State Senator Stephanie Chang and Representative Sharon MacDonell are drafting legislation based on Undersea Hyperbaric Medical Society recommendations to prevent another explosion like the one which killed Thomas Cooper in January. No mention whether these two Democrats will reference the applicable national standard: ASTM manual MNL36-2ND-EB, Safe Use of Oxygen and Oxygen Systems: Handbook for Design, Operation, and Maintenance. It explains these ASTM National Standards:
ASTM G128: Standard Guide for Control of Hazards and Risks in Oxygen Enriched Systems
ASTM G88: Standard Guide for Designing Systems for Oxygen Service
ASTM G4: Standards Technology Training course Controlling Fire Hazards in Oxygen Handling Systems
ASTM also offers an educational video on oxygen system safety:
Two Michigan lawmakers seek to regulate hyperbaric chambers after deadly explosion
By Hannah Mackay - March 27, 2025An effort to license and regulate hyperbaric oxygen chambers in Michigan appears to be picking up momentum after the death of a 5-year-old boy who was inside a chamber in Troy when it exploded, prompting plans by two lawmakers to introduce legislation this spring.
Thomas Cooper was receiving his 36th treatment in a hyperbaric chamber, a pressurized environment filled with 100% oxygen, at the Oxford Center in Troy on Jan. 31 when the machine ignited into a fireball. Cooper was killed within seconds, according to the Oakland County medical examiner's office.
Michigan does not require any oversight of hyperbaric chambers, which prompted state Sen. Stephanie Chang, D-Detroit, and Rep. Sharon MacDonell, D-Troy, to start drafting such legislation in a bid to prevent similar tragedies. About a dozen other states have hyperbaric chamber regulations.
"We're not just pretty sad about what happened, but we're pretty angry about the behavior of the Oxford Center and that they were able to use this equipment with no oversight, no regulations, no licensing," said MacDonell, who lives a few miles from where the explosion occurred. "We're hoping that we can get some regulations going in Michigan over hyperbaric chambers."
Chang and MacDonell have consulted with the Undersea Hyperbaric Medical Society, which accredits facilities that use the chambers, to ensure they are maintained and working properly. They plan to introduce legislation that would limit hyperbaric therapy services in Michigan to facilities accredited by the society.
"Right now, it's kind of the wild west out there. We're understanding that people can just import these machines and use them in beauty parlors or places like this, where they're claiming to just be wellness centers," MacDonell said.
Attorney General Dana Nessel accused the Brighton-based Oxford Center, which operated the chamber in Troy, of routinely operating sensitive and lethally dangerous hyperbaric chambers "beyond their expected service lifetime and in complete disregard of vital safety measures and practices considered essential by medical and technical professionals." The Oxford Center is not among the Undersea Hyperbaric Medical Society's accredited facilities.
Two facilities in Michigan are on the Undersea and Hyperbaric Medical Society's list of accredited facilities, and both are associated with Corewell Health.
Cooper's family retained Southfield-based Fieger law in the wake of the explosion. Managing partner James Harrington said the boy's death was a preventable tragedy.
"Michigan's lack of regulation over hyperbaric chambers left his family vulnerable. We urge state lawmakers to immediately pass strong regulations, mandatory licensing and rigorous safety standards," Harrington said. "No family should ever suffer such a devastating loss again."
The two legislators said they're drafting the bills with a goal of having experts and others start to review them by mid-April.
"We're ... still waiting but hoping that we can get something really solid introduced this spring, but we want to make sure that we're also getting this right," Chang said.
The potential legislation faces uncertain prospects in the Legislature, where Democrats control the Senate and Republicans lead the House.
The office of House Speaker Matt Hall, R-Richland, didn't respond to a request for comment. Two Metro Detroit GOP lawmakers told The Detroit News they are interested in exploring ways to prevent tragedies like the Troy explosion.
Senate Majority Leader Winnie Brinks, D-Grand Rapids, looks forward to reviewing the legislation when it's available, her Deputy Chief of Staff Rosie Jones wrote in an email.
Expert: Legislation might be a first
The Oxford Center is a Brighton-based medical company that advertises the use of its hyperbaric chambers for the treatment of more than 90 conditions, including attention deficit disorder, COVID-19 and Alzheimer's disease. The Food and Drug Administration has only approved the chambers for use in treating 13 conditions, ranging from burns to decompression sickness.
Nessel criticized the center employees for purportedly ignoring safety procedures, tampering with the machines and trying to make money by promoting "unfounded treatments."
Nessel announced this month criminal charges against four Oxford Center employees in connection with Cooper's death. Tamela Peterson, the center's owner and founder; Gary Marken, the primary manager; and safety director Jeffrey Mosteller were arraigned on second-degree murder and involuntary manslaughter charges. A second-degree murder conviction could result in up to life in prison, while an involuntary manslaughter conviction could result in up to 15 years behind bars.
Aleta Moffitt, a technician operating the hyperbaric chamber that exploded, faces charges of involuntary manslaughter and intentionally placing false information on a medical record. All four employees pleaded not guilty.
Raymond Cassar, Marken's attorney, said neither the second-degree murder nor involuntary manslaughter charges make sense because the fire was an accident, "not an intentional act."
At the arraignment, Peterson's attorney, Gerald Gleeson, said both of Peterson's parents used the chambers regularly, arguing that this "tends to discount the idea that she was somehow operating these with reckless abandon."
Michigan would be the first state to require UHMS accreditation for all hyperbaric chamber facilities, said John Peters, the society's executive director. Utah requires accreditation for hospitals that accept state money for Medicaid, the government health care program for the poor, and the UHMS has been trying to reach out to payers to create standards for hyperbaric treatments, Peters said.
Accreditation and licensing of the hyperbaric chambers with the state could prevent what Peters calls "ghost facilities," or those offering hyperbaric treatment that only take cash and don't bill insurance, from operating without oversight.
"I think this is the ... domino that we are looking for to change and increase transparency and accountability for the specialty, and it ultimately results in better care for the patient," Peters said.
The UHMS's accreditation standards are the baseline that facilities should achieve, he said. Tragedies like Cooper's death will be repeated without regulation, he added.
"It'll happen again, until, you know, the regulation, the authorities having jurisdiction, decide to actually do something about it," Peters said. "It is the least regulated part of medicine that I've ever experienced."
The society's executive director estimated that the UHMS could evaluate the 42 hospitals and seven physician offices that practice "legitimate hyperbaric medicine" for accreditation in Michigan within 18 months.
The UHMS participated in the investigation into the Oxford Center fire in Troy. Peters said society experts would have been able to identify problems with the procedures and safeguards if consulted ahead of time.
"We would have seen a lack of physician participation," he said. "We would have seen the gaps — there are many. You could drive a semi truck through the gaps that were involved in that clinic, unfortunately."
One of the legislative ideas is that the state would register and license the hyperbaric equipment, likely through the Michigan Department of Licensing and Regulatory Affairs, to track where the chambers are used at accredited facilities.
"They won't be licensed to work in the state of Michigan unless an organization like LARA says, 'OK, we have checked they have their accreditation,'" MacDonell said. "We'd probably have to have a small fee for that to pay for the work that the agency would have to do. ... Most importantly, licensing would lead to registration and a list of all of the in-use chambers in the state."
Promoting awareness
The Undersea and Hyperbaric Medical Society's accreditation requirements include several industry standards, such as the American Society of Mechanical Engineers' Safety Standard for Pressure Vessels for Human Occupancy and the National Fire Protection Association's health care facilities code. To maintain accreditation, facilities must undergo a survey once every three years, according to the society's accreditation manual.
MacDonell hopes that the legislation can require a physician trained in hyperbaric treatments to be present when the chambers are in operation, and for people receiving treatment to be aware of the conditions the machines are approved to treat.
"The clients should be well aware that the FDA approves hyperbaric therapy for only about 15 conditions, and that they may be using it for an off-label condition," MacDonell said.
Police claim that Cooper's death could have been prevented if the facility had followed standard safety protocols, such as using a grounding wire, according to transcripts from the court. The Attorney General's Office accused the staff at the Oxford Center of manually altering the cycle counter on the chamber that exploded, which measures the machine's lifespan.
"One of the concerns is that somebody could do something like that and then sell it to a third party," MacDonell said. "By licensing and registering the units, the state agency would be able to follow where they are and try to make sure that a very old unit doesn't just keep getting resold and used by people who don't know what they're doing."
MacDonell views the regulations as a safety issue rather than a political one. She chairs the Michigan Legislative Disability Caucus and worries that companies may take advantage of parents of people with disabilities who are desperate for treatments.
"While there might be some folks who might usually be opposed to new 'regulations,' this is one of those where ... the good actors in this space probably actually do want regulation and want there to be some consistency," Chang said. "I think that we'll hopefully see that same understanding from, you know, our colleagues across the aisle."
State Sen. Lana Theis, R-Brighton, said law enforcement's initial reports about the Oxford Center incident are "extremely alarming and heartbreaking."
"As a mother and a lawmaker, my heart goes out to the family affected by this unimaginable loss," Theis said in an emailed statement. "While I will continue to stay closely updated on this case, I fully defer to law enforcement and the prosecutors as they conduct their investigation and determine the appropriate course of action."
The GOP lawmaker said hyperbaric treatments must be held to the highest safety standards.
"I am currently reviewing the existing regulations — or lack thereof — governing these types of facilities and treatments in our state," Theis said. "I am working closely with medical experts, safety specialists, and my legislative colleagues to determine whether new laws or oversight mechanisms are needed to help ensure a tragedy like this never happens again."
State Sen. Michael Webber, R-Rochester Hills, said the Legislature has a moral obligation to ensure that patients' safety and rights are protected.
"This heartbreaking tragedy exposed glaring and dangerous gaps in oversight of these types of facilities," Webber said in an emailed statement. "I am committed to working with my colleagues in the Legislature to protect the most vulnerable from devastating incidents like this in the future."
The latest. Still no evidence these legislators are aware of the established industry standards for hyperbaric facilities:
ASTM manual MNL36-2ND-EB, Safe Use of Oxygen and Oxygen Systems: Handbook for Design, Operation, and Maintenance. It explains these ASTM National Standards:
ASTM G128: Standard Guide for Control of Hazards and Risks in Oxygen Enriched Systems
ASTM G88: Standard Guide for Designing Systems for Oxygen Service
ASTM G4: Standards Technology Training course Controlling Fire Hazards in Oxygen Handling Systems
ASTM also offers an educational video on oxygen system safety:
Deaths prompt state lawmakers to consider new hyperbaric oxygen therapy rules
By Anna Claire Vollers - September 15, 2025Just before 8 a.m. on Jan. 31, an explosion rocked a nondescript one-story office building in an affluent suburb of Detroit.
The building was home to The Oxford Center, a health clinic that provided hyperbaric oxygen therapy to treat a variety of disorders.
Inside the clinic, a spark had ignited the high-pressure, pure-oxygen atmosphere in a hyperbaric chamber where 5-year-old Thomas Cooper lay with a pillow and blanket, receiving treatment for ADHD and sleep apnea. A fireball consumed the inside of the chamber in seconds, killing the boy, law enforcement later said.
His mother suffered third-degree burns on her arms as she tried to free her son.
Within weeks of the tragedy, Michigan Democratic Attorney General Dana Nessel charged three Oxford Center employees, including the center’s owner, with second-degree murder and involuntary manslaughter, and a fourth employee with involuntary manslaughter. Nessel said the staff disregarded multiple safety protocols.
The Michigan death and another fatality less than six months later at a wellness clinic in Arizona have thrown a spotlight on the largely unregulated world of hyperbaric oxygen therapy. A treatment once primarily confined to hospitals, it has surged in popularity in alternative health spaces in recent years.
About 1,200 hyperbaric medicine programs operate in the United States, according to estimates from the Undersea and Hyperbaric Medical Society, a nonprofit organization recognized by the U.S. Food and Drug Administration as an accrediting body for hyperbaric oxygen therapy. Of those, 140 are accredited by the organization.
While nearly a dozen states require hyperbaric oxygen chambers to comply with certain safety standards, no states have comprehensive requirements specifically for accreditation or inspection of HBOT facilities.
Wellness clinics, sometimes without physician supervision, use the pressurized chambers for off-label treatments — those not approved by the FDA.
Before the explosion that killed Thomas Cooper, Michigan state Sen. Stephanie Chang had never heard of hyperbaric oxygen therapy. The Oxford Center is located in her district, just a block from where she takes her daughter for tutoring, she said.
Chang, a Democrat, was aghast when she learned the state doesn’t accredit or regularly inspect clinics that offer the therapy. It doesn’t even track where such clinics operate.
“I think many people in the community felt the same way,” she said. “This is happening in our community without any regulation? We’ve got to do something.”
MAHA fans
Earlier this year, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. visited wellness podcaster Gary Brecka at his home, where they hung out in a hyperbaric oxygen chamber before taping an episode of Brecka’s show.
Hyperbaric oxygen therapy has found a support network inside Kennedy’s Make America Healthy Again movement, among wellness influencers and anti-aging gurus. Podcasters including Brecka and Joe Rogan have touted the benefits of the chambers, while a hyperbaric chamber manufacturer had a presence at this year’s MAHA Spring Gala in Florida.
Before Trump’s reelection, Kennedy said in a social media post that the “FDA’s war on public health” was about to end, and he criticized its “aggressive suppression” of alternative health treatments, including hyperbaric therapy.
In hyperbaric oxygen therapy, also known as HBOT, patients rest inside a special chamber where they breathe pure oxygen. The air pressure in the chamber is raised to a level higher than normal to help increase the amount of oxygen in the blood to in turn accelerate healing.
Modern HBOT has been used for decades and is approved by the FDA to treat more than a dozen conditions, including burns, carbon monoxide poisoning and non-healing diabetic wounds.
Last month, in the wake of the Michigan and Arizona deaths, the FDA issued recommendations for HBOT providers and facilities to help reduce safety risks.
But as the wellness industry has ballooned, HBOT has seen “an exponential increase” in nonmedical providers, said John Peters, executive director at the Undersea and Hyperbaric Medical Society.
Wellness clinics like The Oxford Center in Michigan advertise that HBOT can treat a multitude of conditions off-label, from cancer and HIV to dementia and autism. Scientific research has been inconclusive. For example, some studies have shown benefits for children with autism, while others have found insufficient evidence to recommend it as a treatment.
Peters believes much of the off-label claims are exaggerated.
“There are people with discretionary income willing to spend it on these sales pitches,” said Peters. “What’s more sad than that are the people who are vulnerable. These are individuals who have sick family members or are sick themselves and they’re grasping at straws, looking for any relief. And they are tricked by these carpetbaggers.”
Most insurance plans will cover HBOT for FDA-approved uses, including the treatment of burns or carbon monoxide poisoning. Medicare, Medicaid and Tricare — the health insurance for active-duty and retired members of the military — also have a short list of approved conditions. For everything else, it’s cash-only.
And HBOT typically isn’t a one-and-done treatment. It can cost $200 or more per treatment session, with dozens of sessions recommended. Thomas Cooper had been on his 36th of 40 treatments for attention-deficit/hyperactivity disorder (ADHD) and sleep apnea, the Detroit Free Press reported. The FDA has not approved HBOT for either condition.
Unaccredited clinics like The Oxford Center are “making a lot of money and they have no one overseeing them,” said Michigan Democratic state Rep. Sharon MacDonell, who also represents the district where The Oxford Center was located and is working with Chang on a bill to regulate HBOT.
“No health insurance company is asking for documentation, no system is checking in. No state has figured out a way to do this, so we’re trying really hard.”
States in the dark
Deaths in hyperbaric chambers are rare, but the Michigan incident was one of two fatalities this year: In July, Walter Foxcroft, a 43-year-old physical therapist, was killed in an apparent flash fire in a hyperbaric chamber at his wellness clinic in Lake Havasu City, Arizona, according to municipal officials. First responders found him dead inside an intact chamber that appeared to have been on fire.
There have been other deaths and injuries over the past two decades.
In 2009, a 4-year-old boy and his 62-year-old grandmother died in a fire when a chamber exploded at a Florida clinic. That clinic, like the ones in Michigan and Arizona, was not accredited.
In 2023, a hyperbaric oxygen chamber exploded at a wellness spa in Utah, seriously injuring the two people inside, according to local fire officials. And in 2012, a hyperbaric chamber at a veterinary center in Florida exploded, killing the horse inside and a woman who had been operating the unit.
Nearly a dozen states require hyperbaric oxygen chambers to comply with certain safety standards for pressure vessels laid out by the American Society of Mechanical Engineers.
But Peters, with the Undersea and Hyperbaric Medical Society, said a large number of hyperbaric chambers imported from countries such as China and Poland that don’t meet those standards. He said experts believe there could be 20,000 noncode compliant chambers operating in the United States.
The FDA guidance does nothing to curb the proliferation of noncode compliant chambers into the country and the use of those chambers.
– John Peters, executive director at the Undersea and Hyperbaric Medical Society
That’s one reason he believes the recent FDA guidance for safe use of the chambers rings hollow.
“The FDA guidance does nothing to curb the proliferation of noncode compliant chambers into the country and the use of those chambers,” he said. “It does nothing to address the secondary market. You can buy a hyperbaric chamber and sell it to another individual without any requirement.”
Access vs. safety
Chang and MacDonell say they want to require accreditation for hyperbaric chambers and for the clinics that offer the therapy, including requiring a physician or other medical provider to oversee treatment.
But some people, including some autism advocates, have expressed concern that overregulation could hurt access to HBOT for families that want it.
“I think these folks recognize they want to keep access but don’t want people getting taken advantage of by bad actors in this space, and want to ensure they’re going to a facility that’s doing things the right way,” Chang said.
Chang said the bill would not regulate a newer, more portable type of hyperbaric chamber that are popular in wellness circles and sometimes used in homes. They have soft outer shells and seal with a zipper, unlike traditional steel-cased chambers. The soft-side chambers provide so-called mild hyperbaric oxygen therapy at lower pressure and aren’t considered medical devices like hard-shell chambers. But in North Carolina, state fire marshals have shut down the use of such devices at wellness clinics over safety concerns.
Fire officials in other states, including Utah, have also expressed concerns over the soft-side chambers.
In recent years, veterans groups have pushed for HBOT to be available and covered for treating traumatic brain injury and post-traumatic stress disorder. Thirteen states have passed legislation to require or support such treatments for veterans, according to Eric Koleda, national director of state legislative efforts for TreatNOW, a coalition that promotes HBOT access for veterans.
Koleda said he’s glad the Michigan lawmakers are working on the issue, though he’s not convinced stricter regulation is needed.
“We’re not proposing that there needs to be an enormous amount of regulation because there are already safety standards in place, and if they’re adhered to, that ensures a safe level of operation,” he said. “This is treatment that’s already done safely every day.”
In July, Missouri Republican Gov. Mike Kehoe signed a bill into law establishing a fund to pay for HBOT for veterans with a traumatic brain injury or PTSD. The bill passed with overwhelming bipartisan support in the legislature.
Veteran-related HBOT bills have also been introduced this year in Indiana, Iowa, Kentucky, New Jersey, New York and Oregon. Koleda said his organization is also working to get the FDA and the Centers for Medicare & Medicaid Services to add traumatic brain injury and PTSD to the list of conditions approved for HBOT treatment.
Indiana state Sen. David Niezgodski, a Democrat, introduced a resolution in April urging the state’s legislative council to study regulation of HBOT. The deaths in Michigan and Arizona caught his eye, he said, because Indiana has a law promoting the treatment for veterans. The resolution passed but wasn’t taken up by the council.
“I am 100% for trying to do everything we can to get this treatment where those who need it are truly able to benefit from it,” he told Stateline. “Though I want to be certain that we do everything we can to make sure that when they receive that treatment, it’s going to be safe at all times.”
The Michigan lawmakers stress their bill doesn’t restrict HBOT’s off-label use and they’re continuing to work with stakeholders. They hope to get it filed before the end of the year.
“When you go into what you believe to be a medical facility, you assume it is being regulated and that it is licensed and that the people running this complex technology know what they’re doing,” said MacDonell. “That’s our goal.”
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