Presented September 3, 2025 at the 2025 APSF Stoelting Conference on “Transforming Maternal Care: Innovations and Collaborations to Reduce Morbidity and Mortality”
SUMMARY
Michael Mestek, PhD’s presentation addresses the issue of equitable monitoring with pulse oximetry to help close maternal healthcare gaps. He highlights that current pulse oximeters exhibit dark skin pigmentation bias, leading to a significant misdiagnosis of hypoxemia in patients with dark skin. This inequity is a complex problem influenced by the device’s base performance and factors like sensor placement and patient-specific perfusion. The company’s vision is to achieve equitable care by improving technology performance and focusing on rigorous clinical testing in a dedicated research lab that ensures diverse representation across skin tones.
Key Points:
- Skin Pigmentation Bias
Current pulse oximeters show dark skin pigmentation bias, particularly in low perfusion states [05:30]. Misdiagnosis of hypoxemia is virtually non-existent (approx. 1%) for light-skinned patients but occurs in over 20% of patients with dark skin [05:52, 06:02]. - Source of Inequity
Inequity in pulse oximetry is multifactorial, stemming from the device’s base performance, suboptimal sensor selection/placement, and patient-specific factors like profusion state [07:36, 07:49]. - Commitment to Equity
Industry efforts are focused on improving technology performance to ensure accurate readings for all patients. This involves testing both the SPO₂ value and the pulse rate—a crucial metric in labor and delivery [06:29, 06:42]. - Research and Representation
Progress relies on rigorous research conducted in dedicated clinical physiology research laboratories that enroll subjects with diverse skin tones, such as across the Monk Skin Tone Scale, to improve future devices and reduce inequities [10:05, 10:47].
ABOUT THE SPEAKER(S)
Michael Mestek, PhD
Vice President of Clinical Research & Medical Science
Medtronic
Acute Care & Monitoring Operating Unit
Michael Mestek, PhD is the Vice President of Clinical Research & Medical Science for Medtronic’s Acute Care & Monitoring Operating Unit headquartered in Colorado. He and his team produce clinical and economic evidence and educate on non-invasive physiological sensing technologies and airway management tools that are designed to help clinicians advance patient care. Michael joined Medtronic in 2009 and has held positions of increasing responsibility in Research & Development, Global Marketing, in addition to Clinical Research & Medical Science.
In addition to his role in industry, Michael is an Adjunct Professor in the Department of Bioengineering at the University of Colorado Denver | Anschutz Medical Campus where he has taught graduate-level courses related to medical device commercialization. He is also the Chair of the Board of Directors for the Colorado BioScience Institute, a non-profit that provides education, workforce and career development, and innovation support to the local bioscience community.
Prior to joining Medtronic, Michael was a Research Fellow and National Institutes of Health trainee in the Department of Integrative Physiology at the University of Colorado at Boulder where he conducted translational research on how lifestyle modification improves cardiovascular and metabolic health. He holds a PhD in Exercise Physiology from Auburn University.
