Dr. James C. Johnston is a Consultant Neurologist and Attorney focused on improving evidence-based medicine. He founded the non-profit Global NeuroCare® to advance healthcare in developing regions, particularly sub-Saharan Africa.
Global NeuroCare® is accredited by the World Health Organization, affiliated with the Office of the Special Adviser on Africa, and holds Special Consultative Status with the United Nations ECOSOC.
One of the organization’s projects focuses on education regarding the misuse of electronic fetal monitoring (EFM) in normal pregnancies. Medical malpractice attorney Thomas P. Sartwelle, BA, LLB, Medical Ethicist Professor Berna Arda, MD, PhD, and James C. Johnston, MD, JD have published over a dozen peer-reviewed journal articles and book chapters providing extensive review and analysis on the improper use of EFM as it relates to cerebral palsy.
EFM should not be performed in routine labor because it has a 99.8% false positive rate, and does not predict or prevent cerebral palsy or any other neonatal neurological injury. It does increase the C-section rate, with a concomitant increase in maternal and newborn mortality, birth complications, and long term consequences. In recent years Australia, Canada, and the United Kingdom have advised returning to intermittent auscultation (IA), and the American College of Obstetrics and Gynecology, after years of delay, finally recommended that women be given an informed choice between IA and EFM.
Unfortunately, many developing nations are increasingly seeking EFM in a misguided approach to reducing perinatal mortality and morbidity, a trend perpetuated by universities and private foundations supplying EFM machines, compounded by machine manufacturers focused on Africa as the greatest source of income for a failed medical device.
Dr. Johnston and his colleague Neurologist Mehila Zebenigus, MD have addressed these concerns in Ethiopia, where an ineffectual procedure like EFM will add another layer of morbidity and mortality to an already desperate situation, and waste scarce resources that should be used to recruit and train healthcare workers to care for children with cerebral palsy and related disorders.
Global NeuroCare® is accredited by the World Health Organization, affiliated with the Office of the Special Adviser on Africa, and holds Special Consultative Status with the United Nations ECOSOC.
One of the organization’s projects focuses on education regarding the misuse of electronic fetal monitoring (EFM) in normal pregnancies. Medical malpractice attorney Thomas P. Sartwelle, BA, LLB, Medical Ethicist Professor Berna Arda, MD, PhD, and James C. Johnston, MD, JD have published over a dozen peer-reviewed journal articles and book chapters providing extensive review and analysis on the improper use of EFM as it relates to cerebral palsy.
EFM should not be performed in routine labor because it has a 99.8% false positive rate, and does not predict or prevent cerebral palsy or any other neonatal neurological injury. It does increase the C-section rate, with a concomitant increase in maternal and newborn mortality, birth complications, and long term consequences. In recent years Australia, Canada, and the United Kingdom have advised returning to intermittent auscultation (IA), and the American College of Obstetrics and Gynecology, after years of delay, finally recommended that women be given an informed choice between IA and EFM.
Unfortunately, many developing nations are increasingly seeking EFM in a misguided approach to reducing perinatal mortality and morbidity, a trend perpetuated by universities and private foundations supplying EFM machines, compounded by machine manufacturers focused on Africa as the greatest source of income for a failed medical device.
Dr. Johnston and his colleague Neurologist Mehila Zebenigus, MD have addressed these concerns in Ethiopia, where an ineffectual procedure like EFM will add another layer of morbidity and mortality to an already desperate situation, and waste scarce resources that should be used to recruit and train healthcare workers to care for children with cerebral palsy and related disorders.
