Is it Illegal to Change Settings on One's CPAP Machine?

[rippersmom]

I'm not an RT. I'm a patient who has heard conflicting things about the legality of pressure setting changes, and just trying to sort out fact from fiction.

My 2 cents: I paid an exhorbitant price for a glorified blow drier that now belongs to ME. It is MINE to do with whatever I choose. My Dr. wrote the Rx for a certain pressure and that is what the RT set it at.

Now that I'm doing the donning of the mask and turning the machine on to initiate MY treatment......the ball is in my court. If I decide to change the settings, the consequences are my responsibility, no one else is to blame. I should check with my Dr if I change stuff, but I don't have to....it isn't illegal. It's my property, not the government's or the doctor's.

To be told by the RT that it's illegal for the patient to change stuff is baloney. If the RT sets a machine contrary to the prescription...THAT would be illegal/unethical for sure.

I have no legal basis for the above comments....just common sense.

sleep well
Nancy in AZ

[Gale Hawkins]

And if you're prescribed "one tablet daily, with food" for some pill, will they arrest me if I take two or forget to eat?

My thoughts too.

I can treat myself but if I did that for others then I am doing it without a license. It it legal for me to kill myself with tobacco or alcohol use. Yes it is and the tax payers will pay for my treatment if I changing my mind about wanting to die from the use of either or both.

CPAP machines will become an over the OTC item.

[sleepguide]

Yes, I do find it weird that no RT, doctor, sleep lab tech, etc. has actually come forth with proof that it's illegal. so i challenge anybody to present that evidence here. if nobody does, then we can draw our own conclusions from the silence.

[blogginsjoe]

I am a CPAP user that is still on a trial. I have trialed a Resmed Vantage 8 Machine and am no using a Remstar A flex unit. My oximetry levels have dramatically improved since being on a machine but have still not reduced my AHI numbers below 10 on a continuous basis. Also, I have not been able to use the machine throughout the entire night. I have been on a trial for about 5 weeks. I use a Swift Lt II breathing device. I have met with my DME numerous times and discussed my condition. I have completed one hospital sleep- over which became a disaster as the night progress. The person in charge of the lab was less than cooperative in the sharing of information and assisting with the visit. Although it wasn't very successful for a variety of reasons, my doctor believed, from the information gathered, that I could very well have Central Apnea. This, in my studies, didn't seem to be able to be reduced by the Resmed A10 algorithm thus the change in machines. I have an appointment this week with my Dr. to review the printouts that we have taken over the past five weeks from both machines and hopefully we will be able to come up with a solution to this on-going problem. The question I have is whether a Bi-Level machine is an option for treatment of this condition?? I have again read a variety of theories in this regard. I believe that I’m experiencing apneas that are not being preceded by snores or flow limitations and thus and are not being addressed in a rapid enough manner to prevent them from occurring. It seems that an apnea followed by another sudden or runaway apnea needs a specific treatment that doesn’t seem appropriate using a Remstar A Flex machine or a Resmed Series 8 machine that is not able to provide Bi-level therapy. Not trying to self diagnose here but need some options to take to my Dr. so we’re speaking the same language when I meet with him later this coming week. Any suggestions???? Thank to all in advance for the support!!

[rested gal]

About halfway down page 1 of this old thread:

viewtopic.php?t=3366

A guest posted this:
"Just so you know....you should really contact your doctor before doing that. In almost any state, doing that without doctors orders is considered illegal and your insurance company can deny all claims regarding treatment of OSA and any complications/symptoms that you have that are anywhere near that in relation. Just an FYI"

That thread continued on with a pretty interesting discussion. A particular state law was finally unearthed that referred to licensed health care professionals, and talked about which of them (licensed health care professionals) could legally set or adjust pressure on someone else's (a patient's) CPAP...when the pressure had been prescribed in the first place by a physician. In that thread, no law was presented that forbade a person from changing the pressure on his/her own machine. At least not in that state (Indiana, if I remember correctly) at that time.

[rested gal]

Mike (Sleepguide), I understand the distinction you are asking about in your blog...
http://www.sleepguide.com/profiles/blog ... ettings-on
...when you wrote (about a law in California):

"Going to the law books themselves, I have to say, I can see some zealous prosecutor somewhere making a case that changing the settings on a CPAP machine is illegal. I do not think they would have a winner of an argument, because the law, as set forth below, seems to be regulating those who sell and distribute the machines, not the people who actually use them. But I think their reasoning would be that the sale of a CPAP requires a prescription for a certain setting, and re-jiggering each pressure setting would require a separate prescription."

I think you're right about a zealous prosecutor not having a winner of an argument, for precisely the reason you mentioned... most laws that even touch on CPAP machines are to regulate who can sell or distribute the machines and who can prescribe a setting, and which health care professionals can "dial in" the setting that was prescribed.

As for re-jiggering each pressure setting, yes, it would require a new order from a licensed physician before a health care professional could re-set the machine for someone else (a patient) to the new pressure ordered by the physician. I'd bet most of the state laws that go into "who can set the machine" probably are licensure laws about scope of duties under the license. For example, perhaps that only a licensed Respiratory Therapist can set a patient's CPAP machine, per the doctor's order.

As you said, the laws don't specifically refer to a person (patient... cpap user) who actually uses the machines... changing the pressure on his/her own machine.

Interesting questions.

[LoQ]

I'm not an RT. I'm a patient who has heard conflicting things about the legality of pressure setting changes, and just trying to sort out fact from fiction.

Your first post talked about something being unsafe. Where do you get the idea that it might be illegal to change the pressure setting?

[sleepguide]

Rested Gal,
I've gone through the thread where the anonymous "Guest" referenced the Indiana Code, and if that's the best he/she can come up with, then I think it is, in fact, some myth perpetrated by the so-called experts on unsuspecting patients. Clearly, the nature of the Indiana statute is not to regulate patients themselves, but it's more of a protectionist statute staking out territory for "respiratory care practitioners" to ply their trade.

Mike

[SharkBait]

CPAP machines will become an over the OTC item.

Do you really think so? With the money being made I would tend to think not. As soon as someone gets the idea to make CPAP OTC, the medical community will flood the powers that be with scare articles, studies, and "statistics" that will make SAG's PurSleep crusade look like a couple of notes jotted down on a napkin.

[Jason S.]

Yes. I got busted for that back in '99 and had to do a nickel in Leavenworh.

[ozij]

I believe all those dire warning for RT's are there because people receive mechanical respiratory assistance when their breathing and immediate well-being are far more compromised than ours. If I my life depended on a ventilator's settings, I would want changes in the setting made only by someone who was qualified to make them. I'm sure this "thou shalt not" part of RT education is similar to pharmacist education: When you see a prescription, you do what the doctor tells you! You do not change the patient's Rx, and if you think it's necessary, you contact the doctor.

Applying this ruling to CPAP therapy is simply a carry-over from those other situations.

Just like the idea that the correct pressure can be found in a single night in the lab is a carry-over from the days they created a tracheotomy, and did indeed solve the OSA with one move.

O.

[DreamStalker]

I believe it should be illegal for people to have to change their clocks regardless of whther one is certified of being a clock changer or not!

[luke]

Can anyone recommend a good lawyer for those of us who have been charged with CPAP pressure tweaking ?



Sorry couldnt resist !

[DreamStalker]

Can anyone recommend a good lawyer for those of us who have been charged with CPAP pressure tweaking ?



Sorry couldnt resist !

I think Alberto Gonzales may be free to take your case at the moment although I don't know if he will continue to be after congress .... uhhh, investigates.

[mdbarthe]

I suspect the RT who dispensed the controversial information in the first place, did so with the motive or preserving her own job security. I have heard this before and when I pressed the issue for proof in the law, I was provided with a statute that prohibited the practice of medicine or health care without a license. The theory being that if an "over-zealous" prosecutor wanted to go after someone they could use that statute to bring charges.

As everyone has pointed out, the whole concept is ludicrous and I can't imagine any responsible authority even trying such a thing. I think I would have asked the threatening RT, "Do you know you can be arrested for practicing law without a license? Sounds to me like you're dispensing legal advice."