Fidelity of ECT Devices : An alert to Clinicians

In India, the fidelity of electro convulsive therapy (ECT) devices is not regulated by any statutory body; as a result, it is conceivable that marketed devices may not meet the highest standards of quality. We therefore subjected 4 ECT devices, obtained from 4 different manufacturers, to quality testing in a biomedical engineering laboratory. The newest device was one month old, and the oldest device was 13 years old. Two devices were in regular use, and two were standby instruments, We found that not a single device was working in accordance with the manufacturer's specifications. One device was not working at all; one was delivering varying intensity, uninterrupted current rather than constant current brief pulses (whatever the settings applied); one was delivering blocks of pulses the description of which was enormously at variance with the instrument settings; and one device, the best of the four, was delivering brief-pulses with small errors in each setting that cumulated to an error of 49.3% at a common charge setting for clinical ECT. We conclude that clinicians must test the fidelity of their ECT devices at the time of purchase as well as at frequent intervals thereafter. Finally, the fidelity of ECT devices should be regulated by an appropriate statutory body in India.