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January 2nd, 2014

Medical device improv

By Elizabeth Harty, Sr Communications Specialist
JunFen with Dr. Amy Macintosh

Amy McIntosh, M.D., with JunFen

If people had only used duct tape for its original purpose of (sealing canisters and repairing cracked windows and vehicles during World War II), we wouldn't enjoy the more than 6,000 books written about the many, many other ways to use this marvel of modern adhesive technology. This kind of inspired adaption, dare we say innovation, is also currently taking hold in the medical device world, as a recent Star Tribune article points out.

When it comes to treating patients, the article says doctors are given "complete discretion to use medical devices in any way they think helps their patients." Including, it suggests, "off-label uses that were never envisioned." One such "off-label" use is happening right here at Mayo Clinic, where "Mayo Clinic's Dr. Richard Marsh helps control brain seizures in epileptic patients with a fiber-optic laser first introduced to treat prostate tumors." Dr. Marsh tells the Star Tribune that such product "adaptions" are often the result of doctors being left with no other choice when trying to decide how to best treat a patient. Still, he says any "decision to adapt" is never taken lightly. 

Another Mayo physician featured in the article, pediatric orthopedist Amy McIntosh, M.D., has been putting her medical improv skills to work for one particular young patient from Roseville, Minn., suffering from severe scoliosis. Karin Freihammer and her husband brought their daughter, JunFen, to Mayo Clinic in Rochester at the end of 2009, seeking help for a 108-degree spinal curve that was bending JunFen's body in half. During a recent operation, Dr. McIntosh inserted several steel rods and screws into JunFen's spine to help correct that curve. But first she had to adapt the adult-sized pieces to make them fit JunFen's small body. "Maybe 25 to 30 percent of the time I end up taking something that was not specifically made for a kid and figuring out a way to make it work," Dr. McIntosh says.

JunFen today

A photo of JunFen today

Now, after 12 more operations to adjust and expand those rods and screws to conform with JunFen's growing body, the curve of her spine has been improved to 30 degrees, far exceeding both her parents' expectations and those of Dr. McIntosh. "Her shoulders are back now, her chest is open, and she doesn't appear so bent over," Karin Freihammer told us. "Had she not have had any of these surgeries, it could have impacted her life span or at the very least created problems with her heart and lungs because having the kind of severe curve she had, it made those organs work a lot harder."

The article is careful to stress that not all medical device improvisations have worked out as well for other patients. Still, Freihammer says Dr. McIntosh's freedom to improvise and adapt medical devices to better meet the needs of her patients not only saved her daughter's life, but extended it as well. "While the corrections may have been life-saving, they've also been life-lengthening," she tells us. "JunFen is now expected to live a full, normal number of years."  

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Tags: Amy McIntosh, Innovation, orthopedic, Patient Stories, pediatric orthopedist, pediatrics, Practice story, Richard Marsh

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