kids need devices too

I spent Thursday and Friday attending the first annual  PMDI conference. Impressive? Well, you probably don't know what PMDI is or why it needs a conference. Guess what? I will tell you.

The Pediatric Medical Devices Institute (PMDI) exits to bring inventors together with medical providers, engineers and regulators to enhance the development of medical devices that are useful and necessary for children.

The two days of the conference were spent in the presence of scientists, physicians, entrepreneurs, students, and regulators. We learned about the product life cycle, and heard practical advice about how to conceive an idea, develop and test a potential product, and finally bring it to market. We learned about the struggle to get the government to recognize the problem of pediatric medical devices, and how the American Academy of Pediatrics was instrumental in passing recent  legislation that enabled the funding of consortia, like the PMDI, so that children have a chance to get the same attention as adults in getting the help they need.

You see, the problem is that kids have special issues when it comes to medical devices.

Think about an adult who receives a joint replacement. The joint is fully grown, and the replacement is generally necessary because of damage to the joint or the bone. It is not going to have to grow or develop, and generally, most joint replacements are expected to last from 10-20 years. What about when a child needs an implant of some sort? Well in this case, the story is completely different. We do need to plan for growth and for development, and we need to be concerned about the potential long term effects of placing that foreign material in the child if it might stay for 50-70 years or longer.

Oh, and what size is a child?

 You see, any device for use in children will have to come in numerous different sizes to fit children of different ages and sizes. Often, physicians find themselves having to "tinker" with a commercially available device made for adults to get it to fit or work in a child. In such cases, there has been no official testing of the device in the final form in which it will be inserted or used in the patient. Not a great situation, but for years, it was the best we could do. Recently, however, the FDA was charged with doing something to facilitate increased  development and testing of medical devices for children.

So the PMDI, headquartered in Roanoke, and lead by Dr. Andy Muelenaer, chief of pediatric pulmonology at Carilion Clinic Children's Hospital and Dr. Al Wickes, professor of mechanical engineering at Virginia Tech, has been getting physicians together with engineers and entrepreneurs and manufacturers to try to help solve the problem of a lack of adequate development and testing of products for children.

I had a great time. I met many individuals from many different parts of the country. The conference was held in Winston Salem, and was hosted by the Brenner Children's Hospital and the Childress Institute for Pediatric Trauma located at the children's hospital there. Much research is ongoing as folks come together to try to find solutions for multiple problems that would otherwise be unsolvable. The conference will likely become a yearly occurrence, and I hope that it continues to grow.

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About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

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