Re: Keepsake 3D

From: art fougner, md (evsono@pipeline.com)
Sun May 16 11:40:13 2004


SKELOS INTRODUCES LEGISLATION BANNING "KEEPSAKE" ULTRASOUNDS

Bill Follows Opening of First Prenatal Photography Studio in New York

Thursday, May 6, 2004

New York State Senate Deputy Majority Leader Dean G. Skelos (R-C, Rockville Centre) today announced the introduction of legislation prohibiting non-medical ultrasounds used solely for entertainment purposes. Although private prenatal "photography" shops have appeared in shopping malls around the country, New York’s first private ultrasound studio recently appeared in Manhattan.

"The FDA has concluded that these unregulated ultrasounds ‘put a mother and her unborn baby at risk,’" said Senator Skelos. "This is high-powered, equipment and every step must be taken to ensure that mothers and their unborn children are protected from unforeseen harm. This legislation will guarantee that ultrasounds are limited to medically-necessary treatments and administered by trained professionals."

Generally, ultrasound equipment produces a high-frequency sound wave to generate diagnostic images of developing babies. Since the 1960s, ultrasounds have offered an invaluable tool for diagnosing pregnancy and any potential abnormalities and determining the proper course of medical care. When correctly administered by trained professionals, such as sonographers, radiologists and obstetricians, low-power ultrasounds are generally considered a safe means of gaining information about a pregnancy.

Utilizing state-of-the-art 4D technology, the most advanced ultrasound machines can provide much clearer pictures than older equipment—including facial contours, muscle definition and hair—and combine these images into short videos. However, this modern ultrasound equipment is capable of producing intensities eight times higher than the machines commonly used by medical professionals.

As introduced by Senator Skelos, S.6776-A would restrict the administration of any ultrasound on a pregnant woman to those performed pursuant to an order or referral by a licensed physician, nurse practitioner or licensed midwife. In addition, the legislation prohibits the dispensation of ultrasounds for entertainment purposes or those not warranted by the condition of the patient. If enacted, a violation of this new law would be a Class A misdemeanor, with a maximum prison sentence of one year.

"Ultrasounds on pregnant women are used for medical purposes, to obtain information about the pregnancy," said William B. Rosenblatt, M.D., President Medical Society of the State of New York. "The practice of performing ultrasounds on pregnant women without a medical reason and an order from a physician, nurse practitioner or nurse midwife should not be done. The Medical Society of the State of New York supports this bill as an effort to end this unnecessary and extremely costly practice."

A U.S. Food and Drug Administration (FDA) investigation concluded that non-medical, entertainment ultrasounds are often performed without a doctor’s supervision. Moreover, the FDA warned that "[u]ltrasound is a form of energy, and even at low levels, laboratory studies have shown it can produce physical effects in tissue, such as jarring vibrations and a rise in temperature." As such, the FDA concluded that "prenatal ultrasounds can’t be considered completely innocuous." Further, the FDA noted that many of these companies use the ultrasound machines at higher energy levels and for as long as one hour to secure clear pictures and/or videos for their customers.

The FDA first became aware of the "keepsake" ultrasound industry in 1994 (Texas) and informed these providers that anyone promoting, selling or leasing ultrasound equipment for the making of "keepsake" fetal videos could be breaking the law. Although the ultrasound devices are regulated by the FDA and, as such, the FDA can take action against the "keepsake" video industry for using a prescription device without a prescription from a medical professional, the qualifications and behavior of technicians and physicians is regulated by the states.

"In the new Manhattan studio’s first month, more than 40 mothers-to-be have paid $300 each for a procedure that could have dire consequences," said Senator Skelos. "Even General Electric, the leading seller of 4D ultrasound machines, has joined the Medical Society, the American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists and the New York State Radiological Society to express its opposition to the use this equipment for nonmedical purposes. Until all the risks associated with this new technology are completely known, we must make every effort to err on the side of public safety."

http://www.senatordeanskelos.org/press_archive_story.asp?id=8664

art

At Fri, 14 May 2004, art fougner, md wrote: >
>Terry
>
>In the US as you well know, every afternoon you can channel surf and
>find a court show. Americans are afflicted with lawsuit mania. If
>something bad happens, even if they don't feel that way, someone in the
>family or a neighbor encourages them to sue. And that is how those
>cases will go to litigation. Not necessarily because we agree with the
>principle but because that's the American way. Just as a woman can
>place a cup of hot coffee between her thighs and get burned and then sue
>McDonald's, just as folks who could read a pack of cigarettes but smoke
>anyway could sue, just as folks who get fat and bloated by subjecting
>themselves to supersized whoopers could sue, that is how folks will sue
>the Fetal Fotomats. And the disclaimer about we don't do medical will
>hold up about as well as the "Not Responsible" disclaimer in the parking
>lot will hold up. It will sooner or later be up to a jury to decide.
>And once that happens, the game is afoot.
>
>Terry, I agree with you in principle but there is a dearth of FDA
>inspectors for Ultrasound labs so the Fotomats can, as Monty Python
>exclaimed, "Fart in their general direction." Caveat emptor will prevail
>here - for better or for worse. Therefore, it is up to us to provide
>for our patients our best efforts and let the chips fall where they may.
>We can only hope that Karma prevails. And it usually does. Again, the
>pity is that the same folks who unhesitatingly fork over a wad of cash
>money for their Foto-op are the same folks who fight tooth and nail to
>forgo the meager copay at your lab when you participate with their
>insurance plan. To quote Yacov Smirnoff - " America - What a Country!"
>
>At Fri, 14 May 2004, DuBose, Terry wrote:
>>
>>Art, will an uneducated, unskilled, & unwashed person who doesn't have a
>>clue as to the difference between a uterine synechia vs. an amniotic
>>band, and won't care because it isn't a "medical" exam, be held to the
>>same standard as a registered sonographer or MD? This, I fear is the
>>fallacy in the legal solution to this problem.
>>
>>Given enough time the "unwashed" will develop the psychomotor skills to
>>acquire pretty pictures of faces, but won't have a clue about VSDs, etc.
>>and won't care. In time the public will come to view these folks as
>>the real face of sonography because that is the "fun" part; and the real
>>sonographers will become the gnomes in the bowels of the hospital,
>>giving out the bad news. We will be held to a higher standard because
>>of our experience, while the uneducated will be able to throw up their
>>hands and exclaim "gastroschisis, what is that? Who knew?"
>>
>>Unless the FDA actually enforces their own regulations on non-medical
>>uses, then the legal system will not treat all by the same standards.
>>The FDA needs to either enforce their own regs or release us all to
>>compete in the "free market", and then we can beat the unwashed at their
>>own game. I include registered sonographers in this issue of the "free
>>market".
>>
>>"Just my opinion, I could be wrong."
>>
>>Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>>
>>Assistant Professor & Director
>>Diagnostic Medical Sonography Program
>>University of Arkansas for Medical Sciences, CHRP
>>4301 West Markham St. Mail Slot #563
>>Little Rock, Arkansas, 72205 USA
>>501-686-6510
>>DuBoseTerryJ@UAMS.edu
>>http://www.io.com/~dubose/
>>http://www.uams.edu/chrp/dms/default.asp
>>http://www.obgyn.net/us/panel/panel.htm
>>---------------------------------------------------------------
>>
>>---------------------------------------------------------------
>>---------------------------------------------------------------
>>---------------------------------------------------------------
>>---------------------------------------------------------------
>>---------------------------------------------------------------
>>---------------------------------------------------------------
>>-----Original Message-----
>>---------------------------------------------------------------
>>From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
>>---------------------------------------------------------------
>>---------------------------------------------------------------
>>art fougner, md
>>---------------------------------------------------------------
>>Sent: Friday, May 14, 2004 11:04 AM
>>---------------------------------------------------------------
>>To: Multiple recipients of list ULTRASOUND
>>---------------------------------------------------------------
>>Subject: Re: Keepsake 3D
>>
>>i'm equally sure that there are anomalies missed at non-3D sites as
>>well. the glass house has many rooms. yogi had it right - "it ain't
>>over til it's over."
>>
>>however, the missed anomalies will come back to haunt the Keepsake
>>Centers as it already has haunted us all - if you perform an ultrasound
>>for whatever reason, my feeling is that you should and will be held to
>>the published standards.
>>
>>art
>>
>>At Thu, 13 May 2004, David Nyberg wrote:
>>>
>>>Larry
>>>
>>>I know of a case here in Phoenix where a reputable group missed a cleft
>>lip/palate that was then picked up by a commericial 3D site 2 weeks
>>later. I know that's not what you're looking for, but it could work
>>both ways. Of course a 3D site may be more likely to pick up facial
>>abnormalities since that's where their focus is. I'm sure there are
>>plenty of nonfacial abnormalities missed by 3D sites.
>>>
>>>Dave
>>>
>>>On Thu, 13 May 2004 LDPLATT@aol.com wrote:
>>>
>>>> Does anyone have or kno a patientw of had a keepsake video done in
>>one of the
>>>> "commercial"centers who subsequently had a major fetal abnormality
>>??? If
>>>> so would they be willing to talk about the experience? Thanks
>>>>
>>>> Larry Platt ldplatt@aol.com
>>>>
>>>--
>>>David Nyberg, MD
>>>10401 E McDowell Mtn Ranch Rd
>>>#2-372
>>>Scottsdale, AZ 85255
>>>ph cell 480-797-0993
>>>fax 480-512-8737
>>>work 480-512-3850
>>>
>>--
>>art fougner, md
>>ich bin ein New Yorker
>>
>--
>art fougner, md
>ich bin ein New Yorker
>

--
art fougner, md
ich bin ein New Yorker



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