrest will probably suffer broken ribs and eventually die - yet just because something new was tried on this patient, people assume that conventional treatment would have been more effective.

[HCFRFF 0]

well anybody who has done CPR knows there gonna feel some ribs cracking, more common in elders. some even say " if you feel the ribd cracking you know your doing good CPR".

Im surprised they havent tried to bring the crew up on charges yet.......politics politics ](*,)

[Guest]

It amazes me that, in general, it is almost automatic to blame the machine and or the crew and not just face the music that it might have been that particular persons time.

On a side note it sounds like billy-joe-bob the mechanic sold a hopped up drill press to that ems equipment distributor.

[Guest]

It is asinine that they would even think of putting the device out of service, now the patients will get even worse or no CPR when they are in cardiac arrest. The reason they use these things is to free up a set of hands because the companies are too cheap to send enough medics to the job, now what are they going to do? That's right, when the patient goes into arrest while in the back of the rig with only one crew member, they will either get no ALS or no CPR or not enough of both.

As far as the cause of death goes, I already know the autopulse did not kill him. The first sentence says the senior citizen was "pulled from a local pool." He probably had a sudden cardiac arrest and was dead BEFORE the "paramedics used a new automated CPR machine to revive him." Not to mention all the water and chlorine that filled his lungs, also BEFORE the autopulse was attached to his chest.

If this is how they investigate things in Palm Springs, then the autopulse is going to be put out of service every time it is used correctly. What a bunch of morons!!!

[WAS967 97]

As far as the cause of death goes, I already know the autopulse did not kill him.

Thay aren't looking into it as the CAUSE of death. They are looking to determine if it was a CONTRIBUTOR in the patient's death. They won't know that until the ME makes his/her report. Until then, they are wise to take the device out of service. In our litigous society, they stand to be sued if it is determined that the device even was SUSPECTED of contributing to the patient's death. Continuing to use it after suspicion has risen would just open them up to further problems. They will just have to make due until the device returns to service.