A brief history of medical instrumentation

A partial history of technology in medicine

The following is a selective timeline view of the use of technology in medicine, including the development of medical error monitoring. The development of technology usually far outpaces the management of same: the carriage in front of the horse syndrome. Note below, the beginnings of medical error assessment.

1733 Stephen Hales is the first to measure blood pressure using invasive techniques.
1752 Pennsylvania Hospital.
1771 New York Hospital.
1805 Korotkoff used the stethoscope to monitor the pulse.
1816 Rene Laennec invents the stethoscope. 1876 – Von Bosch invented an instrument which could measure blood pressure in humans noninvasively (sphygmomanometer).
1821 – American physician, Enoch Hale, introduced castor-oil, intravenously, into his bloodstream.
1845 – American dentist, Horace Wells, administered nitrous oxide to induce an artificial sleep during tooth extraction.
1845 – The first hollow needle and syringe were invented by an Irish physician, Francis Rynd, for subcutaneous injections of morphine to nerves in the treatment of neuralgia.

– The ophthalmoscope was invented in by a German professor of physiology, Hermann von Helmholtz.

1860 Florence Nightingale establishes Training School for Nurses.
1883 – Swedish engineer, Carl Gustav Patrik de Laval invented the centrifuge for separating cream but was applied to medicine in the early 20th century by his fellow countryman, Theodor Svedberg, a chemist.
1895 – X-rays were discovered by a German physicist, Wilhelm Konrad Roentgen, while he was studying the energy produced by the cathode-ray tube.
1901 Willem Einthoven develops the electrocardiograph.
1906 – President Roosevelt signed the Food and Drugs Act, known simply as the Wiley Act, which the Bureau of Chemistry was charged to administer. It prohibited the interstate transport of unlawful food and drugs.
1917 The American College of Surgeons develops the first Minimum Standard for Hospitals in the U.S..
1925 – 7000 hospitals in the U.S.. According to the American Hospital Association, as of 2001, there were 10,709 hospital facilities of all types.
1929 – German physician, Werner Forssmann, threaded a urologic catheter through a vein in his arm and into his heart. This procedure was done clandestinely since he did not have official approval for such a daring experiment. Dr. Forssmann took a chest x­ray, which demonstrated the catheter’s position, and he published the procedure as a brief report.
1931 Knoll and Ruska build the electron microscope.
1938 Nuffield builds an ‘iron lung’ at Morris Motors.
1941 André Cournand and Dickinson Richardsused the cardiac catheter as a diagnostic tool to measure right-heart pressures and cardiac output at Bellevue Hospital, New York. Awarded Nobel Prize in Medicine in 1956.
1947 William Shockley, John Bardeen, and Walter Brattain invented the transistor at Bell Labs.
1950 – Started as Instrument Laboratories, Electronics for Medicine was the first manufacturer of ICU and CCU patient monitors–allowing for the first time, critical diagnosis and detection without personal attention.
1953 Brownell and Sweet build brain (PET) scanner.
1954 Edler and Hertz reported the continuous recording of movements of the heart walls and later described the use of the ultrasonic cardiogram (echocardiography) in treating mitral valve diseases.
1960 Theodore Maiman constructs first working laser.
1961 – President John F. Kennedy expands U.S. Space Program.
1961 – Desmond Julian presented the 1st description of the CCU to the British Thoracic Society. The next year, Gaston Bauer and Malcolm White started a CCU in a Sydney hospital. Around the same time, K.W.G. Brown in Toronto, Hughes Day in Kansas, and Lawrence Meltzer in Philadelphia began monitoring patients in CCUs.
1964 – Coronary artery bypass surgery via the internal mammary artery was pioneered by Michael E de Bakey in America and Vasilii Kolesov in Russia.
1971 – The first (CT) brain scanner was installed at the Atkinson Morley Hospital, London, and Hounsfield and Cormack shared a Nobel Prize in 1979.
1971 Raymond Damadian’s scan of a mouse tumor, reproduced on the cover of Science magazine, was the first MRI of a live subject.
1976 – FDA Medical Device Amendments “provided several mechanisms to achieve this goal including classification of medical devices, device listing, establishment registration, adherence to Good Manufacturing Practices (GMP), and extensive control over market introduced of medical devices.”
1979 – A personal account–reporting a medical error due to equipment failure.
1995 – Joint Commission on Accreditation of Health Care Organizations begins tracking “Sentinel Events.”
2000 – National Academy of Sciences, “To Err Is Human: Building a Safer Health System” is published. “This book sets forth a national agenda–with state and local implications–for reducing medical errors and improving patient safety through the design of a safer health system.”