X-Message-Number: 30653
Date: Wed, 26 Mar 2008 23:55:41 -0400
From: 
Subject: CI's 81st Patient Benefited from SA Treatment (Part II)

The Cryonics Institutes 81st Patient
Greatly Benefited from Suspended Animation Treatment
(Part II, continued from Part I)


   The case for the claim that the patient experienced harm rather
than benefit from Suspended Animation is based on the following
lines from the case report written by Suspended Animation:

> "Two minutes later he [the funeral director] exclaimed in  surprise  
> as he made an incision and found blood spurting onto
>  him under pressure from the cannula that was already attached to
>  the ATP on the arterial side. He was heard to ask if the
>  ATP pump was running. The Third Team Member confirmed that  it was.?

   These statements are based on interpretations of case notes
and voice recording, which contradict information in both the
case notes and what the funeral director told me. If I make an
explicit statement of the interpretation that the above lines might
imply, it would be:

   "The ATP was connected to the femoral artery and was creating
high pressure in the patient's blood vessels which resulted
in blood shooting out of the femoral vein at the instant that
the funeral director made his incision."

   For this statement to be true, the ATP would have to have been
switched-on at the very instant that the funeral director made
his cut. If the ATP had been pumping into the arterial side even
five seconds before the funeral director made his incision, the
blood vessels would have burst before he made his incision.
Additionally, blood would have continued spurting until the ATP
was shut-off. But nowhere is there a description of more than
one spurt or of an effort to turn-off the ATP to stop gushing.
In the unlikely event that the ATP had been switched-on at
the instant that the incision was made, and then immediately
switched-off, the pressure relief of the spurt would have
prevented blood vessel damage.

    Many contradictions can be found among the many sources of
evidence for what happened in this case, but little of that
evidence points to vascular damage. The case notes of one
team member states that chest compressions were being given
when the spurt occurred, whereas the team member reportedly
giving the compressions states in his notes that he was not
giving compressions at the time of the incision.

   When I spoke to the funeral director about the case he
provided three especially salient comments:

(1) the spurt was from the femoral vein (not the artery)

(2) the spurt occurred when he was inserting the cannula
     (not when he was making an incision)

(3) the ATP could not have caused the spurt because it was
     not "hooked up" when the spurt occurred

   To choose to believe only the first statement while
rejecting the second and third on the grounds that I spoke
to the funeral director several months after the event is
hard to justify. The fact that there was only one spurt
rather than a continuous surge is hard to reconcile with
the idea that the ATP was "hooked up" and running. Volume
displacement by the insertion of a large cannula into a
vein that had already been cut could explain a spurt.
Possibly even the team member who denied giving chest
compressions at that moment had actually done so.

    It is certainly to be expected that the ATP would run
before it was "hooked up" as standard procedure to remove
bubbles from the circuit before beginning perfusion.

     I am making what seems to me to be the most reasonable
interpretation of contradictory reports given by others
concerning an event I did not witness. During the vitrification
perfusion in Michigan there was no evidence that vascular
damage had been inflicted by Suspended Animation
-- quite the opposite. There was good flow on the left side,
with clear fluid emerging from the left jugular. There was
initially no flow on the right side until a clot was
dislodged that was undoubtedly associated with the
hemorrhagic stroke that the patient suffered on the right
side. A clot of that magnitude due to a stroke would not
be expected to be dislodged by the streptokinase
administered by Suspended Animation. Streptokinase can
surround and dissolve small clots, but could not be
expected to penetrate into a region where clotting is
so great that there is no flow. Without flow the
streptokinase could not even come into contact with
the clot. The fact that the clot would be dislodged by
the vitrification perfusion and not by the washout is
not surprising in light of the high osmolality of
cryoprotectants.

    How could such good vitrification perfusion have been
possible on the left side if blood vessels had been
damaged by excessive pressure at the time of the
wash-out?

    It is harmful to potential patients and
unsubstantiated to claim that Suspended Animation
is likely to cause harm rather than great benefit.
I would not disagree that many things could and
should have been better. I would not have written
the case report that Suspended Animation wrote without
at least attempting to speak to the funeral director.
The failure to send a full team on the grounds that
the patient was not fully funded has reflected
negatively on perceptions of Suspended Animation
deployment.

   I have no doubt that for future patients who are
fully funded that Suspended Animation will send a
full team which includes a paramedic or other medical
professional. Kelly Kingston is completing an EMT
training. Suspended Animation has been having regular
and thorough practice/training sessions in the last
year. Not only did the 81st CI patient receive great
benefit from Suspended Animation, but future patients
can expect to receive even greater benefit.

                -- Ben Best

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