Skip to main content
SpringerLink
Log in

Passive Victims of Faulty Machines? Anticipating and Taming ICD Shocks

  • Chapter
  • First Online:
Resilient Cyborgs

Part of the book series: Health, Technology and Society ((HTE))

  • 348 Accesses

Abstract

New technologies produce new sensory experiences. This claim is perhaps revealed most vividly when people with implantable defibrillators endure the shocks these devices give to intervene in life-threatening heart-rhythm disturbances to help prevent a sudden cardiac arrest. Because ICD shocks may happen anywhere, understanding the techno-geography of resilience requires the study of important new spaces such as public places, the home, and online communities. Importantly, defibrillators may give shocks even when they don’t need to. This unwanted agency should not be considered as an intrinsic property of the technology, but it emerges in a techno-legal culture that prioritizes the economic principle of avoiding lawsuits over the quality of care. Reflecting on these findings, I suggest that the vulnerabilities constituted by ICDs introduce a particular kind of ‘existential uncertainty’ (Giddens, Modernity and self-identity: Self and society in the late modern age. Cambridge: Polity Press, 1991). This technology-mediated existential uncertainty involves both constitutive parts of the cyborg: ICDs enhance awareness of both the fragility of bodies and the vulnerability of technologies. Despite these vulnerabilities, people living with ICDs don’t position themselves as passive victims of faulty machines but engage actively in sensing and taming the unwanted agency of their devices to diminish their existential uncertainties.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    News item Medtronic, 29 March 2011. http://www.medicalnewstoday.com. Accessed 15 October 2014.

  2. 2.

    See Chap. 2, endnote 15 for a more detailed description of this source.

  3. 3.

    See Pollock (2008) for similar observations.

  4. 4.

    For example, the educational meeting at the VUMC I observed paid no attention to what patients can expect when their ICDs fire. Hospital websites may include a very brief explanation; for example, that the experiences of shocks varies among patients “from a light thump to a strong kick in the chest” (https://stanfordhealthcare.org/medical-treatments/i/icd.html. Accessed 22 November 2015), but there is no information about inappropriate shocks.

  5. 5.

    The Dutch Society for Heart and Vascular Nurses, for example, distributes a leaflet among patients who have experienced shocks that includes a detailed explanation of the symptoms and experiences of ICD shocks (Anonymous 2014).

  6. 6.

    Oral communication, Heather M. Ross, Arizona State University.

  7. 7.

    See Palmboom and Willems (2014, 281) for a similar observation.

  8. 8.

    Recent articles in cardiology journals also report that inappropriate shocks increase the risk of mortality (Rees et al. 2011, 14), although this risk is downplayed by other researchers affiliated with major ICD manufacturers in the US (Kaiser et al. 2013). Obviously, the stakes are high when it concerns death related to faulty machines. Other damage reported in the scientific literature includes increased risk of heart failure or malign arrhythmia and cellular damage (Toquero et al. 2012).

  9. 9.

    As has been described in Chap. 3, the wires that connect the ICD to the heart are considered as its weakest part. In the past decade, the FDA has issued several recalls of models of major ICD brands because of fractured leads. During these recalls, all affected people were notified of the potential risk of inappropriate shocks, and physicians received instructions for reprogramming or replacing the devices (Frascone et al. 2008).

  10. 10.

    Obviously, ICD manufacturers seem less reluctant to give magnets to patients. They reduce the risk of liability by asking patients to sign off that they understand how to use a magnet and what it does (Bouthillet 2009, 9).

Bibliography

  • Adams, V., Murphy, M., & Clarke, A. (2009). Anticipation: Technoscience, life, affect, temporality. Subjectivity, 28, 246–265.

    Article  Google Scholar 

  • Alaimo, S., & Hekman, S. (2008). Introduction: Emerging models of materiality in feminist theory. In S. Alaimo & S. Hekman (Eds.), Material feminisms (pp. 1–19). Bloomington/Indianapolis: University of Indiana Press.

    Google Scholar 

  • Anonymous. (2014). Nazorg folder shocks. Nederlandse Vereniging voor Hart en Vaat Verpleegkundigen (NVHVV). www.nvhvv.nl/werkgroep/icd-begeleiders/downloads-icd. Accessed 12 Dec 2014.

  • Bateman, S., Gayon, J., Allouche, S., Goffette, J., & Marzano, M. (2015). Inquiring into human enhancement: Interdisciplinary and international perspectives. Houndmills/Basingstoke/Hampshire: Palgrave Macmillan.

    Book  Google Scholar 

  • Bijker, W. E., Hommels, A., & Mesman, J. (2014). Studying vulnerability in technological cultures. In A. Hommels, J. Mesman, & W. E. Bijker (Eds.), Vulnerability in technological cultures: New directions in research and governance (pp. 1–27). Cambridge, MA/London: MIT Press.

    Google Scholar 

  • Blume, S. (2010). The artificial ear: Cochlear implants and the culture of deafness. New Brunswick: Rutgers University Press.

    Google Scholar 

  • Bouthillet, T. (2009). Ineffective or inappropriate ICD shocks – Part III. http://www.ems12lead.com/2009/05/17/ems-topics/patient-management/. Accessed 25 Apr 2015.

  • Braidotti, R. (2006). Affirming the affirmative: On nomadic affectivity. Rhizomes: Cultural Studies in Emerging Knowledge, 11(12), 12–19. http://www.rhizomes.net/issue11/braidotti.html

  • Braunschweig, F., et al. (2010). Management of patients receiving implantable cardiac defibrillator shocks: Recommendations for acute and long-term patient management. EP Eurospace, 12(12), 1673–1690.

    Article  Google Scholar 

  • Camm, A. J., & Nisam, S. (2010). European utilization of the implantable defibrillator: Has 10 years changed the ‘enigma’? EP Eurospace, 12(8), 1063–1069.

    Article  Google Scholar 

  • Coeckelbergh, M. (2013). Human being @ risk: Enhancement, technology, and the evaluation of vulnerability transformations. Dordrecht/New York: Springer.

    Book  Google Scholar 

  • Cooper, K., & Scammell, J. (2013). Professional culture and vulnerability. In V. Heaslip & J. Ryden (Eds.), Understanding vulnerability: A nursing and healthcare approach (pp. 91–111). Boston/Oxford: Wiley-Blackwell.

    Google Scholar 

  • Dalibert, L. (2014). Posthumanism and somatechnologies: Exploring the intimate relations between humans and technologies. PhD thesis, University of Enschede, Enschede.

    Google Scholar 

  • Denis, J., & Pontille, D. (2015). Material ordering and the care of things. Science, Technology and Human Values, 40(3), 338–367.

    Article  Google Scholar 

  • Frascone, R. J., Salzman, J., Griffith, K., & Dunbar, D. (2008). Shock factor: How donut magnets can suspend inappropriate shocks. JEMS: A Journal of Emergency Medical Services, 33(7), 104–107.

    Article  Google Scholar 

  • Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Cambridge: Polity Press.

    Google Scholar 

  • Haraway, D. (1985). Manifesto for cyborgs: Science, technology and socialist feminism in the 1980s. Socialist Review, 80, 65–108.

    Google Scholar 

  • Heaslip, V., & Ryden, J. (Eds.). (2013). Understanding vulnerability: A nursing and healthcare approach. Boston/Oxford: Wiley-Blackwell.

    Google Scholar 

  • Hommels, A., Mesman, J., & Bijker, W. E. (Eds.). (2014). Vulnerability in technological cultures: New directions in research and governance. Cambridge, MA/London: MIT Press.

    Google Scholar 

  • Jacob, S., et al. (2011). Clinical applications of magnets on cardiac rhythm management devices. EP Eurospace, 13(9), 1222–1230.

    Article  Google Scholar 

  • Jain, S. (1999). The prosthetic imagination: Enabling and disabling the prosthetic trope. Science, Technology and Human Values, 24(1), 31–54.

    Article  Google Scholar 

  • Jones, C. A. (2006). The mediated sensorium. In C. A. Jones (Ed.), Sensorium: Embodied experience, technology, and contemporary art (pp. 5–49). Cambridge, MA/London: MIT Press.

    Google Scholar 

  • Kaiser, C., et al. (2013). ICD not to blame for higher CV mortality after shock. Medpage Today. http://www.medpagetoday.com/Cardiology/Arrhythmias/39981. Accessed 25 Apr 2014.

  • Kraft, B. A. (2011). New FDA approved medtronic ICD only shocks heart when necessary. Medical News Today. MediLexicon, Intl. http://www.medicalnewstoday.com.articles/220428. Accessed 28 Apr 2014.

  • Leder, D., & Krucoff, M. W. (2011). Toward a more materialistic medicine: The value of authentic materialism within current and future medical practice. The Journal of Alternative and Complementary Medicine, 17(9), 859–865.

    Article  Google Scholar 

  • Lettow, S. (2011). Somatechnologies: Rethinking the body in philosophy of technology. Techne, 15(2), 110–117.

    Google Scholar 

  • Manyena, S. B. (2006). The concept of resilience revisited. Disasters, 30, 433–450.

    Google Scholar 

  • Mauldin, L. (2014). Precarious plasticity: Neuropolitics, cochlear implants, and the redefinition of deafness. Science, Technology & Human Values, 39(1), 130–154.

    Article  Google Scholar 

  • Mesman, J. (2014). Relocation of vulnerability in neonatal intensive care medicine. In A. Hommels, J. Mesman, & W. E. Bijker (Eds.), Vulnerability in technological cultures: New directions in research and governance (pp. 71–89). Cambridge, MA/London: MIT Press.

    Google Scholar 

  • Nancy, J.-L. (2000). L’Intrus. East Lansing: Michigan State University Press.

    Google Scholar 

  • Nordmann, A. (2007). If and then: A critique of speculative nanoethics. NanoEthics, 1, 31–46.

    Article  Google Scholar 

  • Oudshoorn, N. (2015). Sustaining cyborgs. Sensing and tuning agencies of pacemakers and ICDs. Social Studies of Science, 45(1), 56–76.

    Article  Google Scholar 

  • Palmboom, G., & Willems, D. (2014). Dealing with vulnerability: Balancing prevention and resilience as a method of governance. In A. Hommels, J. Mesman, & W. E. Bijker (Eds.), Vulnerability in technological cultures: New directions in research and governance (pp. 267–285). Cambridge, MA/ London: MIT Press.

    Google Scholar 

  • Pollock, A. (2008). The internal cardiac defibrillator. In S. Turkle (Ed.), The inner history of devices (pp. 98–110). Cambridge, MA: MIT Press.

    Google Scholar 

  • Rees, J. B., et al. (2011). Inappropriate implantable cardioverter-defibrillator shocks incidence, predictors and impact on mortality. Journal of the American College of Cardiology, 57(5), 556–562.

    Article  Google Scholar 

  • Reichertz, J. (2007). Abduction: The logic of discovery of grounded theory. In A. Bryant & K. Charmaz (Eds.), Handbook of grounded theory (pp. 214–228). London: Sage.

    Chapter  Google Scholar 

  • Sandberg, A., & Bostrom, N. (2006). Converging cognitive enhancement. Annals of the New York Academy of Science, 1093, 201–227.

    Article  Google Scholar 

  • Santini, M., Lavalle, C., & Ricci, R. P. (2007). Primary and secondary prevention of sudden cardiac death: Who should get an ICD? Heart, 93(11), 1478–1483.

    Article  Google Scholar 

  • Sobchack, V. (2006). A leg to stand on: On prosthetics, metaphor, and materiality. In M. Smith & J. Morra (Eds.), The prosthetic impulse: From a posthuman presence to a biocultural future (pp. 17–41). Cambridge, MA/London: MIT Press.

    Google Scholar 

  • Star, S. L. (1991). Power, technology and the phenomenology of conventions: On being allergic to onions. In J. Law (Ed.), A sociology of monsters: Essays on power, technology and domination (pp. 22–56). London/New York: Routledge.

    Google Scholar 

  • Star, S. L., & Strauss, A. (1999). Layers of silence, arenas of voice: The ecology of visible and invisible work. Computer Supported Work, 8, 9–30.

    Article  Google Scholar 

  • Stiles, S. (2014, February 21). Cutting inappropriate ICD shocks: Long arrhythmia-detection time strategy confirmed. Heartwire, p. 5.

    Google Scholar 

  • Toquero, J., et al. (2012). New ways to avoid unnecessary and inappropriate shocks. http://www.intechopen.com/books/cardiac-defibrillation-mechanisms-challenges-and-implications/new-ways-to-avoid-unnecessary-and-inappropriate-shocks. Accessed 25 Apr 2014.

  • Turkle, S. (Ed.). (2008). The inner history of devices. Cambridge, MA: MIT Press.

    Google Scholar 

  • Verbeek, P.-P. (2008). Intentionality: Rethinking the phenomenology of human-technology relations. Phenomenology and the Cognitive Sciences, 7(3), 387–395.

    Article  Google Scholar 

Digital Sources: Posts at the SCA Association Support Community website 2007–2014. Accessed 1 April 2014

  • P1. ‘Inappropriate ICD shocks, 50’. 22 replies between January 21 and April 26, 2012.

    Google Scholar 

  • P2. What to do if ICD goes off. 26 replies between February 27 and March 4, 2014.

    Google Scholar 

  • P3. 45 inappropriate shocks. 15 replies between March 31 and April 6, 2011.

    Google Scholar 

  • P4. ICD firing when not needed. 9 replies between February 12 and 15, 2012.

    Google Scholar 

  • P5. Malfunctioning ICDs and Magnets. 32 replies between May 14 and June 4, 2012.

    Google Scholar 

  • P6. Recover after ICD shock. 13 replies between February 6 and March 13, 2012.

    Google Scholar 

  • P7. Storms. 19 replies between June 27 and October 22, 2012.

    Google Scholar 

  • P8. How many zaps do I get? 11 replies between August 31 and September 15, 2012.

    Google Scholar 

  • P9. Electrical tingling sensation by ICD. 12 replies between October 13 and 17, 2012.

    Google Scholar 

  • P10. Great article relative to dealing with trauma from ICD shocks. 38 replies between February 13 and 16, 2013.

    Google Scholar 

  • P11. Inappropriate firings. 8 replies between February 15 and 17, 2013.

    Google Scholar 

  • P12. Dealing with feelings. 9 replies between February 11 and 15, 2013.

    Google Scholar 

  • P14. Can’t shake the fear of being shocked. 15 replies between October 17 and November 26, 2013.

    Google Scholar 

  • P18. ICD and shocks. 28 replies between April 1 and 4, 2011.

    Google Scholar 

  • P19. What a Shock! 10 replies between February 5 and 14, 2011.

    Google Scholar 

  • P20. Repetitive shocks. 6 replies between September 24 and October 3, 2007.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Science, Technology and Policy Studies, University of Twente, Enschede, The Netherlands

    Nelly Oudshoorn

Authors
  1. Nelly Oudshoorn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nelly Oudshoorn .

Rights and permissions

Reprints and permissions

Copyright information

© 2020 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Oudshoorn, N. (2020). Passive Victims of Faulty Machines? Anticipating and Taming ICD Shocks. In: Resilient Cyborgs. Health, Technology and Society. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-15-2529-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-2529-2_4

  • Published:

  • Publisher Name: Palgrave Macmillan, Singapore

  • Print ISBN: 978-981-15-2528-5

  • Online ISBN: 978-981-15-2529-2

  • eBook Packages: Social SciencesSocial Sciences (R0)

Publish with us

Policies and ethics

Search

Navigation