Robot as scapegoat

A front page Wall Street Journal article (Surgical Robot Examined In Injuries) raises safety concerns about the Da Vinci surgical robot and questions the appropriateness of its manufacturer’s marketing practice. I think they are throwing stones at the wrong targets.

Here’s what the Journal says…

By way of background…

The da Vinci has been billed as a breakthrough in the quest to make surgery less invasive. With its four remote-controlled arms and sophisticated camera, it enables surgeons to operate through small incisions with greater precision and visibility.

…regarding its safety…

At Wentworth-Douglass [a Dover, NH hospital using the robot], however, the robot has been used in several surgeries where injuries occurred. One patient… was so badly injured that she required four more procedures to repair the damage. In earlier robotic surgeries, two patients suffered lacerated bladders.

…and about the marketing approach…

[S]ome surgeons have questioned the way the robot has been marketed. Intuitive Surgical has marketed the da Vinci to hospitals as a way for them to increase their revenues and gain market share.

A 14-minute video on the company’s website features testimonials from surgeons and hospital administrators. A key message: The robot has been good for business. One cardiac surgeon in the video says at least 70 of his 250 annual cases are new patients who wouldn’t have been referred to him if not for the robot.

Here’s the problem with the Journal’s two arguments:

  • I definitely believe that injuries occurred in surgeries where the robot was deployed. And it’s believable that this hospital lacked the volume of cases to use the robot successfully. Yet mistakes happen in surgery all the time. A robot is no prerequisite for a medical error. There’s nothing in the article to compare these anecdotes with the rate of errors in the hospital’s non-robotic surgeries. If anything I would say the article makes a good argument not to have surgery at a small hospital.
  • Of course the robot is being marketed to hospitals as a money maker. That’s not da Vinci’s fault at all. The company is just responding to the way doctors and hospitals operate: as profit-seeking, revenue maximizing entities. If someone wants to change that, blaming the robot won’t help.
May 6, 2010

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