Clinic Death Raises Questions about Oxygen Therapy

After a fire that instantly killed a 5-year-old Michigan boy undergoing treatment in a hyperbaric oxygen chamber, experts are urging clinicians to take a conservative approach to the controversial but increasingly popular therapy.

Experts who spoke with Medscape Medical News said when patients ask about using hyperbaric oxygen therapy (HBOT), primary care physicians (PCPs) should read the literature around the therapy and the patient’s illness, seek out only centers with proper accreditation, ask patients how and where they learned that high-pressure oxygen might help their particular condition, and investigate individual centers the patient or their family members have in mind.

High-pressure oxygen is “a therapy given under a doctor’s prescription, and it is like any other drug,” said Paul G. Harch, MD, a clinical professor of emergency medicine at Louisiana State University in New Orleans, who has spent his career studying the technique. A physician prescribing blood-pressure medication would expect professionals to carry out that prescription.

“Seek a medical practitioner,” preferably one with an MD or a DO degree, said Harch, former director of the University Medical Center Hyperbaric Medicine Department and LSU Hyperbaric Medicine Fellowship. Patients also should confirm if their medical insurance covers any of the cost of a session, which can run hundreds of dollars.

Mysterious Explosion 

Whether a trained medical professional was by the chamber is one of many unanswered questions about the January 31 accident at the Oxford Center in Troy, Michigan, that killed Thomas Cooper of nearby Royal Oak, and injured his mother. Also not yet publicly known is what caused the chamber to ignite, what the boy was being treated for, and whether protocol was followed by both the center and authorities.

“It’s just about your worst nightmare,” said John Peters, executive director of the Undersea & Hyperbaric Medical Society (UHMS) in North Palm Beach, Florida, the accrediting nonprofit which has issued guidelines for hyperbaric centers associated with hospitals and universities. UHMS lists 142 accredited centers in the United States. The Oxford Center is not on the list.

“We do not know if they had a physician on site,” Peters said. “Our policy is that there should have been. We lay out a foundation for the profession that is almost universally accepted in hospitals.”

Jay Buckey Jr, MD, section chief of hyperbaric medicine at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, said his center usually follows the list of 15 UHMS indications for treating patients with high-pressure oxygen. Occasionally Dartmouth will treat patients for other conditions but not without documented evidence of efficacy. The center is also careful to follow the National Fire Safety Association codes for hyperbaric facilities. “You want to be 100% compliant,” Buckey said.

The fire and police departments in Troy, a suburb of Detroit, have offered no further details since the day of the fire. “It’s an ongoing investigation and due to that we are not making any comments at this time,” said Courtney Flynn, the city’s’ director of communications. “We do not as a city license hyperbaric chambers.” 

The Oxford Center is a freestanding facility, so it should be subject to rules from state and local governments, Peters said. UHMS sent representatives to Troy to help investigate the accident and found a lack of state or regional oversight of the clinic. “Where was the breakdown in safety protocols?” he asked. A local fire marshal would inspect such a place, “but we don’t know if that happened.”

Peters said while he was not a doctor, if a patient approached a PCP about hyperbaric oxygen “I would hope that a physician would say, ‘Let me sit down and do some research.’” 

In HBOT, patients are put into a person-sized chamber that delivers 100% oxygen in an atmosphere where pressure is significantly higher than at sea level. (Room air is

“This therapy is a phenomenal therapy,” said Harch, who noted the technique has been used for more than 360 years. HBOT was first tried in diving bells and is commonly associated with treating divers who suffer from decompression sickness. Other approved uses include crush injuries, air embolisms, arterial problems, burns, diabetes-damaged tissue, anemia, and injuries caused by radiation treatment. Literature has found it useful for some people with Crohn’s disease, fistulas, and other skin conditions. It has also been used on people with symptoms of COVID-19.

The chambers are regulated by the US Food and Drug Administration as devices, but hyperbaric oxygen itself is a drug. “No one has understood this therapy, and they struggle to define it,” Harch said. Because of this misunderstanding, “the barrier of entry into this field is extremely low.” Such confusion has enabled even “massage therapy people” to open HBOT centers.

The founder of the Oxford Center, Tami Peterson, who goes by “Dr Tami Peterson,” has a PhD but no medical degree. She said that she started Oxford after her daughter successfully recovered from encephalitis with the use of HBOT. The center promotes HBOT for conditions including autism, healthy aging, attention-deficit/hyperactivity disorder, dyslexia, and Lyme disease — indications for which the science behind them is questionable, Peters said. The center did not return calls for comment.

The fatal fire is not the first time the Oxford Center came under the scrutiny of both law enforcement and experts in the hyperbaric oxygen field. Last year, Kimberly Coden, the center’s former director of services, pleaded guilty to impersonating a healthcare official when she used someone else’s credentials to pass herself off as a behavior analyst. She also pleaded guilty to intimidating a witness in a text message. In December 2024, she was sentenced to 4-10 years in prison.

Harch said one question doctors and patients should ask is, “Who’s practicing medicine there?” With 100% oxygen, the risk for explosion is extremely high. Both Buckey and Harch said their centers take steps to minimize the chances of a fire by providing 100% cotton material for patients, as synthetic fibers can cause static electricity; ensure the chamber is grounded; and do not allow into the chamber devices with lithium batteries — like mobile phones and iPads — that can swell under pressure and explode.

“Anything that burns” is out, Harch said. “I have the oversight responsibility for fire safety, all these things. It always falls on the doctor.” 

In the case of PCPs and under-regulated facilities, “your doctor is asked to write a prescription for a therapy in a place that has no doctors. They carry out the prescription — or don’t. They do what they want.”

The sources in this story reported no relevant financial conflicts of interest.

John Dillon is a journalist in Boston.