Tomisa Starr, a 61-year-old with multiple chronic health problems, including heart failure, experienced skepticism from doctors regarding false pulse oximeter readings in Black Americans. Despite research showing that the devices may not work as well on darker skin, doctors ignored her concerns. The FDA issued draft guidance to address flawed pulse oximeter readings on darker skin tones in 2021, following decades of known issues. Companies have historically not included a significant number of dark-skinned people in studies, leading to potential racial disparities in pulse oximetry.
Pulse oximeters, which measure oxygen levels in the blood, provide a non-invasive alternative to invasive arterial blood draws, but are limited in accuracy for people of color due to melanin absorption of light. Dr. Thomas Valley and colleagues at the University of Michigan identified racial biases in pulse oximeter readings in 2020, highlighting disparities in healthcare for Black patients, including potentially limiting access to advanced therapies like heart transplants. Additional research has found that people of color have higher COVID-19 death rates and may be disadvantaged in qualifying for certain medical procedures due to faulty pulse oximeter readings.
Ongoing research at the University of California, San Francisco is evaluating over 50 pulse oximeters to determine which devices work equally well regardless of skin pigmentation. While some devices perform better than others, the reasons behind these disparities are still unknown. Delays in addressing these issues have led to frustration among healthcare providers treating predominantly Black patients, prompting legal action against pulse oximeter manufacturers. Despite the limitations of pulse oximeters, patients like Starr continue to rely on them for monitoring their health, highlighting the urgent need for more accurate and inclusive medical devices.
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