Your Health Checkup: Worsening Electrical Blackouts Threaten the Medically Vulnerable

June 6, 2023

Your Health Checkup

Weather-related power outages intensified by climate change and other factors imperil the health and life of patients dependent on AC-powered medical equipment.

Douglas P. Zipes, M.D.

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"Your Health Checkup" is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.

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It happened 66 years ago at 9 a.m. on October 31.

C. Walton Lillehei, M.D., a widely known and respected cardiovascular surgeon, had pioneered surgical correction of congenital heart defects in children at the University of Minnesota hospitals in Minneapolis. Following surgery, some infants suffered heart block that caused life-threatening slow heart rates. A large, cumbersome external pacemaker powered by alternating current (AC) — state-of-the-art technology at the time — kept their hearts beating at a normal rate until a life-sustaining heart rhythm returned.

On that fateful Halloween morning in 1957, the Twin Cities experienced a two-and-a-half-hour blackout. For most people, that was only a transient inconvenience. For one postop baby, though, it spelled death. The hospital had generator backup in its surgical suites and recovery area, but not in patient rooms, and the baby died when its AC-powered pacemaker failed.

The next day, Lillehei asked Earl Bakken to build a better pacemaker. Bakken, co-founder of Medtronic, was an electrical engineer working at the hospital at that time. (Note: In the interest of transparency, I was a consultant to Medtronic from 1975 to 2010; Medtronic created the Medtronic Zipes Chair in Cardiology at Indiana University in 2004.) In his autobiography One Man's Full Life, Bakken wrote, "Back at the garage, I dug out a back issue of Popular Electronics magazine in which I recalled seeing a circuit for an electronic, transistorized metronome. The circuit transmitted clicks…the rate…could be adjusted…I simply modified that circuit and placed it…in a metal box with terminals and switches on the outside." Lillehei used it on a patient the very next day. So, merely four weeks after the baby's death during the blackout, the world had its first wearable, transistorized, battery-powered cardiac pacemaker.

A recent article suggests we’ve come full circle and that weather-related power outages – intensified by changing climate, increasing energy demands, and an aging electrical grid – still threaten the health of patients dependent on AC-powered medical equipment. Climate change-induced high temperatures, hurricanes, flooding, and other natural disasters can cause blackouts that are life-threatening to patients being supported by ventilators, dialysis, oxygen concentrating devices, infusion pumps, and other medical equipment in hospitals, nursing homes, and medical facilities around the globe.

Although there are other causes, these severe weather events are the major drivers of electrical blackouts, occurring in almost two-thirds of disruptions that lasted eight hours or longer, according to the JAMA article. From 2000–2021, storms and severe weather conditions in the U.S. caused 83 percent of large-scale outages (those affecting at least 50,000 customers).

Loss of medical equipment is not the only consequence. Disruption can cause loss of heat and air conditioning, resulting in heat stroke or freezing, loss of refrigeration with food spoilage, loss of recharging for battery operated cars and other devices, and economic losses.

Underprivileged communities experience the longest and most frequent outages. In a report covering 2018 to 2020, electrical outages primarily driven by major events such as hurricanes, wildfires, and snowstorms annually triggered an average of 520 million customer-hours without power, affecting almost three-fourths of the U.S. population. There were 17,484 outages lasting eight hours or longer, a time span certain to cause many deaths in electrically dependent patients, while over 200,000 outages lasted an hour or longer.

What can be done? Patients dependent on electrically powered medical devices should have a backup plan if the electricity fails. Not all can afford a generator, which may be banned in high rise buildings and can be a dangerous source of carbon monoxide poisoning. Communities should provide a central area where people can charge essential electrical equipment during an outage. The U.S. should also modernize ancient electrical grids to handle increased loads, severe weather, and cyber-attacks. Portable battery packs, charged and ready for emergency use, can be a useful backup.

We need to ensure that tragedies like the one that occurred in Minneapolis over 60 years ago are no longer a threat in the modern world.

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