Hyperbaric oxygen therapy (HBOT) has long been recognized for its life-saving potential in treating conditions such as decompression sickness, carbon monoxide poisoning, traumatic brain injury, and wound healing. Despite its extensive use in clinical settings, concerns regarding its safety occasionally surface, particularly in the wake of rare accidents. To put these concerns into perspective, it is crucial to compare HBOT safety statistics with other common activities, including air travel and medical procedures.

Key Takeaways

1. HBOT is Extremely Safe Compared to Everyday Risks – The risk of a fatal HBOT accident is about 1 in 305,000 treatments, significantly lower than many common activities like driving (1 in 93) or falling (1 in 98). Statistically, HBOT ranks among the safest medical treatments available today.

2. Human Error, Not Technology, is the Primary Cause of Accidents – Just like in aviation and other medical procedures, most HBOT-related incidents stem from human error rather than equipment failure. Adhering to strict safety protocols and proper training can further minimize risks.

3. Ongoing Safety Improvements Enhance HBOT’s Reliability – As with air travel, every rare HBOT accident leads to improved safety measures, better training, and technological advancements. When proper protocols are followed, HBOT remains an incredibly effective and safe therapy for numerous medical conditions.

Understanding HBOT Safety

The idea that advanced medical technology inherently carries excessive risk is not supported by statistical evidence. HBOT, when conducted in controlled environments, has an exemplary safety record. Over the past 88 years, only 216 fatalities have been recorded worldwide in clinical hyperbaric chambers, with fewer than ten occurring in the United States. This equates to less than two HBOT-related deaths per year on average, making it an extraordinarily low-risk medical procedure.

For comparison, the Federal Aviation Administration (FAA) reports that only 0.007% of flights encounter any problems. Similarly, HBOT carries a 0.0008819% chance of an accident. In practical terms, the risk of death from an HBOT session is roughly 1 in 305,000 treatments. By contrast, the odds of dying in a motor vehicle accident are 1 in 93, and the risk of a fatal fall is 1 in 98. These figures highlight how HBOT ranks among the safest medical treatments available today.

Perspective on Risk in Daily Life

While medical technologies and air travel receive heavy scrutiny after accidents, a broader perspective reveals that many everyday activities pose a significantly higher risk. The leading causes of death in the United States include heart disease (1 in 6) and cancer (1 in 7), with medical errors contributing to between 25,000 and 250,000 deaths annually. Even accidental opioid overdoses claim more lives each year than HBOT accidents, with a death rate of 1 in 58. Service member suicides alone have resulted in over 151,000 deaths since 9/11, a staggering figure compared to the minuscule number of HBOT-related fatalities.

Further, activities that people routinely engage in, such as riding a bicycle or being outdoors during a storm, present far greater risks than HBOT. In a recent ten-year period, bicycle accidents led to 7,049 fatalities, making up 2.2% of total traffic deaths in 2021. Meanwhile, the odds of dying due to a cataclysmic storm are 1 in 20,098, and the chance of a fatal dog attack is 1 in 53,843—both still higher than HBOT-related fatalities.

The Role of Human Error in Medical and Aviation Accidents

Both medical procedures and aviation rely heavily on stringent safety protocols, advanced technology, and human oversight. When accidents occur, investigations often point to human error as the primary cause rather than equipment failure. Medical settings see an average of 2,211 anesthesia-related deaths over six years, yet surgical procedures continue because their benefits outweigh the risks. Similarly, commercial airline crashes remain exceedingly rare, but when they do happen, pilot error is frequently cited as a contributing factor.

HBOT is no different in this regard. Incidents involving hyperbaric chambers typically stem from improper safety protocol adherence rather than inherent flaws in the technology itself. The recent hyperbaric oxygen fire in Troy, Michigan, that tragically claimed the life of a five-year-old boy is a heartbreaking example of how safety failures can have devastating consequences. However, such cases are anomalies, not the norm.

Why Did This Accident Occur In Troy Michigan?

While at this time, we are not sure of the specific mechanism that led to the fire, there are some commonly seen issues that can lead to fire. The Oxford Clinic, the clinic the incident happened at, was utilizing high pressure, pure saturation dives, the most dangerous form of HBOT and rarely seen outside of a hospital setting.

What is pure saturation?

A pure saturation dive is when the chamber is pressurized with 100% medical grade oxygen. This is rarely seen in 2025 due to the large safety risks that can be associated with it. Common practice to pressurize the chamber with ambient air or room air (which contains 27% oxygen) and let the individual breathe in supplemental oxygen through a mask at a rate of 10L per minute. This at most can bring the concentration of oxygen up to 34% inside the chamber, well below the flammable threshold.

The point of HBOT is to diffuse extra oxygen into the body. Gasses like oxygen can only be absorbed by the lungs and not through the skin. If we pressurize with ambient air and breath in oxygen through a mask, we can get an extremely similar effect compared to diving in a pure saturation dive in my opinion and experience as a physician.

At the end of the day, I am sure this clinic had rationale for placing this child into a pure saturation dive, but somewhere safety protocol was broken. Something as simple as a zipper on a jacket going up and down can cause a static electricity spark. Common hospital practice is to place patients in these chambers in a paper gown, with no risk of static electricity and no ability to sneak in an electronics.

For the safety of my patients, we never place patients in a pure saturation dive at Clarity Hyperbarics and never will pursue that option. Pure saturation dives can be done safely, but should be reserved for an emergency situation and not for routine treatment.

Learning from Accidents: Strengthening Safety Measures

Whenever a major accident occurs, whether in aviation or medical treatment, extensive analysis follows to enhance safety measures. Investigations into air travel collisions and HBOT incidents alike prompt technological advancements, improved training, and revised safety protocols to mitigate risks.

The recent air collisions in Washington, D.C., and Philadelphia, coupled with the Troy, Michigan, HBOT accident, are stark reminders of the responsibilities that come with using advanced technologies. While it is premature to determine the exact causes of these events, historical data suggests that human factors, such as operational errors or safety violations, are more likely to be responsible than mechanical failure.

Enhancing HBOT Safety Moving Forward

Hyperbaric oxygen therapy will continue to be an essential treatment for a wide range of medical conditions, from diabetic foot ulcers to traumatic brain injuries. Rather than retreating from HBOT due to isolated accidents, the medical community must focus on improving operational safety standards. Key measures include:

• Strict Adherence to Safety Protocols: Ensuring that all facilities comply with rigorous safety guidelines can prevent avoidable errors.

• Ongoing Training for Operators: Educating technicians and medical professionals on best practices helps mitigate human error.

• Enhanced Equipment Standards: Advancements in chamber design and safety mechanisms further reduce risks.

• Regular Safety Audits: Conducting routine inspections of HBOT facilities ensures continued compliance with best practices.

Conclusion: HBOT Remains One of the Safest Medical Treatments

The fear surrounding hyperbaric oxygen therapy is disproportionate to its actual risk. The statistical probability of an HBOT-related fatality is negligible when compared to the dangers of everyday activities like driving, falling, or undergoing anesthesia. The public's perception of risk is often skewed by high-profile accidents, yet the data consistently demonstrates that HBOT is among the safest medical procedures available today.

Just as air travel remains an integral and highly safe mode of transportation despite rare accidents, HBOT continues to be a valuable and reliable treatment option. With proper safety measures, continuous training, and adherence to protocols, the risk associated with HBOT can be minimized even further. The focus should remain on maximizing its life-saving potential rather than allowing fear to overshadow its proven benefits.

Our hearts go out to the family of those who were lost.