I have a relative who has distant relative imprisoned in China. That prisoner is gravely ill cardiac. His cardiograms were highly abnormal, but prison officials refuse to send him to hospital. He made a complaint on this subject and right after that, his cardiograms suddenly became normal, though he did not feel any improvement in his heart functioning, but rather quite opposite.
Of course you can falsify a reading in such a case, anyone could do it. The first thing during an ECG is the patients name is typed into the machine, which is printed out on the report. This of course doesn't have to match the patient laying there, that could be any healthy person. You would get a clean ECG from a patient called Z laying on the bed with the name X on the report. How much easier can it get?
Do I understand it correctly that one can connect patient to a machine and then print out something from memory with patient's name on top? Could you name the buttons from the machine which one should watch for to expose the fraud?
There are no buttons to produce a desired ECG using a legitimate recorder. Unless you directly observe the ECG machine while it is recording and no one has tampered with the recorder then the tracing should be exactly what is going on. You don't believe and are concerned about an ECG done in China? If you are not there at the time of the ECG there is no way to determine who the patient is or weather it is legitimate. It could be anyones ECG.
What I'm saying is, there is no authentication between patient and machine, no dna, no fingerprinting, no retina scan etc. I'm not speaking about using memory, simply a different patient. Let me give you another scenario. A Doctor has a patient, and he has an abnormal ECG but the Doctor wants the ECG to look normal (for whatever reason). He tells his nurse he wants to test the ECG machine, and gets her to lay down. He wires her to the machine, but enters the name of the patient with the abnormal heart rhythm. He takes a printout of the Nurses heart with the wrong name on it, which looks normal. Hey presto. One normal ECG printout for the patient with an abnormal heart.
I've gotten copies of ekg's that I requested from my dr that were "normal" without any name or info on it - there's no way of knowing if that was really my EKG :P
another example - was it just a coincidence that I remembered having 3 ekgs done during this one visit because the nurse commented - this can't be right and kept redoing the ekg's; yet when I sent for my records; there's only 1 EKG and it was "normal"...or was the normal one not mine since he was a weight loss dr and didn't want to be caught prescribing amphetamines to a patient like me? this was done just a few short months before my heart stopped.
Q: "Is it possible to tamper with ECG machine in such a way it would produce a normal cardiogram when it is connected to a cardiac patient with quite abnormal heart?"
Assuming the patient's physiology is not altered, the same equipment, and the leads are properly placed would require a hardware change of the EKG functionality. Because the EKG monitoring relates and measures the timing and degree of resistance to electrical impluses that pass through the heart tissues. As an example, it the electrical impulse meets high resistance, that would cause an increase of amplitude (vertical axis) of the associated wave and that could indicate scar tissue from a prior heart attack, and if the time for impluse to pass through the tissue could indicate an increase of wall thickness.
There is a voltage criteria for left ventricle hypertrophy (enlargement) and if the imput voltage to the tissue is attenuated by reducing the resistence (hardware change) that would effect all other segments that are being tested at the same time and would show an abnormality for the other segments being tested. The result would show a false positive for something other than cardiac hypertrophy. It doesn't seem possible to attenuate the voltage criteria for a specific abnormality without effecting and causing an abnormality with the EKG test.
If the timing for the impulse is attenuated to show appropriate time interval for a hypertrophy, that same timing would effect the other metrics of other segments and show an abnormality.
It seems it wouldn't be possible to just change the voltage and timing for as an example LVH, and then correct voltage and timing for other segments included in the test for a normal reading.
Did I understand you correctly that by changing voltage, one can change the printout and make abnormal cardiogram look like normal? Shouldn't cardiogram machine use fixed voltage which could not be changed or should not be changed?
Your response sounds very interesting. Could you give more details as to what the doctor tried to do while making new cardiograms. Did you actually see that particuliar cardiogram printed with words "normal"?
I am sure you pursued the doctor in Court. Did you find out during trial how exactly he falsified your cardiogram?
I don't think Lisa implied that the doctor falsified her EKG's, if I'm wrong I'm sure she'll jump in. These can be affected by incorrect lead placement for the EKG. It is easy to look at an EKG and see a major change or obvious error which requires the tech to correct the placement of the lead. If the lead is not in the right spot it will not record the impulse properly leading to an abnormal finding. I had this happen to me, it was not done to falsify the EKG, just to get it right.
Here's how it's done in my hospital....
As an OUTpatient. You arrive at the reception and are given a ticket to go and have an ECG. On arrival they hand the printout back to you, and you present this back at reception where it's supposed to go into your records folder. I have seen patients leave them in the reception tray when nobody is there, but there is no name on the printout. So this is open to many errors. If two or more patients leave their printouts in a tray, how could you know which printout belongs to which patient.
As an INpatient (in a ward), the ECG is done while you are laying in your bed. The nurse takes the printout and writes your name on it immediately. There is a date/time stamp on the printout, so I can't see any problems here.
The EKG I had done in 2004 had no name or anything on it; I questioned how was I supposed to know it was mine with no identifying factor on it - they could have sent me anyone's EKG.
The EKG in Nov 2008; said Normal except Bradycardia on it and had my name. I remember the nurse had to redo it 3 or 4 times and complained what a difficult patient I was and had to move the leads each time.
In June 2009 I slipped and fell breaking my foot. I went to my primary and he questioned about my heart history. I told him the only problem I knew of was in Nov 08 with the EKG so he wrote it down. In August 2009 I had to have an ablation and my EKG from 2008 was brought up because of an insurance issue and I had to prove the"normal" EKG was mine and that I didn't have a "pre-existing" condition.
I don't know if the leads moving farther out have anything to do with it or not; I just found it weird it took 3 or 4 tries for a "normal" reading.
I thank you all for input, but you are all writing on the wrong subject. I am posing question not about false abnormal cardiograms, I am talking about false NORMAL cardiograms, and I am talking about ability to do deliberately and maliciously. If you have something to say about this subject, I would very interested to read it.
Actually we have been on topic I believe. We have explained the ONLY ways that an ECG can be used in error. To actually deliberately get the machine to print false readings on a patient to look 'normal' if they are NOT normal, you would have to be a very good software engineer, break into the machine and swap out the program chips.
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