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Even before Karp died, rumors began surfacing that the artificial heart (technically known as an orthotopic cardiac prosthesis) had been developed at least partially with funds assigned to a DeBakey research team and that it had been used without adequate testing and without DeBakey's knowledge or permission. The National Heart Institute has asked DeBakey and Cooley if federal funds were used in the development of the device. If so, said Dr. Theodore Cooper, NHI's director, its use was subject to federal guidelines covering human experimentation. He explained that these guidelines stipulate that "if experiments are going to be carried out on man, every effort must be made to ensure that the experiment is safely conceived, that the procedure is done with the informed consent of the patient, and that scientific and ethical matters involved be reviewed by scientists and physicians at the hospital not themselves involved in the experiments."
Some of DeBakey's associates implied that the artificial heart used by Cooley and Liotta had been developed almost entirely by DeBakey's federally funded research team. "It's the same damn heart we've been working on for years," said one of them. Though Cooley is not a member of the team, Liotta is. In this case, DeBakey's permission—and that of a special medical review board—should have been received before the heart was used.
DeBakey, 60, a pioneering open-heart surgeon, is president of the Baylor University College of Medicine; Cooley, 49, is a member of the faculty. The two Texans have scrupulously avoided public battles, but their subordinates have been less inhibited. Those loyal to DeBakey, for example, have fostered the impression that Cooley has performed some of his 20 heart transplants prematurely. Cooley's lieutenants, on the other hand, dismiss this as professional jealousy; they point out that Cooley performed his first transplant three months before DeBakey did. DeBakey's associates also expressed concern about the purely experimental status of artificial hearts. The Baylor heart was reportedly tested in calves at least four times. The animals died on the operating table or shortly after the implantation. One survived for three days. Large-scale damage to the blood cells—one of the chief obstacles to the use of artificial hearts*—was cited as a contributing factor in the calves' deaths. Medical authorities, however, carefully refused to speculate whether any damage might have been done to Karp by similar "traumatization" of his blood cells.
Experience Needed. Cooley, for his part, remained unruffled. He claimed that the artificial heart used in Karp was developed entirely with funds from the Texas Heart Institute and other private sources. But he was cautious in appraising its usefulness. "We have demonstrated that a mechanical device will support the body," he declared after Karp's death. "But we've got to get more experience. It can only be used in a person who is at the brink of death or in a person who has already died, as, in effect, Mr. Karp had. He was completely dependent on the mechanical heart-lung, so that if it had been disconnected he would have been dead. That was the only justification for doing something as radical as this."