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4.1.2014
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News Room: BUSINESS COURIER: Recycled pacemakers? Cincinnati surgeon helps lead effort

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Business Courier

By: Barrett J. Brunsman

Dr. Thomas Carrigan plans to implant three pacemakers in patients today and seven more over the next few days – even though he’s on vacation 5,500 miles from his cardiology job at St. Elizabeth Healthcare in Edgewood.

“I’m here in Ghana,” Carrigan emailed me from the African nation on Monday. “We spent (the day) screening patients, getting the OR ready and doing inventory of our equipment. We have 10 patients to do this week.”

He followed up with an email at 1:01 p.m. Tuesday, noting that he had completed two operations. “We have one more to go for a total of three today,” he said. “Probably done in an hour or two.”

Carrigan made the trip to show doctors at Komfo Anokye Teaching Hospital in the city of Kumasi how to implant pacemakers. The devices, which can cost $5,000 to $10,000 depending on the location of a hospital, were donated by Minneapolis-based Medtronic.

Eventually, Carrigan hopes to recycle pacemakers no longer needed by patients in the United States and donate them for implantation in poor patients in Ghana.

Carrigan, 37, who lives in Anderson Township with his wife, Kellie, and their 3-year-old daughter, Hailey, has worked at St. Elizabeth for five months. He was a finalist in the Business Courier's 2014 Health Care Heroes awards program.

The surgeon, whose specialty is clinical cardiac electrophysiology, said he implants pacemakers every week at St. Elizabeth. He’s done hundreds of such operations during his career, and Carrigan hopes that Dr. Yaw Adu-Boakye of Ghana, who speaks English, will be able to pick up on his surgical techniques and train other doctors there.

The operation usually takes 1 to 1½ hours, and the standard survival rate is about 95 percent, Carrigan said. Without the operation, a patient with an abnormal hart beat can suffer fatigue, shortness of breath, fainting, organ damage or death.

A friend who is a software engineer loaned Carrigan a pair Google Glass eyewear to videotape the operations. The $1,500 computer system, which is available only in limited release, will transmit images to Carrigan’s laptop via a custom software program written by the engineer.

Carrigan wants to determine whether it is feasible for doctors in Ghana to someday wear Google Glass while implanting pacemakers and live-stream the operations back to St. Elizabeth Hospital, where he could observe and offer guidance.

“This is the kind of thing that can revolutionize medical education,” said Carrigan, who received his medical degree from the University of Kansas, served a residency at the Cleveland Clinic, and was a fellow at Case Western Reserve University and the University of Michigan.

Carrigan is on the board of directors of Project My Heart Your Heart, a research study based out of the University of Michigan. He traveled to Ghana to implant new pacemakers for the first time last July on behalf of the group, which hopes to obtain approval from the U.S. Food and Drug Administration sometime this year to export used pacemakers.

“There’s no federal regulation to support (such a plan) because it’s a single-use device,” Carrigan said. Without FDA approval, it would be illegal to reprocess gently used pacemakers.

Why would an American no longer need a pacemaker to control abnormal heart rhythms? “They pass away, they get infected or the device needs to be upgraded,” Carrigan said.

“We have a collection of them,” Carrigan said. “More than 500. They have been donated. Not all of them have sufficient battery life. You can’t change the batteries. It’s not like a remote control.”

A battery can last nine to 13 years, depending on the pacing mode. Some patients require pacing for every beat of the heart.

The used pacemakers, which are removed from the body of the original patient either at a hospital or funeral home, are shipped to Ann Arbor, Mich. There, they are sterilized, tested for battery life and functionality, and packaged for reprocessing.

St. Elizabeth is reimbursing Carrigan for the cost of traveling to Africa. It took nearly 24 hours for him to reach Kumasi. He flew out of the Cincinnati/Northern Kentucky International Airport on Saturday, caught two connecting flights, and then was on a bus for about five hours.

His hotel is being paid for CardioStart International, a Florida-based group of volunteers who provide free heart surgery and medical services to children and adults in developing countries.

The people he’s operating on in Africa tend to be in their 50s.

“It’s kind of a self-selected population,” Carrigan said. “Many of the people who are truly ill pass away.”


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