The Science Journal of the American Association for Respiratory Care

2000 OPEN FORUM Abstracts

Con: RTs Should modify equipment to meet patients needs

Charles G. Durbin, Jr., MD University of Virginia Health Sciences Center, Charlottesville, Virginia

For the following reasons, equipment used in patient care should not be mechanically altered even if a patient benefits by the changed function:
1. Rigorous testing standards have been developed to provide "Safe" and reliable equipment. Alterations in one area may have unforeseen consequences on other system functions. Standards are then violated and risk increases.
2. Safe patient care is a higher, more important value than ideal or even good patient care.
3. While specific RT individuals may have advanced understanding of equipment function and may be able to safely modify devices, the next shift individual can be caught "off guard" increasing risk.
4. Respiratory therapists are not trained to modify equipment nor do they generally have documented "competency" in this area.
5. Departments and perhaps individuals participating in equipment alteration will be assuming increasing liability and may not be covered by existing institutional liability insurance policies.
6. The institution may not support an individual performing an alteration unless such activity is explicitly covered in his job description.
7. In the case of an investigation of an adverse outcome, the manufacturer can claim an exemption to liability since the equipment is no longer to factory specifications. In the case of a settlement, payments are often "shared" by the responsible parties. This may make the entire burden fall to the therapist, department or institution.

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