Wednesday, November 24, 2010

Amputees with high-tech prosthetics struggle to better educate TSA about their trip through airport security

From Popular Mechanics:

The complaints are piling up about how the TSA is handling airport security. But if you think you have it bad, try walking through an airport checkpoint on the mechanical legs of one of the nearly 2 million Americans who use prosthetics.

Here's a travel scenario: You're flying home to visit the parents for Thanksgiving -- a short flight, some 500 miles away. You arrive at the airport 90 minutes early -- —it is, after all, holiday travel season. After showing your ID and boarding pass, you get to the screening area. You pull out your laptop -- and your iPad, just because -- and place them in separate bins.

You walk through a backscatter scanner and get the wand. Judging by the looks of the TSA employees and the constant beeping, you're not passing either test. "You see," you try to explain to them, "I'm wearing prosthetic legs. I'm handicapped."

This is where the process slows down.

Swabs are taken immediately in and around all prosthetics to detect for bomb-making material. Then you wait. The next step is to go under the CastScope. Sometimes there is a certified employee on the premises. But often, you have to wait for employees to hunt one down.

Once the operator is found, you go under the machine, prosthetic limbs still on. They take X-ray images on the front, back and sides -- about 10 X-rays per below-the-knee prosthetic, more if your prosthesis has a mechanical knee. After these X-rays pass inspection, you're free to fly.

For Jeffrey J. Cain, the chief of family medicine at the Children's Hospital in Denver, Colo., and a below-the-knee double amputee, this is a typical encounter with airport security, by the book. The problem? It rarely goes down like this.

"There's such variability in screening people with prosthetics," Cain says. Sometimes an amputee gets a pat-down after the backscatter scan (which isn't required); sometimes he or she is asked to remove a limb; and always, Cain says, there is confusion: "It's like being pulled over by a policeman -- there's only one correct answer, and it's not that of the police department; it's that of the person in front of you."

Cain is not alone in his grievances. A survey of 7,300 amputees conducted by the Amputee Coalition of America in June showed that travelers with limb loss have been subjected to inconsistent, unfair, abusive and often embarrassing screenings by TSA employees.

According to the Amputee Coalition, the TSA is aware of the problem. Recently, a TSA representative sat down with the Coalition and talked about possible solutions: giving amputees a card to be moved ahead in the line more quickly, better notifying amputees as to what to expect, and aiming for greater standardization.

"At this point, we're continuing to have a dialogue with the TSA," says Cain, who is a director of the board for the Coalition. "My hope is that there will ultimately be a way to prescreen a flyer so that the device could be certified in a standardized way. I, for one, have a license to practice medicine, and am a certified pilot and an Eagle Scout. I'd like to be able to precertify."

But for now, Cain says, prescreening for amputees is not on the table. Furthermore, as prosthetic technology rapidly advances, some doubt the TSA's ability to keep up with it and communicate changes effectively across the country's airports.

If consistency means knowing what prosthetics are on the market, TSA employees have their work cut out for them. Prosthetic technologies are advancing rapidly. Ten years ago, the standard for amputees was mechanical -- and for many it still is: These limbs usually use springs and elastics to mimic tendons and are controlled primarily by muscles on the remaining parts of the limb.

Since the early 2000s, microprocessors and more heavily "powered" prosthetics have made their way into the market, usually with lithium-ion and lithium-polymer batteries that assist the amputee's movement. Actuators, accelerometers and small computers now help limbs self-adjust while walking, holding objects and even lifting.

Ossur's Proprio foot (pictured), for example, has sensors that detect ankle motion more than 1000 times a second. A microprocessor uses that information to activate the best response to the next step. The iWalk, created by Breakthrough Award winner Hugh Herr, takes this design further, bringing power into the ankle so that it not only senses its environment to make the best next step, but reacts to it with load-bearing servos.

These emerging technologies are giving the TSA trouble. Peggy Chenoweth, a below-the-knee amputee, now wears Proprio Foot, a microprocessor-powered foot that has been for sale in various forms for nearly five years. The current version of Proprio, which she wears now, has been for sale for months. But this high-tech device consistently gets her blank looks.

"I'm sick of taking six X-rays and then having to explain what they're seeing," Chenowith says. "There's an issue with these high-tech prosthetics. Obviously, I'm wearing a high-tech device and I need to be screened -- but authorities need to keep up on the technology. I can understand [the confusion with] prototype devices, but the Proprio foot has been on the market a while."

The TSA couldn't be reached for comment, but its blog and websites say the extra half-hour delay for additional scans is necessary. Cain does not fight this point. "There are people who may use accessibility devices to smuggle weapons," Cain says, "and the TSA recognizes this." What the Amputee Coalition is asking for is a little consistency in its safety measures -- and, as has been noted all over this week, a little more dignity.