Re: Molded to patient model???
John Benson
Description
Collection
Title:
Re: Molded to patient model???
Creator:
John Benson
Date:
9/15/1998
Text:
I have seen many hand cast and modified sockets that produced outcomes as poor the
one attributed to this CAD CAM socket.
It is not the method of gathering data that interprets the value of our work but
the skill with which that gathered data is applied to the production, alignment
and successful fitting of the product. In our profession art is inseparable from
science; and the conscientious application of these is what distinguishes a
valuable service from one that is fraudulent.
<Email Address Redacted> wrote:
> I was asked last week to consult with an elderly diabetic AKA at the Ohio
> State University prosthetic clinic. This patient had a new but extremely
> poorly fitted prosthesis which she was unable to wear. It was fabricated for
> her by a prosthetist who came out and took some measurements and delivered
> the prosthesis a couple of days later. I explained to her that a cast of her
> residual limb would be required for a socket replacement and she again told me
> that the other prosthetist only took measurements.
> The socket (an attempt at ischial containment) was so poorly designed that the
> I.T. was well above the posterior brim and the socket was internally rotated
> to such an extent that the adductor longus was 2 cm. from it's channel.
> My question is does this constitute fraud using HCFA guidelines? The
> descriptors clearly state molded from patient model. Does CAD by the
> numbers meet these guidelines?
> I know is is becoming common practice for many facilities to order sockets
> (and orthoses) which are measurement based and are not created from either a
> custom impression or virtual casting system. In reality, I have seen some of
> them fit rather well, however, It seems to me that this is not the issue
> What is the feeling of the group? Does a measurement based prosthesis or
> orthosis meet the molded from patient model guidelines? Do we need new L
> Codes for measurement based systems?
> I look forward to your response.
> Ron Kidd, CPO
> American Orthotic & Prosthetic Lab., Inc.
> Columbus, Ohio
one attributed to this CAD CAM socket.
It is not the method of gathering data that interprets the value of our work but
the skill with which that gathered data is applied to the production, alignment
and successful fitting of the product. In our profession art is inseparable from
science; and the conscientious application of these is what distinguishes a
valuable service from one that is fraudulent.
<Email Address Redacted> wrote:
> I was asked last week to consult with an elderly diabetic AKA at the Ohio
> State University prosthetic clinic. This patient had a new but extremely
> poorly fitted prosthesis which she was unable to wear. It was fabricated for
> her by a prosthetist who came out and took some measurements and delivered
> the prosthesis a couple of days later. I explained to her that a cast of her
> residual limb would be required for a socket replacement and she again told me
> that the other prosthetist only took measurements.
> The socket (an attempt at ischial containment) was so poorly designed that the
> I.T. was well above the posterior brim and the socket was internally rotated
> to such an extent that the adductor longus was 2 cm. from it's channel.
> My question is does this constitute fraud using HCFA guidelines? The
> descriptors clearly state molded from patient model. Does CAD by the
> numbers meet these guidelines?
> I know is is becoming common practice for many facilities to order sockets
> (and orthoses) which are measurement based and are not created from either a
> custom impression or virtual casting system. In reality, I have seen some of
> them fit rather well, however, It seems to me that this is not the issue
> What is the feeling of the group? Does a measurement based prosthesis or
> orthosis meet the molded from patient model guidelines? Do we need new L
> Codes for measurement based systems?
> I look forward to your response.
> Ron Kidd, CPO
> American Orthotic & Prosthetic Lab., Inc.
> Columbus, Ohio
Citation
John Benson, “Re: Molded to patient model???,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/210817.
