As of now, there are no pacemakers for infants or defibrillators made for children. If a child has heart rhythm problems, he or she can only receive a device designed for adults. Since these devices are too large to go in a child’s chest, surgeons often have to implant them in a child’s abdomen. As a child grows, implanted medical devices must often be replaced, leading to multiple corrective surgeries.
While medical device innovation is improving the lives of many adults and teenagers around the world, children may be getting left behind.
“The biggest challenge, by far, is size,” notes Dr. Christopher Carter, a cardiologist and pediatrician at Children’s Hospitals and Clinics in Minnesota. “But there are other issues as they get older: They aren’t going to be able to play contact sports. … Really, it becomes a lifetime of compromise.”
For large medical device company, the small market cap of child-sized medical devices doesn’t justify the expense needed to bring these products to market. Instead, medical device manufacturers focus on products that can reach a larger part of the population.
In remarks shared with the press, Medtronic senior vice president Dr. Steve Oesterle stated that cost was often an issue for these devices. Since it can cost $100 million or more to bring a novel medical device to market, spending this sum of money on a device that benefits very few patients isn’t a viable choice.
In 2010, approximately 1,600 children under age 18 received a defibrillator or pacemaker. In comparison, 56,033 patients between the age of 45 and 64 received one of these devices. For patients between ages 65 to 84, a whopping 155,446 received a pacemaker or defibrillator.
On top of this, children are usually not considered during the development of treatments for movement disorders and pain. During 2010, only 200 children received artificial hips. For knee implants, the same held true: Only 188 children received these devices during 2010.
That said, physicians and child-patient-advocates are working to develop a variety of different technologies that are compatible with children. For example, some companies are developing specialized tracheal tubes that won’t damage an infant’s esophagus. Other companies are developing specialized defibrillators that don’t connect to the heart with wires. Since these devices would be a better fit for children, they would be more durable and efficient.
“The need is for a whole variety of low-tech and higher-tech devices that are optimized for kids,” notes Donald Lombardi, leader of the Pediatric Innovation in Cambridge, MA. “It’s not rocket science to develop these things. But it takes good engineering — and an overall market.”
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