194 Engineering Ethics: An Industrial Perspective
WHAT ARE YOU DOING NOW?
I continue to work with the state occasionally on groundwater problems.
CASE 5: 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
I was working at a medical device startup, reporting to the Vice
President of R&D. The device we were developing attached to the wrist
and was to be used in the hospital operating room. Over the course
of 1 month, a mechanical engineer and I conducted many experiments
on our own wrists. At the end of the month, when our wrists began to
ache, I went to the biomedical library to investigate the cause of this
constant pain.
Through three journal articles, I discovered that I had given myself
carpal tunnel syndrome. The work the other engineer and I had been con-
ducting involved applying pressure to our wrists that, when measured
with an external pressure sensor, exceeded 200 mmHg. According to the
articles, the median nerve within the carpal tunnel would be compromised
if pressure within the carpal tunnel exceeded 9 mmHg below diastolic
blood pressure (typically 60 mmHg). I told my boss that patients using
our device might get injured. Though he thought I was exaggerating and
hypothesized I might have an “unusual” wrist, I kept insisting injury was
possible. Eventually, he asked me to tell our principal investigator of
experiments in the operating room, an anesthesiologist, about my pain.
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Anonymous Industrial Engineering Ethics Cases 195
The anesthesiologist immediately arranged for a meeting with a vascular
surgeon and hand surgeon to discuss my findings.
At this meeting, the CEO, the VP of Marketing, the VP of R&D, a
mechanical engineer, and I discussed my findings with the anesthesiologist,
vascular surgeon, and hand surgeon.The three physicians agreed that I had
given myself carpal tunnel syndrome. Even worse, because the device was
mounted on a steel wrist brace completely encircling the wrist, the two sur-
geons believed that during a long surgery, too little blood would circulate
to the hand, causing tissue necrosis (tissue death). As we left the meeting,
the VP of Marketing joked, “So you go in for hip surgery, but come out
without a hand. Is this bad?!” I did not find this funny.
A few days later, we had our quarterly meeting with our technical advi-
sor, who was also an anesthesiologist. This technical advisor was on the
Board of Directors. When the technical advisor heard about carpal tunnel
syndrome and tissue necrosis, he immediately mandated that the wrist
brace design be changed. After the meeting, he apologized for our pain,
and told the mechanical engineer and me that our company would pay for
any treatment that we needed. It the first time a manager at the company
had shown concern for our injuries.
LOOKING BACK, WHAT WOULD YOU HAVE DONE
DIFFERENTLY
?
Of course, if I had known about carpal tunnel syndrome, I would not
have conducted so many experiments on myself. But I would not have
changed anything else I did. I felt a duty towards not injuring patients
using our device. That’s why I kept complaining. I didn’t know it then, but
I am glad that doctors vow to “first, do no harm. Without the insistence of
the anesthesiologist on the Board of Directors, the wrist brace design
would not have been changed until a patient in the operating room was
severely injured.
W
HAT ARE YOU DOING NOW?
I left the startup less than a year later, when I got a new job at another
device company. Believe it or not, this was only one of many incidents that
happened to me at this startup and caused me to leave.
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