Biphasic should replace Monophasic Defibrillators

False Claims: Throughout this debate, my opponent has made several false claims. R1: In his non-resolutional advocacy, my opponent claims that "for the same reasons biphasics are superior to monophasics, triphasics are superior to biphasics". This statement is simply not true. My opponent has failed to provide a conclusive study with the various available biphasic waveforms, compared with equal triphasic waveforms at the same energy levels that would back up this statement. There are currently two commercially available external defibrillators, and two commercially available ICD's- monophasics and biphasics, though patents for triphasic ICD's have been submitted. My opponent's conclusion to this paragraph is "I am advocating replacing both monophasics and biphasics with triphasics, thus, the resolution is negated". My opponent's position is impossible, as there are no commercially available triphasic defibrillators. Because there is no way I can provide a source for what does not exist, I would urge all who question the validity of this statement to diligently search Google for any mention of triphasic defibrillators. You will find patents for triphasic ICD's, but none commercially available, and tests for triphasic waveforms. Conduct a similar search for biphasic defibrillators and you will come up instantly with at least 4 manufacturer's and various models- HP, Philips (which acquired HP's medical unit), Zoll, Medtronic/Physio Control. Medtronic/Physio Control is the market leader in defibrillation technology, and has not submitted a triphasic defibrillator to the FDA for consideration for Class II (commercially available devices) as it has with it's biphasic defibrillators. My opponent also made the following claim: "Thus, it is extremely easy to convert most biphasics into triphasics." He has failed to show how it would be "extremely easy" to convert biphasics into triphasics, and has referenced his first study to back this statement up. When I asked for elaboration, he said he didn't need to elaborate because he was citing a credible source. Indeed his source is credible, but his source did not make the same claim. Furthermore, I have demonstrated that his source was referring to ICD's for which the authors submitted a patent for the triphasic ICD they converted from a commercially available biphasic ICD. R2: In this round he sources another study, and claims it is statistically significant. I demonstrated how the authors of the study themselves claimed their study was inconclusive as there were other studies that showed biphasic cardioversion at higher levels amongst humans, and their study was porcine. My opponent denied this claim, which came directly from his source. My opponent makes this claim as well: "By requiring less energy/amps/ to be put through a subject's body for effective defibrillation, triphasics are not only more effective, they can also cause less damage to a subject". This is a false claim, as it refers to energy delivered at 50J and 100J regardless of phase, delivered at 6.8A, 8A, and 10A. Joules is a measurement of energy, and amperes is a measurement of current. The formula for joules is a little complicated, but in this case the current is constant, and it is the time applied that changes: triphasic (4.8/4.8/4.8 ms) and biphasic (7.2/7.2 ms). My opponent then makes the following false claim: "If we don't accept this reasoning, then we should continue using monophasics due to their cheaper manufacturing costs." He implies that manufacturing costs would somehow negatively affect the manufacturer and the consumer (the hospital), but he later claims to not know the manufacturing costs, and ignores my statements regarding the cost for the hospital. He ignores that triphasic defibrillators are not commercially available, and have not even been submitted to the FDA for consideration. This would mean there is a window of at least ten years before they would become commercially available and trusted within the industry (biphasics were invented in 1996 and took over the market around 2006). And the following: "There is likely too much defibrillation for the biphasics to handle alone, otherwise hospitals would not ever have a reason to use a monophasic", ignoring the fact that monophasics were around before biphasics, hence my recommendation that they finally be replaced once and for all as an obsolete technology. He repeats the following: "I provided a reliable source for my claim that the conversion was possible and simple" which is simply nonsense. Biphasic external defibrillators cannot be converted into triphasics, and biphasic defibrillators that CAN be have NOT been because all the studies are inconclusive, even though there is a manufacturing model already patented. And makes the following claim: "Due to triphasics being superior, the FDA should approve them". The FDA has not received any triphasics for approval. Studies are still being conducted, but none have yet been done on humans. And this statement makes no sense: "It shouldn't just approve them as a general rule, but sould approve the specifications the hospitals would be switching to." The FDA cannot simply approve a "conversion" procedure, or whatever it is he is referring to. This would violate patents, copyrights, trademarks, would violate NFPA 99 recommendations which is law in some states, Joint Commission guidelines on equipment alterations, etc. Due to limited space, I will jump to his false claims in Round 4. "He claims to have pretty much the same qualifications as the people conducting the studies I linked"- Not true. I claimed we had similar backgrounds and specifically pointed out that I work for the Biomedical Engineering Department at St. Joseph's Hospital. Some of the participants in his studies work at Biomedical Engineering Departments, and it is this department that would validate these claims when considered by a hospital during capital purchases. "No matter his qualifications, he is still required, like anyone else, to back up his assertions"- I've left no assertions un-referenced. I pointed out my background simply to make it clear that I understand what the sources are referring to, while my opponent ignores facts within the sources themselves. "I concede this point. It's irrelevant anyway, since the first study I linked was inconclusive."- Yet he later asserts the biphasic/triphasic conversion referred to was not specific to ICD's, though the authors submitted for a patent for their converted ICD. "The only logical conclusion is that it was truly referring to 'most defibrillators,"- Other statements made within the study refer to ICD's as "defibrillators". The authors never referenced any external defibrillator, nor any external application. The only logical conclusion is they were referring to the biphasic ICD they converted into a triphasic for the study, and similar ICD's which contain very similar hardware. "My opponent is not arguing against this fact, so it seems he agrees that triphasics are indeed superior."- All you have to do is read the study and see it states various times that the study was inconclusive, and limited for various reasons. "the results, while valid, might not be the same in humans"- I quoted the study itself. My opponent claims the study came to conclusions the authors themselves do not claim. "If biphasics can be converted to triphasics easily"- I am dying for elaboration. I challenge you to show me how a Lifepak 12 Adaptiv Biphasic Defibrillator can be converted into a triphasic. My opponent claims to have given an explanation of how a biphasic defibrillator can be converted into a triphasic. He has seriously underestimated the number of internal components of a Lifepak 12, Lifepak 20, Hearstart XL, Zoll M series, or any biphasic defibrillator. My opponent's claims are simply not true. He has failed to show why biphasics should not replace monophasic defibrillators. Thank you.