Catherine Reinhard Proper precautions not taken for pre-exisiting implanted device during unrelated surgery

Your Name: Catherine Reinhard

Patient’s Name/Relationship: Catherine Reinhard/self

City/State: Westlake/OH

When did event occur (what year)? 2018

Where did event occur? Acute Care General Hospital

What type of medical harm did you experience or witness? Harm From a Medical Device or Implant

Please describe what happened. I have a deep brain stimulator (DBS) that was implanted two years ago and was working well. The battery case/computer is implanted in my abdomen. In February, 2018, I had unplanned surgery to treat an intestinal blockage. The surgery for the blockage was done at a local hospital that is affiliated with Case Western Reserve Hospitals in Cleveland, OH. Case Western is where I had the DBS surgery, so the local hospital and Case Western, should have been communicating about the special requirements for managing the possibility of exposure to high energy from surgical procedures, such as the cauterizing that is part of closing the surgical site. I was shocked that when I was admitted to the local hospital, I received wrist ID bracelets with my name, SSN, etc., along with a neon red wrist band alerting to my celiac disease. But there was no wrist band alerting to the DBS implant. No one Interviewing me ever asked if I had any kind of medical implant or the identity of the device manufacturer. Between being admitted and the intestinal surgery, there were three days, plenty of time for surgical personnel to have contacted my neurologist at Case Western and the device manufacturer about the special considerations for surgery with the implant. The implant was not turned off during surgery as it should have been. Implanted medical devices are becoming quite common and I believe anyone who enters a treatment facility with a pre-existing implanted device should receive a wrist band alerting anyone who interacts with this kind of patient of the special considerations the implant presents. Exposure of the implant to high energy, which often happens during surgery can cause serious harm including stroke or death. I was lucky, the implanted device still works, though with some degradation in effectiveness.

What was the outcome of the medical harm issue? Minor injury