United States: The patient was a black, African American man of about 60 years of age with his emphysema. An oximeter on the fingertip registered well above the 88 percent blood oxygen saturation level that indicates an emergency risk of organ failure and death.
But his doctor Noha Aboelata thought the patient was sicker than the device indicated. Thus she sent him for a lab test, which confirmed her suspicion he must take oxygen at home.
As reported by CBS News, In December 2020, months later, Aboelata recalled her patient when reading a New England Journal of Medicine article that found that pulse oximeters were three times less likely to detect dangerously low blood oxygen levels in Black patients than white.
The finding came at a time when Black Americans were dying of COVID at high rates, and hospitals around the nation were scrambling to find beds and oxygen to patients who might need it.
“The thing I said afterwards was, ‘Were I missed other patients?’ ” ‘Kids start getting dangerously underweight in four or five years,’ said Aboelata, a family physician and the CEO of Oakland-based Roots Community Health.
“There was so much anger and frustration because we had every reason to believe we could depend on this device, that we had, and it was not working at all for the population we served,” she said as she shared the article with colleagues.
And government attorneys general and U.S. senators have pressed the FDA to address pulse oximetry’s racial bias, which has kept patients from getting their life-saving treatment on time and result in worse health outcomes; more recently, there are questions about hospital AI tools that rely on flood of data from the devices.
Producers and stores that sell oximeters have been sued by Aboelata’s clinic, which is demanding they yank the devices or put safety warnings on labels. A lot of her patients use home oxygen, which only requires accurate readings for the Medicare to cover.
But also getting rid of the devices central to the care for the heart and lung disease, sleep apnea and other conditions, isn’t an option.
Since the 1990s the convenient fingertip clamps have come to stand in for many uses of the arterial blood gas readings and which are the gold standard for determining the oxygen levels but dangerous if not done carefully and the makers of the oximeters will sell around 3 billion USD and of them this year because they are used in the nearly every hospital and the clinic and the long term care facility.
During the pandemic, hundreds of the thousands of Americans bought them for home use.
On of them was Walter Wilson and a 70-year-old businessman in San Jose, California and who has had two kidney transplants since the year 2000. Wilson contracted COVID last December but the delayed visiting a doctor because his home pulse oximetry readings were in the normal range.