Bankrupt Hospital’s Dilemma — What to Do with a Nuclear-Powered Pacemaker?

  • We don’t know about you, but having some plutonium in our body cavities would certainly get our hearts racing.

Hahnemann University Hospital in Pennsylvania went bankrupt in 2019. By now, its buildings are empty and the medical records have been transferred to elsewhere.

But there’s one piece of Hahnemann’s legacy that still lingers. What should they do about a woman who still has a nuclear-powered pacemaker in her chest cavity?

We didn’t know they made nuclear pacemakers, either. But apparently they were a thing until the end of the ‘80s.

The anonymous woman received her pacemaker, powered by plutonium-238, in 1975 when she was just 23. It functioned until 1995, when she received a more modern, lithium battery-driven device.

However, the doctors left the nuclear one inside her. Removing it would’ve required extensive surgery, which could’ve endangered the woman’s life.

The issue is that, according to Pennsylvania law, the Hahnemann hospital is responsible for disposing of the radioactive device. But it won’t be coming out of the woman until she dies, and the hospital no longer exists.

So… What will they do?

“Doctor, do you need more light?” “It’s fine, I’ll operate in the glow of the pacemaker.”

Radiant Patients

But let’s take a step back here and unpack this story a bit. First of all — nuclear pacemakers? Really?

As we said, they used to be a thing.

The radioactive pacemakers are small, usually square or round thin metal discs, roughly the size of a palm, reported Wall Street Journal. And they do indeed get their power from plutonium.

According to the Nuclear Regulatory Commission, practically none of them have been implanted since the late 1980s. The NRC knows this, because it’s their job to keep track of all nuclear-powered devices.

But despite the fact that doctors stopped using them, some of them are still inside people’s bodies even today. One of them is Laurie DiBari from New Jersey.

She got her own little radioactive helper when she was 25, more than 30 years ago, at Newark Beth Israel Medical Center in New Jersey. Her device, however, is still perfectly operational.

It has to be, because DiBari is still alive. She hasn’t had the nuclear pacemaker replaced because she hasn’t needed to.

“I’ve never had a problem with it, so I’m not going to touch it,” she said.

Doctors check up on DiBari’s pacemaker’s status remotely every three months. She moistens her arms and puts on a bracelet, which pushes data to a landline receiver that further forwards it to the hospital.

But like the device Hahnemann installed, DiBari will eventually have to relinquish her pacemaker.

“They told me when I pass away it has to be returned,” said DiBari.

It makes sense. After all, the government probably doesn’t want the plutonium contained in the pacemakers to start making rounds.

Gee, wonder why they stopped using these things?

Handle with Care… Or Don’t

Now that we know what a nuclear pacemaker is, let’s get back to Hahnemann. The hospital closed its doors, but that didn’t nullify its contract with the State of Pennsylvania.

According to Hahnemann’s pacemaker license, the hospital would be required to maintain regular contact with people to whom it gave a plutonium pacemaker. And when they die, it’s Hahnemann who has to appropriately dispose of the devices.

In reality, however, this isn’t often what happens. Historically, doctors and funeral home operators have handled every which way.

One device, for example, was given to a deceased man’s spouse. The hospital even engraved the man’s name on the pacemaker’s radiation shield.

Smart idea, there.

In some cases, hospitals just aren’t able to get the devices to a disposal agency. In such a last-ditch scenario, the pacemaker is usually buried with its owner.

Although the contain plutonium, the pacemakers are actually quite safe. The radioactive material is well-sealed in a way that it can’t leak out, so burial is generally a fairly smart option.

Besides, the things aren’t that radioactive. In fact, getting one dental X-ray will give you more radiation than wearing a nuclear pacemaker.

But laws are laws, nonetheless, and Hahnemann was stuck liquidating its operations. In September 2021, however, they finally solved their problem.

A bankruptcy court allowed Hahnemann to transfer is pacemaker license, alongside the related disposal duties. From now on, Atlanta-based Perma-Fix Environmental Services will get rid of the radioactive tickers.