My articles tend to be related directly to decompression science and clinical methodologies, but this article addresses what is soon to be a major shakeup for many traction/decompression clinics. Those utilizing the ubiquitous exposed "scissor/hinged"-type lift mechanisms (especially with a floor control switch) may be subject to an FDA reconfiguration/modification (or open recall) of the equipment.
A tragedy almost beyond comprehension has recently rocked the chiropractic world. As is so often the case, accidents have many victims, not the least of whom can be the person(s) perceived to be responsible. The following information, though too late for the victim and their family, may save many of us using this type of equipment the unspeakable pain and legal devastation lack of diligence toward safety can bring.
On June 10, a woman being treated on a St. Paul, Minn. DC's Chattanooga Group DTS decompression table (TRT-600) was lowered onto her playful and curious 18-month-old son. The unregulated lowering power and weight of the table crushed the young boy, who suffered major head trauma beyond resuscitation. The woman was receiving an unattended traction session while her three children played in the room in close proximity to the table.
When the child entered the undersection of the table, he obviously activated the floor switch and created the deadly sequence of events. The young mother, who was strapped into the table with a belt system that features a double ring-loop cinch with no quick-release mechanism, could not free herself and then screamed in an effort to get help, but was unable to stop the table from crushing her son. No safety mechanism is available for the patient to control the vertical movement of the table, even if the motor's safety shut-off is activated. There is also no shut-off switch if the table encounters resistance on its downward travel (such as seen in garage door motors, which immediately stop and elevate when pressured upon closing).
This "scissor-lift" type of mechanism is certainly no stranger to the chiropractic profession. However, traction tables may acutely expose us to the dangers and safety shortfalls of this type of mechanism since many, many DCs leave their traction patients unattended. 97012 (CPT code: traction, mechanical) requires only "in office" supervision, not constant attention.
Many tables that elevate vertically utilize an ultimately safer option of an enclosed single- (or dual-) pedestal column. The reduction of scissored/hinged metal pinch-points eliminates the potential of the recent tragedy. Why certain lift-mechanisms are chosen may come down to cost, production time and materials available to the manufacturer.
The TRT-600 is the Chattanooga Groups' DTS (Decompression Traction System) and has been a popular offering of the now California-based conglomerate since 2007. There are warnings in the instruction manual to not let children under the table; however, after several years of use, we clinicians often become "desensitized" to otherwise relatively large safety risks. One should never simply assume that since it hasn't happened, it won't happen – or worse, "that it just won't happen to me!" Having been associated with various manufacturers over the past two decades, I have had many discussions regarding the injury potential of the exposed "scissor-lift" mechanism.
Manufacturers that have understood the safety issues have opted unequivocally for a single-pedestal design with no exposed scissor mechanism, and have limited the downward travel of the table system and caudal surfaces. They had foreseen potential "crush" injuries and felt it a necessity to limit that risk as thoroughly as is possible.
This is perhaps just another of many examples of a product design that will not be changed until a trial lawyer sues the company that made it. In my opinion, the scissor mechanism and floor controls should have been enclosed and protected. Children being in a room with a parent is foreseeable, as is their inherent curiosity. Sadly, it may take a tragedy like this to get a jury to teach the DC and the product maker why safety should always be job one.
If you own one of these tables, you should request it be modified ASAP (perhaps even before you are required) to prevent children from access to the dangerous mechanism. Relocating the foot switch only makes sense as well.
Without intent and forethought is the problem. Ford Motor Co. didn't intend for its Pintos to burst into flames in rear-end collisions, but they did. Ford knew the inherent risks beforehand, and yet made a conscious decision, forethought, to save $7 per Pinto by leaving out a plastic fuel tank projector. It took the death of a beautiful young woman and a multimillion-dollar verdict in Corpus Christi, Texas, to force a design change that saved thousands of other lives.
Before anti-tipover devices were required for kitchen stoves, hundreds of innocent children were horribly burned. The device only cost $2 to include with new stoves. Only after being hit with several multimillion-dollar verdicts did stove manufacturers begin including the anti-tip device.
When the parents of the child killed on June 10 begin to heal from the initial shock, their anger may surface in a lawsuit against both the DC and the manufacturer. It is my opinion that the evidence will likely establish that in order to save a few dollars in manufacturing costs, no child protective devices were installed.
All manufacturers have a non-delegable duty to design safely. Many doctors and certainly most patients (and parents) don't appreciate the inherent risks involved with many pieces of equipment in our offices. "First do no harm" is an imperative both in our treatment applications and in our physical office layout and equipment choices. There are overt as well as covert risks. This tragic loss of a precious 18-month-old child should serve to pique our interest in and diligence for safety. Our thoughts and prayers go out to all those suffering through this.
