UPMC criticized on live pigs for trauma training

October 7, 2010 12:00 am

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A complaint filed Wednesday with the U.S. Agricultural Department against UPMC says the hospital system's continued use of live pigs in its trauma training program violates the federal Animal Welfare Act because there are non-animal alternatives available.

According to the complaint filed by the Physicians Committee for Responsible Medicine, using live animals in trauma training makes UPMC one of only 11 medical facilities left in North America -- out of 225 that offer the training -- that still does so, and the only one of 12 such hospitals in Pennsylvania.

"We believe that this animal use is a violation of the Animal Welfare Act because there are non-animal training methods available that are educationally equivalent or superior," the complaint sent to the USDA's Animal and Plant Health Services said, in part.

USDA spokesman David Sacks said because of the complaint an inspector will be sent to check out UPMC's program "in the near future" and make sure it is complying with the law, but it probably won't mean shutting the program down.

UPMC is allowed by law to use animals in the training, but it must follow procedures that demonstrate it is properly caring for the animals and that it has looked at alternatives, he said.

"Our focus is on the welfare of the animals we regulate. It's not on telling the registrants what kind of research to conduct or how they conduct their experiments," he said. "We're not taking an ideological stand on anything."

In a statement UPMC said only: "Any educational use of animals at Pitt or UPMC complies with all applicable laws and voluntary accreditation standards."

Through a spokeswoman it refused to answer any specific questions.

John Pippin, the Physicians Committee's senior medical and research adviser, said the consensus in the medical community now is that modern mannequin simulators or the use of human cadavers are better for training than using animals anyway.

"We're well past the point where using an animal to do that is preferable to the overwhelming majority of hospitals," said Dr. Pippin, a Dallas cardiologist. "And since 95 percent of hospitals aren't using [live animals], UPMC can't say there aren't alternatives."

UPMC holds six to eight of the trauma training courses a year at UPMC Presbyterian Hospital, and Dr. Pippin said a typical program involves about 16 physicians working on one pig for every four doctors. The pigs are euthanized after the training is completed.

Formed in 1982 and based in Washington, D.C., the Physicians Committee for Responsible Medicine is known for grabbing attention and raising the hackles of those it has attacked on a variety of issues where the welfare of animals intersects with medical-related topics.

An advocate of vegetarianism, it has long pushed for the end of the use of animals not only in trauma training but in medical school training and research -- though its complaint against UPMC focuses only on the trauma training.

Thirty years ago, nearly all American hospitals used live animals as part of what is formally known as advanced trauma life support programs, typically using dogs and pigs but sometimes goats or sheep.

The training, usually given either for new surgeons or surgeons renewing their certification every four years, typically involves performing various medical procedures including cutting into the chest, neck and abdomen.

Supporters of the practice argue it is better to use live, though anesthetized, animals because no simulator or human cadaver can accurately replace the experience of working with a live patient.

"There's just no substitute for living, bleeding tissue," said Ronald Gross, chief of the division of trauma and emergency surgical services for Baystate Medical Center in Springfield, Mass., which still uses pigs for its trauma training.

The Physicians Committee filed a similar complaint with USDA last year against Baystate, but the hospital passed a federal inspection, and it continues the practice, Dr. Gross said.

Dr. Pippin and others say that it has been the improved technology of mannequins over the last 20 years that has really driven down the use of live animals, in addition to a more compassionate view of animals generally.

The American College of Surgeons has recommended the use of two mannequin types as live animal alternatives in such advanced trauma training programs: Synman, made by a Swiss company, and TraumaMan by a Seattle company.

"As good as Synman and others are, it's still not the same" as working with live tissue, said Dr. Gross, who has tried out the mannequins.

Allegheny General Hospital, however, stopped using live animals four years ago and began using TraumaMan, AGH spokesman Dan Laurent said, "based on the experience of other trauma centers around the country using the mannequins."

That's in addition to the fact, Mr. Laurent said, that "when there's an acceptable alternative to using animals, that's what we prefer to do."

Stephen Smith, who was recently named AGH's chief of acute care and surgery, said hospitals have moved away from the use of live animals for basic reasons.

"No. 1, I don't think any of us felt that great about requiring the use of animals," Dr. Smith said. "But, the simulator devices now in use, in my opinion are better than animals because they're based on the human anatomy."

Sean D. Hamill: shamill@post-gazette.com or 412-263-2579.
First Published October 7, 2010 12:00 am

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