Friday, July 18, 2014

Medical Device Sales: “Fascinating Captain!” Part 4

By Rick Fromme

This edition of our ongoing medical device series, “Fascinating Captain!” indeed runs the gamut. From an innovative type of biomaterial that acts as internal “scaffolding” to assist internal tissues, to a remote-controlled exoskeleton that can help paraplegics better ambulate themselves, to non-wearable wearable technology, one thing is clear: the breadth and scope advances in medical device technology continues to be far reaching, with life-changing implications for many. 

A Peep into Your Sleep (a.k.a., An App for Your Nap)

Misfit Wearables, a company known for its aesthetically pleasing wearable, Shine, is now collaborating with Beddit, a Finnish sleep analysis company. The move pairs Beddit’s thin, unobstrusive sleep monitor, which fits under a mattress, with Misfit’s tracking app for iOS and Android networks.

It presents a logical option for Misfit Wearable users who don’t necessarily want to wear their tracking device to bed, but still wish to gather insights on their sleep patterns. Furthermore, Beddit’s under-the-bed sleep monitor offers deeper analysis than what's was available when just using Shine. The new device partnership analyzes heart beat, respiration and movement, which then wirelessly transmits the data through Misfit’s app via Bluetooth.

Misfit's partnership with Beddit adds integration with its existing fitness app and Shine fitness tracker, plus new algorithms to work with Beddit. It also provides a way for Beddit, which has targeted hospitals and sleep clinics, to have a stronger reach into the consumer market, a campaign it started last year.
The “non-wearable” wearable also offers another way for Misfit to set itself apart from other wearable companies.  

This is Misfit's second move to expand its landscape of connected devices in several weeks, after adding a Pebble app for fitness tracking this past June.

Chip Off the Old Pill

A remote controlled birth control device may be available for consumers within the next four years. Created by MicroCHIPS, a Massachusetts-based drug delivery implant developer, the chip will be inserted under a woman’s skin and can be activated and deactivated by remote control. It works by administering a low dose of the hormone levonorgestrel once a day.
The chip emits the 30 microgram dose of levonorgestrel, which is administered via an electric charge, powered by an internal battery, which causes a seal around the hormone to melt and allows it to be released into the body.The chip will last for approximately 16 years; then the user simply visits her doctor’s office for a replacement.

Remote control operation is wireless but is designed to be tamper-proof. That is, someone wouldn’t be able to turn off the birth control from across a room. Rather, the remote must be practically touching the skin to work. All communications between the remote and the chip are encrypted, too.

The project is backed by the Bill & Melinda Gates Foundation, which funds innovative health projects. It also funded a campaign in 2012 to improve contraception access in developing countries.  

Reading the Body from Head to Toe from Your Bottom  

EarlySense, based in Waltham, MA, is now releasing a new FDA-cleared Chair Sensor that gleams the heart rate, respiratory rate, and motion from the patient’s buttocks. This is the first contact-free sensor for assessing vital signs from a chair.

The sensor, which looks like boxy pillow, is placed on the seat of a chair. A nearby monitor hooked up to the sensor displays and tracks patient’s’ vitals in real time, passing on the readings to the nursing station. In addition to raising alarms when the heart or breathing rates are abnormal, the technology also warns clinicians when a patient is trying to get up from the chair, which ensures someone can assist at a moment’s notice.

Clinicians have long known that ambulating patients from bed to chair improves healing, reduces the risk of complications, and shortens length of stay. Being positioned in an upright position appears to be of most benefit in the early post-operative period by improving lung function and reducing potential pulmonary complications. But to date, there wasn’t an automatic, contact-free solution for keeping patients safe in their chairs while being to assess key physiological vital signs.

The EarlySense Chair Sensor is a tool that empowers clinical staff to provide proactive, effective, timely interventions when patients are deteriorating or at risk of falling, therefore, accelerating recuperation and reducing risks.

Remote-Controlled Exoskeleton Helps Ambulate Spinal Cord Injury Patients

The FDA has approved marketing of the first motorized device intended to act as an exoskeleton for people with lower body paralysis (paraplegia) due to a spinal cord injury. ReWalk, created in Israel, is a remote-controlled, “exoskeleton, motorized device worn over the legs and part of the upper body that helps an individual sit, stand, and walk with assistance from a trained companion, such as a spouse or home health aide.

According to the U.S. Centers for Disease Control and Prevention, there are approximately 200,000 people in the U.S. living with a spinal cord injury, many of whom have complete or partial paraplegia. 

ReWalk consists of a fitted, metal brace that supports the legs and part of the upper body; motors that supply movement at the hips, knees, and ankles; a tilt sensor; and a backpack that contains the computer and power supply. Crutches provide the user with additional stability when walking, standing, and rising up from a chair. Using a wrist-worn, wireless remote control, the user commands ReWalk to stand up, sit down or walk. 

ReWalk is for people with paraplegia due to spinal cord injuries at levels T7 (seventh thoracic vertebra) to L5 (fifth lumbar vertebra) when accompanied by a specially trained caregiver. It’s also for people with spinal cord injuries at levels T4 (fourth thoracic vertebra) to T6 (sixth thoracic vertebra) where the device is limited to use in rehabilitation institutions. The device is not intended for sports or climbing stairs. 
The FDA is requiring Argo Medical Technologies, Inc. to complete a post-market clinical study that will consist of a registry to collect data on possible adverse events related to the use of the ReWalk device, as well as to prospectively and systematically assess the adequacy of its training program.

Doctor’s Gotta’ Brand New Bag

The once-iconic doctor’s bag has lost much of its luster within the past few years as technologies available in health care facilities have made a lot of what’s inside relatively less useful. Yet, mobile technology is rapidly catching up, presenting today’s and tomorrow’s doctors with advanced diagnostic and medical tools that make doctor’s bags – once a quaint image from the past – a high tech marvel. Medgadget editor Shiv Gaglani shows off three recentlyreleased devices that are taking the doctor’s bag into the 21st century.

Fibralign Wins MedTech Award

Fibralign Corporation was the winner of the 2014 MedTech Innovator competition held during the 22nd Annual Medical Device Conference, hosted by law firm Wilson Sonsini Goodrich & Rosati.  
Fibralign's first product, BioBridge, is developed to address Secondary Lymphedema, a global, chronic debilitating disease that affects over 120 million people and has no cure.

BioBridge, a unique extra-cellular matrix scaffold with specially designed fibrils oriented in specific 3D orientations, is much like the body’s own tissues. It alters the mechanical response of implanted scaffolds in the body, which recent research demonstrating it has a major impact on the type of tissue that can be engineered.  The company successfully completed a large animal study that validated BioBridge-treated diseased lymphatic tissue. Fibralign is now preparing for 510(k) submission and a clinical study.

As the first place winner, Fibralign won prizes valued at $150,000, including $100,000 in cash provided by RCT Ventures, $25,000 in cash provided by Johnson & Johnson Development Corporation and $25,000 worth of state-of-the-art lab space at Janssen Labs. 

In this edition of “Fascinating Captain!” I shared with you some of the innovative medical devices that have recently received FDA approval and/or that may one day find their way into the ever-expanding medical device marketplace. If you found this article interesting and useful, please share it with your colleagues and friends. As always, I’m eager to read your comments and questions below.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on FacebookTwitterGoogle+LinkedIn and YouTube

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Monday, July 7, 2014

Health Care Careers: A Day in the Life of a Phlebotomist

By Rick Fromme

Why was the young vampire considered a failure? Because he fainted at the sight of blood. 

Yes, it’s natural to quip about vampires when thinking about venipuncture and phlebotomy.  It’s easy to get — shall we say, “stuck”? — in that mode of thought.  Especially since the previous article I’d posted was among our ongoing “Humerus Я Us,” series, I’m still in a mirthful mode about merry medicine.

But the “point” I want to stress is: Blood testing is a critical component in anyone’s overall health care, whether for assessment, benchmarking, the identification of disease, and other issues.  For aging adults — and that’s a majority of the U.S. population — blood testing is the most critical step to prevent life-threatening issues. From a battery of different blood tests, health care professionals can watch for and catch critical physiological changes before they manifest as heart disease, cancer, diabetes, multiple sclerosis, Alzheimer’s and other debilitating illnesses.

Blood tests can also help one attain a higher quality of life. For example, by monitoring levels of testosterone, estrogen and progesterone, one can take definitive steps to correct a depressive mental state, reduce abnormal obesity, improve memory, increase energy levels, and more.

Of course, the health care specialty that focuses on obtaining blood for these critical tests is phlebotomy. And, as I’d mentioned in my previous blog, “Health Care Jobs Outlook is Jammin’!” one of the top 20 career specialties that’s expected to grow exponentially is phlebotomy.

Medic Red Stewart performs a phlebotomy at a J...
Medic Red Stewart performs a phlebotomy at a JTF-GTMO medical clinic. (Photo credit: Wikipedia)
As with many health care specialties, according to the Bureau of Labor Statistics (BLS), the employment of phlebotomists is projected to grow 27% within the next decade, much faster than the average for all occupations.  

Phlebotomists draw blood for tests, transfusions, research, or blood donations. Some explain their work to patients and provide assistance when patients have adverse reactions after their blood is drawn. Phlebotomists work mainly in hospitals, medical and diagnostic laboratories, blood donor centers, and doctor’s offices.

In a hospital setting, phlebotomists receive orders from the various departments, then take the required tubes in their portable tray. Once in the patient’s room, they carefully identify the patient by their name, medical record number, and date of birth, before drawing the required specimens.  The carefully marked tubes are then returned to the lab and the requisite information for each is inputted into the computer. Then the tubes are delivered to the proper departments such as hematology, coagulation, chemistry, etc., for the techs to then result out the tests.

The actual venipuncture process consists of applying a tourniquet, selecting a vein, cleansing the skin, inserting a needle, and collecting blood for either testing or transfusion purposes.  Upon completion of collection, the needle is withdrawn into a safety device, which prevents re-use of the needle and accidental needle sticks. The needle is then discarded into a biohazard sharps container.

Depending upon a variety of factors that can affect the size and availability of patients’ veins, this process can go smoothly or sometimes needs to be repeated to obtain results. Many seniors, for example, have hard-to-find veins. Children, too, can sometimes prove difficult not only because of the smaller size of their veins, but their outwardly manifested fear factor of the venipuncture procedure itself.

Yet Another Bad Phlebotomy Job
Yet Another Bad Phlebotomy Job (Photo credit: A.Currell)
Or sometimes it simply depends upon a phlebotomist’s skill level. For example, I had to give blood at my doctor’s office last month.  The first person tried two times, but missed or went through my veins altogether. After calling in another med tech/phlebotomist that did the third venipuncture, this one was finally able to obtain the required blood for my lab work.  Good thing, too; I didn’t want to be stuck in the doctor’s office all morning. (Sorry! Couldn’t resist.)

Phlebotomists perform a key diagnostic service in a wide range of health care settings. Depending upon what a patient’s condition is, their ability to obtain proper blood samples could ultimately be life saving. Another good part of the job, many phlebotomists say, is their time spent interacting with patients (and hopefully executing a flawless venipuncture/withdrawl). Especially in a large hospital setting or a major urban laboratory, the range of patients and personalities are quite varied.

Keep in mind that drawing someone’s blood, inserting a needle into their skin while the patient is conscious, is a fairly intimate process. There’s a certain unspoken trust level between the phlebotomist and patient. The patient/donor is trusting the phlebotomist to puncture their skin, obtain accurate and requisite amount of samples as rapidly as possible, while at the same time entrusting the phlebotomist to cause as little pain as possible during the procedure. 

Job Requirements & Training

True Blood
True Blood (Photo credit: Lori Greig)
To become a phlebotomist, one must have a high school diploma or G.E.D. Coursework is required, usually at community colleges, private colleges and even some hospitals. The training varies, typically three to six months. There are clinical hours one must also obtain; oftentimes these are encompassed in the program.  You should always look for an accredited program.

Upon completion, especially if one’s completed an accredited course track, then she or he can oftentimes get certified immediately. Or, after working for a requisite amount of hours, one can take the certification test. By becoming credentialed, phlebotomists demonstrate their competence to carry out their responsibilities, which in turn, allow them increased job prospects, higher salaries, and to gain the respect of other health care professionals. There are different certifying bodies such as The American Society for Clinical Pathology (ASCP), American Society for Phlebotomy Professionals (ASPT) and National Phlebotomy Association. Getting accredited is highly recommended to best further one’s career opportunities.

If a would-be phlebotomist is training at a health care facility, their coursework and training is usually variable, based on a combination of education, experience and on-the-job training.

In this article, I discussed the highly favorable job outlook for phlebotomists, described what their various
responsibilities are (predominately in a hospital setting), described the process of venipuncture, and also talked about educational requirements and credentialing. If you found this article useful, please feel free to share and repost it. If you have any questions or comments, as always, I’m eager to read them.

Combined Nuvola apps dict.png + VampireSmiley....
Combined Nuvola apps dict.png + VampireSmiley.png for use in enwiki novel stub tpl (Photo credit: Wikipedia)
Here’s something to sink your teeth into: From what many of my phlebotomist associates tell me about people’s "vain" attempt at humor, most don’t like being referred to as vampires. 

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on FacebookTwitterGoogle+LinkedIn and YouTube

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Wednesday, July 2, 2014

Humerus Я Us, Part 4

By Rick Fromme

As I’ve pointed out in earlier versions of this series, the study of laughter, scientifically known as gelotology, has repeatedly shown that humor, laughing, etc., creates a variety of positive physiological stimuli that affects our immune system, cardiopulmonary system and others.  (See my previous blog, “Humerus  Я Us.”) 

I don’t know about you, but I’d rather be laughing. So let’s get to it … Stat!  

Specialty Related Humor


As a pharmacist, I am often patients’ source of information about their medications. When one woman came to the pharmacy to get a refill on her suppositories, she asked me if I had any suggestions she could bring to her doctor. She said that the suppositories were not working. “And not only don’t they work, they hurt! Sometimes they even make me bleed!”

I looked at her prescription, pulled some suppositories from the shelf, and opened the box for her. She then showed me that the corners of the hard foil wrapper were sharp. Of course, I cringed when I realized that she was not removing the hard foil covers before inserting them.


An elderly patient went to have her teeth checked.

"Mrs. Sherman, your teeth are good for the next 50 years," the dentist beamed.

To which she replied,"I wonder … what will they do without me?"

A patient has a sore throat and goes to her doctor for a diagnosis. Doctor: “Your tonsils are infected and need to be removed,” the doctor says. I’ll refer you to an ENT. 
“Doctor, with all due respect, I’d like a second opinion,” the dubious patient says.
“Okay,” quips the doctor. “You’re ugly, too. So I’ll also refer you to a cosmetic surgeon.”  

Q: Should I have a baby after 35?
A: No. 35 children is enough.

Q: I'm two months pregnant now. When will my baby move?
A: With any luck, right after he finishes college.

Q: What’s the most common pregnancy craving?
A: For men to be the ones who get pregnant.

Q: What’s the most reliable method to determine a baby's sex?
A: Childbirth.

Q: My childbirth instructor says it's not pain I'll feel during labor, but pressure. Is she right?
A: Yes, in the same way that a tornado might be called an air current.

 A Letter to The Patient's GP Please, Angela

A Baker’s Dozen of Tom Swifties

Created by Edward Stratemeyer, a Tom Swifty (or Tom Swiftie) is a pithy phrase in which a sentence is linked by an adverbial pun that’s related to the subject of the phrase.

"We can take on one more patient today," Dr. Tom admitted.

"The pain’s between my sole and my heel," said Tom archly.

"I need a syringe of adrenaline, now!” barked Dr. Tom, with a bow.

"I'm losing my hair," Tom bawled.

“The patient is Code Blue!” Dr. Tom shouted alarmingly.

"I wouldn't give that nursing student a grade of A," Professor Tom said beratingly.

"I dropped the toothpaste," signaled Tom, crestfallen.

“My new abstract is to be published in an upcoming book,” Professor Tom said contentedly.

"I feel terrible. I think I’m dying," Tom croaked.

"Don't add too much saline," said Dr. Tom with great concentration.

"This decay wasn't there before," said Tom neurotically.

"I won't tell you anything about my salivary glands," said Tom secretively.

"I'm glad I passed my EKG," Tom said wholeheartedly.

Season Three Bloopers Medical Course 

Rhyme Time

The Dentist's Chair

In the dentist's chair I lie,
I am not brave, I think I'll cry.
He turns to me my tooth to fill,
I start to sweat I hear the drill.
I reach around and grab his crutch,
I begin to squeeze, but not too much.
I move my gaze his eyes to view.
“If you hurt me then I'll hurt you.”

Another Senior Moment

My eyes require an examination,
So I have to visit the optician.
As I walk along I can see the sign,
So for the door I make a beeline.      
As I walk through the door I used,
I pause, more than a little confused.
I look around for a place to hide,
As I’ve just walked into the Nationwide.

Is it Urgent?

I awake unwell with swollen glands, 
With fevered brow and sweaty hands.
I shake and shiver and cough and sneeze,
I sweat and flush and choke and wheeze.
I mutter and mumble and grunt and groan,
As I struggle downstairs to find the phone.
I first call work to let them know,
To the office today I will not show.
And then the doctor’s line I dial,
A stern voice answers in a while.
“What name?” is the curt response.
An appointment please, I say at once.
Well is it urgent? She retorts,
“Well, I’m not dying, just out of sorts.”
“You can see a doctor in three weeks time,”
“I hope to be better by then,” I chime.
“Shall I book you an appointment then?”
“No, if I’m not better I’ll call again.
But I'll say to you without offence,
If I’m still ill in three weeks hence,
I’ll eat my hat till I eat my fill
For I have never, ever been so ill.”
                    Bench Doctor Prank

Amused by the News 

True Story

ER Places Bowl Full of Percocet in Waiting Room, Lowers Visits

HANOVER, NJ – Local emergency medicine physicians have developed a ground-breaking way to reduce the number of patients they will see during a shift.  The new policy mimics a common Halloween tradition: leave a bowl full of candy outside with a sign that says Take One’  — allowing one to get drunk and not be bothered by children.

Placing a large bowl of Percocet in the waiting room has drastically cut down on the number of patients checking in at Holy Cross Hospital’s ER.  “We basically say you are on the honor system,” Dr. Runofsky told Gomerblog, quenching concerns about patients taking too many pills home. “They came here demanding ‘Pain Drugs’ so help yourself.”

Typically an ER physician will argue with patients all night long regarding narcotic prescriptions. This causes longer wait times in the ER waiting room for all other comers.  People with sore arms, teeth, ears, frenulums, and chronic abdominal pain will visit local ERs at odd hours for the remote hope that they will be prescribed Percocet — Dilaudid if the opioid gods find favor them.

“At first I was a little cynical of this new plan,” Dr. Harvey told reporters. “I mean most pain patients are allergic to Vicodin, Percocet, Motrin, and Tylenol, therefore — and quite coincidentally — Dilaudid is the only medication that helps with their pain. Was I ever wrong! Last night we had a no-hitter.  That is the first on the books.”

Local resident, Patricia Storm, who used to have a Tylenol allergy raves about the new program. “I used to have a Tylenol allergy but that is when I had to wait three hours to get Dilaudid! Now all I have to do is walk in take a handful of Percocet and head home. My day isn’t ruined by my 10/10 pain.”
Costs have fallen, storage closets are full of script pads, wait times are at record lows, and the ER hasn’t received a complaint in months. Dilaumed prescriptions, not to be confused with Dilaudid, have disappeared completely.
Critics argue some patients prefer Oxycodone and even Fentanyl lollipops for their pain.  Dr. Runofsky replied with an easy solution, “They can wait if they want to.”
To date no one has.

In this article, I briefly described some of the physiological  benefits researchers have found can be attributed to regular "doses" of laughter.  I shared jokes, "Tom Swifties," funny headlines and a news story, poems, videos and images all designed to get you laughing. If you liked this article, please pass it around and share it with others. If you'd like to leave a comment, link, joke, etc., please do so in the comment section below. 
Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on FacebookTwitterGoogle+LinkedIn and YouTube

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