A recent print ad for the da Vinci surgical robot system, which is manufactured and marketed by Intuitive Surgical, has created significant controversy and opened questions about a possible conflict of interest.
The University of Illinois allowed its name and images of some of its doctors to be used in a print ad that is Intuitive Surgical-backed, according to MassDevice.com. The ad ran in The New York Times Magazine and included the statement, “We believe in da Vinci surgery because our patients benefit.” The bottom of the page bore a small print message that indicated that the ad’s copyright is owned by Intuitive Surgical and that some of the pictured physicians received payments from Intuitive.
“The University has allowed its reputation to be used in a nationally distributed advertisement produced and owned by a private party, in benefit to that party’s commercial objectives,” wrote former Beth Israel Deaconess hospital administrator Paul Levy in a blog post entitled “Time to fire somebody,” MassDevice.com reported. Levy, who cited Beth Israel’s code of conduct, wrote that the University’s participation in the marketing, “is not consistent with ‘exercising custodial responsibility for University property and resources.'” Levy concluded with, “So, who should be fired for these violations? Simple: I would choose the highest-rank administrator and clinician who gave permission for this advertisement to be published,” according to MassDevice.com.
In recent years, the financial relationships that occur between industry and health care have drawn much controversy. Critics say that these relationships may create conflicts of interest that disproportionately impact research findings, as well as prescribing practices. The relationships may also lead to situations in which patients are no longer the primary focus in health care decisions.
For instance, an interview recently conducted by Bloomberg.com, involved a 45-year-old woman who underwent a hysterectomy that involved use of the da Vinci robot. She alleged that she was not told that the da Vinci was involved in a number of associated injuries with hysterectomy procedures and is suing Intuitive and her physician. She expressed concern for her job and also alleges that she suffered serious rectal burns, is on long-term disability, and must undergo a third corrective surgery. “If I had known there were other people who had injuries, I would never have done this surgery…. Whatever they have in place is not working,” she told Bloomberg.com.
The American College of Obstetricians and Gynecologists has also announced that, “Robotic surgery is not the only or the best minimally invasive approach to hysterectomy … nor is it the most cost-effective,” according to a The Wall Street Journal report.
Meanwhile, another report reveals that adverse reactions tied to da Vinci surgical robot procedures may be higher than believed. Under-reporting of patient injuries may actually be providing an unrealistically positive perspective concerning the surgical technology to prospective robot surgery patients.
Some patients have said that their injuries, which are significant in some cases, do not appear on the U.S. Food and Drug Administration’s (FDA) database. A Bloomberg.com review of da Vinci surgery reports revealed that dozens of injuries have been unreported for years, noting that details of patient incidences cited in patient interviews and legal documents were missing, as well. The Inspector General’s report revealed that reported incidence numbers are low and dropping—a 37 percent decline was seen from 2003 to 2007—; however, this is not indicative of an incidence decline, but rather, reveals a drop in the reporting of such incidents. The low rate “raises concerns about potential under-reporting of adverse events,” the Inspector General wrote. David Challoner, vice president emeritus for health affairs at the University of Florida pointed out that, “Every link in the chain has a reason not to report,” Bloomberg.com reported.