Hyperbaric Oxygen Therapy Safety: Why Oversight Matters

Two Incidents, One Reminder: Hyperbaric Safety Demands Clinical Oversight

In 2025, two tragic hyperbaric oxygen therapy (HBOT) incidents occurred at wellness clinics unaffiliated with any hospital or physician practice — one resulting in the death of a young child, the other involving a fatal fire under circumstances that raised questions about clinical oversight and supervision.

Though both cases remain under active investigation, they share a critical distinction: neither took place in a hospital or physician-practice setting. These were not clinical programs governed by credentialed oversight, real-time monitoring, or established medical protocols.

They are devastating reminders that while HBOT is inherently safe in the right environment, it becomes dangerous — even deadly — when removed from the guardrails of clinical practice.

While investigational research into off-label HBOT use does exist — often within academic or military settings — these studies are highly controlled and not representative of safe patient care. SHS does not support or endorse off-label treatment outside of formal clinical trials.

We don’t treat theory. We support clinical practice — backed by evidence, governed by protocols, and focused on patients who meet established medical criteria.

What We Know

The Undersea and Hyperbaric Medical Society (UHMS) has issued a public statement urging restraint and discouraging speculation while investigations into these recent events remain ongoing. Shared Health Services fully echoes that position.

Still, here’s what we do know:

• Clinical hyperbaric programs follow rigorous protocols — including external chamber operation, continuous patient monitoring, and formal safety training.

• No chamber fire has ever occurred in a hospital-based HBOT setting in the U.S. — a testament to the strength of these safeguards.

• Wellness and off-label HBOT operations often lack these guardrails, creating serious risk to both patients and providers.

Even equipment designed for safe, external operation — including hospital-grade monoplace chambers — cannot overcome poor training, skipped maintenance, or the absence of structured clinical oversight.

HBOT safety isn’t just about a well-built machine. It’s about the system — daily and weekly safety checks, clinical protocols, preventative maintenance by industry professionals, trained staff, and real-time oversight. That’s what makes it safe.

SHS’s Commitment: Safe Practices, Trained Teams, Trusted Tools

Shared Health Services has nearly 30 years of experience supporting hospital- and physician-practice-based hyperbaric oxygen therapy (HBOT) programs across the country.

The Infrastructure Behind Safe HBOT

We’re not here to chase trends — we’re here to build infrastructure. We believe hyperbaric safety begins with:

• Chambers externally operated by trained staff only — no mirrored controls or self-treatment protocols

• Clinical staff completion of a CMS-approved 40-hour introductory course from the Undersea and Hyperbaric Medical Society (UHMS) or the American College of Hyperbaric Medicine (ACHM)

• Pursuit of formal credentialing by clinical and technical staff, including:

  • Certified Hyperbaric Technologist (CHT) – National Board of Diving and Hyperbaric Medical Technology (NBDHMT)

  • Certified Hyperbaric Specialist (CHS) – American Board of Wound Healing (ABWH)

• Protocols and safety training that align with NFPA 99, ASME PVHO, and CMS guidelines

• Ongoing staff education covering fire risk mitigation, oxygen toxicity prevention, adverse event response, and contraindication screening

While not required for every facility, formal accreditation through organizations such as The Joint Commission (TJC), Det Norske Veritas (DNV), or the Undersea and Hyperbaric Medical Society (UHMS) can provide an additional layer of safety, credibility, and operational oversight. SHS supports partners who pursue these accreditations and can offer guidance on aligning program operations with recognized best practices — even when formal accreditation is not being sought.

SHS partners receive real-world tools and peer-level clinical oversight to help protect patients, staff, and facilities.

In short: We don’t just teach the “how” — we back it with the “why,” the credential, and the compliance.

These layers are what create safe, sustainable HBOT programs — and when even one is missing, risk escalates fast. They are non-negotiable in any environment where oxygen is delivered under pressure.

What We Can Do Right Now

In light of these recent events, we encourage all hospitals and physician practices employing HBOT as an advanced treatment modality to take the following proactive steps:

• Revisit your emergency protocols

→ Ensure everyone knows how to respond to signs of oxygen toxicity (VENTID-C), fire risk, or patient distress.

• Review your contraindications training

→ Confirm staff understand both absolute (e.g., untreated pneumothorax) and relative contraindications (e.g., recent bleomycin, high-dose steroids, claustrophobia, CHF with EF <30%).

• Reinforce observation and monitoring

→ The #1 prevention strategy is patient observation. Know the signs. Be ready to act.

• Check your documentation systems

→ Ensure daily and weekly chamber logs, adverse event forms, and emergency procedure checklists are current, complete, and accessible.

• Support recertification and staff refreshers

→ Whether preparing for CHT/CHS exams or onboarding new staff, SHS can help reinforce competence, confidence, and clinical continuity.

• Reach out to SHS with any questions

→ SHS isn’t just here to answer questions — we serve as a trusted partner in building and sustaining safe, compliant HBOT programs for hospitals and physician practices alike. Whether you need clinical clarity, peer-to-peer insight, or ready-to-use tools, we’re here to support your team at every step.

These aren’t just compliance tasks — they’re life-saving habits. When your team trains with purpose and leads with vigilance, you create a culture where safety becomes second nature.

Our role is to support your team with proven strategies and clinical expertise — the success and safety of your program is yours to own.

Final Thought: Let’s Lead with Vigilance

We don’t share these tragedies to create fear — we share them to re-center the field around what matters most: safety, integrity, and clinical excellence.

Because when hyperbaric therapy is misused or misrepresented, the consequences don’t stop at one clinic. They ripple across every wound care center, every referring provider, and every hospital trying to do it right. Patients lose trust. Regulators take notice. And the entire field suffers for the shortcuts of a few.

A Call to Clinically Grounded Leadership

At SHS, we believe hospitals and physician practices deserve more than reactive guidance — they deserve a partner who helps them lead with vigilance, prepare with purpose, and protect what they’ve built.

Thank you for continuing to uphold the highest standards of care — not just for your patients, but for the future of hyperbaric medicine itself.

If your team is ready to invest in consistency, clarity, and clinical confidence — SHS is ready to support the journey.