St. Jude Medical Pacemakers & ICDs

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TSA and Implants

March 4, 2007

TSA tries to finesse checks of people with implants
By Barbara De Lollis, USA TODAY
Dated 2/7/2005

As the number of people with heart devices and artificial joints and bones grows, so will the number of airline passengers who receive lengthier security exams.

There are no estimates on the number of people with implants passing through checkpoints, but the Transportation Security Administration expects more as the huge baby boomer population ages. The orthopedic implant market, for instance, is already growing at twice the annual rate of five years ago, says Stryker, an orthopedic implant manufacturer. Much of the growth is driven by people ages 50 to 65, who want to ease their pain or return to active lifestyles.

"They’re getting older, and they’re getting new parts in their bodies," says Sandra Cammaroto, who oversees screening procedures for people with disabilities for the TSA. The TSA is trying to improve its screening of passengers with implants.

Implants come in two groups: pacemakers and defibrillators — life-saving devices that regulate heartbeats — and orthopedic implants, such as hips and knees.

Last week, the TSA finished filming an instructional video that teaches screeners how to pat down passengers with newly implanted heart devices without hurting them, Cammaroto says. She received at least two letters from people complaining that screeners hurt them by pressing too hard on their surgical area, she says. The area just below the collarbone can feel sore for weeks after surgery.

"The last thing we want to do in the process is cause this person more pain," Cammaroto says. The video instructs screeners to pat surgical areas lightly and avoid moving clothing, since it won’t reveal anything anyway, she says.

Doctors and surgeons say patients often will ask what they can expect at airport checkpoints.

"They just want to know if they’re going to ring the alarm," says Earnest "Chappie" Conrad, an orthopedic surgeon in Seattle.

Arriving at a checkpoint with an implant or device means a good chance of spending more time there than a companion. Secondary screenings can take three to five minutes, vs. less than a minute for an uneventful step through the gate, according to the TSA. Searches for those with medical conditions or disabilities often take even longer, Cammaroto says.

Frequent flier and Conrad patient Jim Shepherd, 49, used to breeze through the gate when flying for his job each week. An engineer for woodworking machinery manufacturer Weinig Group, Shepherd memorized the TSA do’s and don’ts: no shoes, gum wrappers, coins or metal belt buckles.

But his life changed last year when he broke his right arm, revealing cancer. Conrad did the surgery and gave Shepherd a titanium replacement bone. Shepherd says he now trips the alarm and undergoes secondary searches on most flights. "If you’ve got an implant big enough to set off the alarms, you’re probably used to adversity, so live with it," he says.

Some patients worry about the unwanted public attention. "You’re singled out in the crowd," says Blake Hunter, 36, a Canadian who founded the Pacemaker Club. "Most people would rather walk normally through the checkpoint."

People with devices often visit his club’s Web site,, to complain about airport searches, he says. "For people who are new to it, I can see it being quite a stressful event."

Checkpoint experiences can vary depending on implant type, TSA staffing levels, the individual screener and a traveler’s readiness. The TSA recommends that patients bring medical cards that identify their implant, although many patients say that the card makes no difference in their exam.

What to expect if you have:

•Pacemakers or defibrillators. Many people with these devices follow doctor’s or manufacturer’s advice: Avoid metal detectors and hand wands and request a hand search. Some doctors say there’s a remote risk that electromagnetic interference can cause a device to malfunction. A pacemaker could reset or a defibrillator could deliver a painful shock. The TSA knows of no such incident.

Jeffrey Olgin, chief of cardiac electrophysiology at the University of California-San Francisco who specializes in abnormal heart rhythms, tells patients that walking through a metal detector normally should cause no problem. "They don’t want to stop in the middle of (the detector) or lean up against it."

Manufacturer Guidant recommends a hand search but says that if a screener uses a handheld wand, ask him or her not to hold it near the device "any longer than is absolutely necessary."

Screeners are trained to be discreet when a passenger tells them that they have a device.

San Francisco stockbroker Paul Ruby, 66, who received a pacemaker almost four years ago, doesn’t mind saying "pacemaker" when it’s his turn. He requests a pat-down and considers the extra hassle a small trade-off.

"The gadget’s wonderful," Ruby says. "You’ve got to live with them. You wouldn’t live without them."

•Hips, knees and other metal implants. Metal implants often trip alarms, making further examination mandatory. The TSA won’t let patients go, even if they have a medical card identifying an implant. "When they alarm, we will have to resolve that alarm just like all other alarms," Cammaroto says.

People with hips, knees or rods in their backs have different experiences.

Bob Henderson, a law firm consultant based in Jackson Hole, Wyo., says that he triggers alarms only 10% of the time despite metal rods and screws in his back, knee and hand. But Kathy Kearns, 55, a schoolteacher who lives in Bakersfield, Calif., says her titanium knee sounds alarms in most airports.

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