Chapter 16
Anonymous Industrial
Engineering Ethics Cases
187
CASE 1: BIOMEDICAL ENGINEER
Ethics Dilemma Scorecard
Public Safety & Welfare
Data Integrity & Representation
Trade Secrets & Industrial Espionage
Gift Giving & Bribery
Principle of Informed Consent
Conflict of Interest
Accountability to Clients & Customers
Fair Treatment
TELL US YOUR STORY
After working 20 years at two other hospitals as Director of Biomedical
Engineering, I moved to a similar position at a university hospital. From
the outside, it looked like a great position. But during the 3 years I was
there, I went through hell.
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188 Engineering Ethics: An Industrial Perspective
A hospital biomedical engineering department has four main areas of
responsibility: preventive maintenance (PMs), equipment repair, product
evaluation, and research. Preventive maintenance refers to the JCAHO-
mandated testing of hospital equipment. JCAHO, or the Joint Commission
on Accreditation of Healthcare Organizations, accredits health care facil-
ities. Critical care devices, in areas such as the intensive care unit,
are required to be tested for electrical safety twice per year. There were
7000 pieces of equipment in our preventive maintenance system. Each PM
inspection required the technician to locate the equipment, perform the nec-
essary inspection, and record the results. With only five technicians on my
staff, they were not able to keep up with the demanding PM schedule and
still perform their other responsibilities.
I tried as best as I could. The PMs of all the critical devices, like
defibrillators, were always up to date, since I never wanted to put
patients at risk. But PMs for less critical devices were not conducted, so
about 50% of the equipment was off calibration. Shortly after being
hired I realized the tremendous personnel shortage I had inherited, and
began reporting this concern to upper management. Over the next
2 years I continued to report my inability to comply with JCAHO stan-
dards with my current staffing level, which included 85 pieces of filed
documentation. I continued to request two additional technicians to
help. These people were never hired, and it was even suggested that
I falsify computer records to cover up my department’s inability to
complete the necessary inspections.
After 3 years, JCAHO came for their inspection. The inspector ran-
domly pulled 30 PM numbers, and looked at their calibration records.
Each piece of equipment was required to show an equipment inspection
every 6 months for the past 3 years. Fifty percent of our equipment did not
meet this requirement. Consequently, my department did not pass the
inspection. Overall, the medical center did pass their inspection; however,
the biomedical engineering department was listed as an area that needed
improvement.
Immediately afterwards, I was called into the Vice President’s office and
asked to resign. I was accused of killing patients, which was very disturbing to
me. During my tenure at this medical center, four patient-related incidents had
resulted in patient death. The root causes of the incidents were user error;
equipment never malfunctioned. These were a large number of incidents, com-
pared to my experiences at other hospitals.At the time I didn’t know it, but the
Vice-President’s goal was to outsource my department, which would result in a
fixed and cheaper cost for maintenance and repairs. I refused.
The next morning, I met with my attorney, who advised me that if I
stayed and was eventually fired, I could then sue because I had a strong
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