Australian St John Ambulance to replace all defibrillators after paramedics raise safety fears
Ambulances in Western Australia will have all their defibrillators replaced from the start of next year amid mounting concerns from paramedics about the current model in use in 168 of its ambulances. It comes after a media investigation by the International Consortium of Investigative Journalists revealed the current defibrillator in use had a history of safety problems and was being used in ambulances despite being removed from sale 18 months ago. Since the report, paramedics have contacted journalists to raise further concerns about the function of the MRx device and hit back at a response by St John Ambulance that there was a spare defibrillator in each ambulance. Journalists have learned that this "spare" is a basic model similar to those found in shopping centres and workplaces.
One crew member, who did not wish to be identified, said that if they had to switch to that device during an emergency, "they essentially become just advanced first-aiders". "We are unable to read vital information an advanced life support defibrillator provides," he said. "It also reduces the types of patients that can actually be shocked in a cardiac arrest as the defibrillator has very strict basic life support protocols built in."
And while manufacturer Philips has previously said it would continue to service the MRx devices and provide spare parts until 2022, paramedics also question that commitment. "Crews often need to take components from an off-duty ambulance to allow themselves to be operational," one said. "When that other crew comes on shift they are unable to respond to calls until they either take the part from yet another ambulance, or the crew using theirs returns." Paramedics have provided photos to support their statements.
They have also raised concerns St John Ambulance in Western Australian continues to add disclaimers to the ambulance checks paramedics performed at the start of each shift. The local media has obtained a copy of these daily checks, which include at least eight different checks paramedics have to do on the MRx alone.
Checks and disclaimers include "Any pins that have been identified as damaged need to be reported" and "MRx securing belts in good operational order". "Many believe these questions allow them to pass the buck when systems fail," one paramedic said. Paramedics feared the price tag to replace the MRx was stalling long-awaited plans to switch from manual to electric stretchers. WA is still the only state that uses manual stretchers. "Our current stretcher is the single greatest contributor of workplace injury than any other piece of equipment we use."
The whole situation has angered crews who pointed out St John Ambulance, which runs the ambulance services for the WA government, had $17,5 million in retained profits in 2017, including $1,2 million in the bank and more than $11 million in financial assets.
Following inquiries about these issues, St John Ambulance announced it had decided on a replacement for the MRx. A spokesman said the Corpuls 3 would replace the HeartStart MRx model and said it expected it would cost $6–7 million to replace the devices. "St John has completed a robust, rigorous process which included assessing and trialling suitable alternatives to replace the MRx," he said. "A considerable budget realignment had to be accomplished as the MRx wasn't due to be phased out until 2020."
The service maintains the rollout of the new defibrillator would be a staged process that included installation and training and that the products would be rolled out "as soon as practicable". A spokesman said the public could be assured they would continue to have the best care. "All our resuscitation scenes are attended by multiple crews so we have had as many as six devices at these scenes."
However, if a patient went into cardiac arrest en route to hospital, crews would be relying on the MRx and the basic spare. The MRx had more than a 100 safety complaints and had the third-highest rate of complications of any device in the country as well as being linked to more than 22 deaths in Canada.
WA Health Minister Roger Cook said, in a statement, that St John Ambulance, as the service provider, must maintain its own equipment "in a manner consistent with providing the services and achieving the service standards". "The McGowan government expects St John Ambulance to ensure that patient and worker safety is a priority," Cook said. "I have asked St John Ambulance to provide my office with an urgent briefing on the status of the HeartSmart MRx device."
In a statement, a spokesman for Philips said it products had strong reliability records and were "recommended to remain in service". The company voluntarily took the product off the market in mid-2017, citing the age of the technology but not safety concerns. "If the devices are maintained in a manner consistent with their labelling and operated consistent with their instructions for use, the MRx is safe for their intended usage, for both patients and users of the device," a spokesman said.
Source: ABC Net