Sunday, July 26, 2009

Must We Speculate on SA's Recent Case?

(Reprint of my recent post, on Cold Filter, with minor edits.)

It's been just over a month, since the cryopreservation of Curtis Henderson (CI-95), and Suspended Animation has yet to publish their case report. (In conventional medicine, case reports are typically dictated immediately after the procedure, and transcribed soon thereafter; not written a month, or more, later.) Factual material regarding a medical procedure shouldn't take months, weeks, or even days, to produce.

The information in italics, below, is from Mr. Henderson's CI case report

"...Curtis' heart stopped at 4:15am on the morning of Thursday, June 25th, 2009.

Curtis was given prompt pronouncement of death and placed in the ice bath with the autopulse cardiopulmonary support. But the standby team had to wait an hour for the funeral director before they could leave the hospital. It took another hour for the team to reach the funeral home, driving slowly in the van while the team gave Curtis cardiopulmonary support."

Cardiopulmonary support with the Autopulse? Or, did it fail, again? (I'm wondering why they had to drive "slowly," if the Autopulse was being used.)

"The Suspended Animation team consisted of Suspended Animation staff plus a professional perfusionist."

As I've already stated, (in a previous post), I think it was GREAT that SA had a qualified perfusionist show up for a recent case. However, as far as we know, they still don't guarantee one will show up for every case. (In fact, I think Mathew Sullivan has indicated that SA offers no such guarantee.)

Did Mr. Henderson pay $60K for a professional perfusionist, (who probably wasn't guaranteed to show up but, thankfully, did), a research scientist with surgical experience, (who apparently didn't feel comfortable performing a femoral cannulation), and a couple of other care providers with nothing more than EMT-Basic training followed by little-to-no experience with human patients, and a funeral director Mr. Henderson would have had, anyway?

"For the first two-and-a-half days the team also included a surgeon, but the surgeon could not remain on the standby. Another surgeon was to join the team later in the day Thursday, but that was of no help early Thursday morning when the team needed to do surgery."

After seven years, and probably 10 MILLION dollars, (or more), SA still can't provide someone capable of performing a femoral cannulation, for every case??? The perfusion procedure is the "backbone" of the services SA is said to be providing. If you don't have someone capable of performing a good cannulation, and someone capable of safely performing the perfusion, you have virtually nothing. Also, let's not forget the importance of having someone capable of gaining IV access on a patient with no blood pressure. SA was probably lucky, in that Mr. Henderson was in a hospital, so we can assume he had at least one IV already in place.

"Team-leader Catherine Baldwin had years of experience doing surgery on laboratory animals, but not humans. Catherine solicited the assistance of a funeral director to isolate the blood vessels. "

Does this mean Ms. Baldwin thinks someone who has "had years of experience doing surgery on laboratory animals" is less qualified than a funeral director, for performing a femoral cannulation? What good are Ms. Baldwin's "years of experience doing surgery," if she won't perform the primary surgical procedure associated with SA's services? Isolating the femoral vessels is a relatively easy surgical task, and I believe funeral directors aren't really known for their finesse, as they typically don't have to be concerned with inflicting additional internal damage on their clients.

What were the qualifications of the "surgeon" who showed up but couldn't stick around for the procedure, and the "surgeon" who couldn't make it in time? Were they actual surgeons who have performed femoral cannulations on humans? Or, has most of their experience been with animals, just as Ms. Baldwin's?

"Catherine and the New York funeral director arrived at the funeral home of CI's funeral director Jim Walsh at about 3:30am on Friday morning. Mr. Walsh opened Curtis' chest with a median sternotomy. He could have perfused through the ascending aorta, but insofar as there was already a cannula in place in the femoral artery that had been placed by SA. Catherine told Jim that the cannula in the femoral artery extended all the way up to near the heart. Jim decided to use the existing cannula and take drainage from the jugular. Part of his rationale was concern about problems from pacemaker wires close to the heart. He clamped the axillary arteries as well as the descending aorta (thinking that the cannula in the descending aorta was not being constricted). In retrospect, the main advantage in opening the chest was the ability to clamp the descending aorta, because the decision to use the femoral cannula was only made after the chest had been opened."

There's no "rational rationale" in performing additional cannulations, if the femoral cannulae are in place, and a proper washout has been performed, without complications related to the cannulation. Plenty of heart surgeries are performed, via femoral cannulation. I think I see a lot of evidence as to why cryonics organizations are going to have to either educate a select group of funeral directors, or find "surgeons" who feel confident in performing cannulations.

Was either of the SA vehicles that get so much publicity, and are used for training sessions, used?

Finally, is the SA case report being written by team members who were actually present for the procedure, or by non-medical professionals who weren't even there? If the case is the latter, I will feel compelled to assume some creative writing is taking place, especially given the time-frame in producing the reports.