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Heimlich's Maneuver

Henry Heimlich is Ohio's most revered doctor. He may also be the most dangerous. Ask his colleagues -- and his son.

By Thomas Francis 

On June 22, 1980, the doctor presiding over the otherwise tranquil emergency room of Lima Memorial Hospital saved the life of a two-year-old girl. In so doing, Dr. Edward Patrick rewrote medical history.

Erin Snow had fallen into the water after her parents' raft capsized on Mirror Lake. She had been underwater for 20 minutes, and it took 20 minutes to get her to the Lima hospital, according to an article Patrick wrote about the case.

By the time she arrived at the emergency room, Patrick notes, Erin was in full cardiac arrest. He recalls that mouth-to-mouth resuscitation by paramedics had no effect. He inserted a tube through the girl's mouth, but could draw water only out of her windpipe -- not her lungs. Having exhausted all else, Patrick tried something radical: the Heimlich maneuver.

After a single thrust, "Water gushed into and out the endotracheal tube," Patrick writes.

Based on his success, Patrick declared that "the Heimlich maneuver should be the first treatment for an unconscious drowning victim," replacing CPR. Dr. Henry Heimlich cited the article as proof that his maneuver works wonders on drowning victims.

The maneuver's use for drowning violated much of what was accepted as scientific fact. No matter, Heimlich had already clashed with the medical establishment in the mid-'70s, when he proposed the maneuver for choking in place of backslaps. He wanted the drowning franchise -- and to this end, Patrick's article was invaluable.

There are, however, two significant details that Patrick neglected to note in his article: first, that he was a close friend of Heimlich's. Second, that in reality there was no miracle at Mirror Lake. Erin Snow slipped into a coma that day and died four months later.

In the 24 years since the Erin Snow case, Heimlich has lobbied vociferously for his maneuver's use in drownings. As a branding manager seeks market share, Heimlich hawked his maneuver for a wide range of medical problems. He didn't want to be a one-hit wonder.

Medical experts united against him, arguing that the Heimlich maneuver was not only ineffective, but potentially lethal. They say the same thing today. Heimlich pushes on, furiously insisting that CPR advocates are condoning a veritable massacre -- 1,000 dead kids a year -- by not employing his maneuver at beaches and pools.

If he's been routed at scientific conferences, Heimlich still gets a warm reception among the unscientific, including the nation's biggest private lifeguard-training company, which defied prevailing wisdom by instituting Heimlich's maneuver at pools coast to coast. And his celebrated name allowed him to take his advocacy to the national media, circumventing the medical establishment.

Only recently has his persistence begun to appear dangerous -- especially when it concerns drowning victims.

That neither Heimlich nor Patrick can confirm basic facts about their landmark case only raises more questions.

An interview with Patrick does, however, turn up another startling revelation. Patrick claims to be the co-inventor of the Heimlich maneuver for choking and says that his contributions have been covered up by Heimlich himself, who wanted sole credit.

Now 84 years old and still a towering figure in Cincinnati, Heimlich stands to lose the thing he cherishes above all else: his good name.

It is natural for a son to be curious about his father's career, especially when that father is Dr. Henry Heimlich, whose accomplishments have received increasingly critical examination over the last several years. Less natural is Peter Heimlich's reaction. He does not seem to trust his father.

"Do I think the Lima case is fraud?" he says. "Let's put it this way: There are so many disparities between Dr. Patrick's article and the Erin Snow case, it doesn't look good. If the case is the way Ed and my father say it is, they should produce documentation and talk openly about it."

Dr. Heimlich refused to be interviewed for this story.

Patrick speaks, but for someone with a miracle case on his résumé, he is strangely guarded. He refuses to provide names of other doctors who participated in the case. He refuses to release work records that would prove he was actually working in the Lima Memorial ER at the time. And he refuses to furnish a hospital report from the Erin Snow case. All Patrick offers is his word.

"Let me just tell you that the documentation is there," he says. "Let's accept that, okay?"

It's odd, too, that this trailblazer made so few impressions in the small medical fraternity of Lima. Coroner Bill Noble has worked with the entire roster of the town's doctors and remembers them clearly. He doesn't remember Patrick. Nor does Ginny Keeran, the head ER nurse in 1980. She vaguely remembers his name, but nothing more. Lima Memorial Hospital refused to release his work records.

The ambulance run sheet from that day contradicts Patrick's claim that 40 minutes passed between the child's submersion and her revival. In fact, the run sheet places Mirror Lake nearly across the street from the hospital.

Linda Quan, a University of Washington researcher recognized as one of the world's leading authorities on drowning, deems the Lima case "highly questionable."

Usually, when a case study is biased -- or shown to be fabricated -- the motive is profit. A pharmaceutical company, for example, wants to demonstrate that its drugs work, and it's willing to cheat to do so.

In the Erin Snow case, profit wasn't a factor, but as the man behind the technique, Heimlich had much to gain.

Says Dr. James Orlowski, a drowning expert who spent 19 years at the Cleveland Clinic before moving to Tampa: "He has a personal investment in this whole thing, and he's taken a rather disingenuous approach to it."

Still, the medical field did not initially suspect fraud. It just dismissed Patrick's article as error-ridden and Heimlich's endorsement of it as foolhardy.

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