1. Use The equipment used in the administration of electroconvulsive therapy (ECT) include ECT devices (spECTrum 5000Q), the monitoring of physiological response to ECT (Hewlett Packard Merlin; ECG, pulse oximetry, end tidal CO2), the delivery of anesthesia (anesthesia delivery equipment, suction machine), and equipment available in case of medical emergency (defibrillator, 12-lead ECG). All equipment other than that used in emergencies were in routine use at ECT during 2,000. There were no medical emergencies requiring the use of additional equipment. Several hundred ECT treatments were performed during 2000. All equipment used is selected by appropriate staff based on its safe and effective performance.

2. Y2K In the fall of 1999, all equipment was tested for susceptibility to Y2K problems.  In particular, equipment using date functions (ECT device, Merlin physiological monitor) were stated to be Y2K complaint by the manufacturers and explicitly tested, by advancing the date to 1/1/00.  No problems arose.

3. Maintenance The morning of each treatment day, the working order of the equipment used in the delivery of ECT is checked by the ECT Nurse, ECT psychiatrist, and anesthesiologist prior to treatment delivery. Maintenance schedules and activities follow those recommended by the manufacturer and those detailed in the Policy and Procedures Manual for the conduct of ECT at NYSPI. In particular, ECT devices are subjected to extensive calibration and function testing now on an annual basis, as recommended by the American Psychiatric Association Task Force on ECT (2001), or undergo exhaustive calibration and function testing in the case of malfunction.
The MECTA spECTrum 5000Q was the only ECT device used by the Service during 2000 (2 separate devices).  A Somatics Series IV ECT device has been donated to the Service, but will not be put into use until custom calibration sequences and function tests are developed, along with a testing manual.  Maintenance of the anesthesia delivery system is the responsibility of the Department of Anesthesiology, Presbyterian Hospital. This equipment is subject to a regular maintenance program.

4. Staff Training A new technician was hired in 2000 to assist in the maintenance of ECT-related equipment and in the calibration and function testing of the ECT devices. This individual, Mr. Benjamin Ginsberg, received extensive training in these functions from Drs. Bruce Luber (immediate supervisor) and Dr. Sackeim (Department Chief). All staff are determined to be competent in the use of equipment prior to first actual use, and there is regular and close supervision.

4. Adverse Events There were no adverse events in 2000 involving the use or testing of ECT-related equipment.

I hope this information is helpful.

January 16, 2001

Original report transmitted to EOCC Chairman via email

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 
Harold A. Sackeim, Ph.D.
Chief, Department of Biological Psychiatry
New York State Psychiatric Institute

Professor, Departments of Psychiatry and Radiology
College of Physicians and Surgeons of Columbia University

212 543-5855 phone
212 543-5854 fax
has1@columbia.edu

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