Thomas J. Fogarty
Encyclopedia
Dr. Thomas J. Fogarty is an American surgeon and inventor of the embolectomy
Embolectomy
Embolectomy is the emergency surgical removal of emboli which are blocking blood circulation. It usually involves removal of thrombi , and is then referred to as thrombectomy. Embolectomy is an emergency procedure often as the last resort because permanent occlusion of a significant blood flow to...

 catheter
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...

. Before his invention the success rate for removing an embolus
Embolus
An embolus is any detached, itinerant intravascular mass carried by circulation, which is capable of clogging arterial capillary beds at a site distant from its point of origin.By contrast there are non-traveling blockages that develop locally from vascular trauma or...

, or blood clot, was forty to fifty percent. In 1963, Dr. Thomas Fogarty published an article describing "a new method for extraction of arterial emboli and thrombi."

The balloon embolectomy catheter was used on a human patient for the first time six weeks after Fogarty came up with the idea in 1961. Today, using only local anesthesia
Local anesthesia
Local anesthesia is any technique to induce the absence of sensation in part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with...

, the procedure only takes about an hour.

Fogarty’s invention
Invention
An invention is a novel composition, device, or process. An invention may be derived from a pre-existing model or idea, or it could be independently conceived, in which case it may be a radical breakthrough. In addition, there is cultural invention, which is an innovative set of useful social...

s and the many others that resulted from his original embolectomy catheter heavily influenced the way surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 was performed. When asked about the time the impact his invention had on the field, he says, "I had no concept that [non-invasive surgery] would reach the magnitude that it has." As a result of the invention, Dr. Fogarty, still alive today, went on to win many prizes and patent over sixty inventions.

Early life and education

On February 25, 1934, Fogarty was born into a poor, Irish Catholic
Irish Catholic
Irish Catholic is a term used to describe people who are both Roman Catholic and Irish .Note: the term is not used to describe a variant of Catholicism. More particularly, it is not a separate creed or sect in the sense that "Anglo-Catholic", "Old Catholic", "Eastern Orthodox Catholic" might be...

 family as the youngest of three children living in Cincinnati. His father worked as a railroad engineer, but he died when Fogarty was just eight years old.

Fogarty assumed a role of greater responsibility at a young age, but, as he points out later in life, his father’s absence also nurtured his own creative nature as an inventor. He fixed things that his mother needed fixed, and he worked with soapbox derby cars and model airplanes. "I just had a natural inclination and inquisitive nature about building things. I looked at things and just naturally thought, 'Okay, how can I make this better?'" His business side was evident in childhood as well. The model airplanes that he built were sold to neighborhood kids. When he became frustrated with motor scooter gears, he built and sold a centrifugal clutch
Centrifugal clutch
A centrifugal clutch is a clutch that uses centrifugal force to connect two concentric shafts, with the driving shaft nested inside the driven shaft....

.

As for Fogarty’s educational background, he was not a top-notch student, and his original career goal was to be a boxer. “I wasn’t a very good kid. They sent me to a camp to keep me out of trouble. One of the routine activities was boxing. I became the Midwest Golden Glove
Golden Gloves
The Golden Gloves is the name given to annual competitions for amateur boxing in the United States. The Golden Gloves is often the term used to refer to the National Golden Gloves competition, but it also can represent several other amateur tournaments, including regional golden gloves...

 champ.”

To help his family get by in the late 1940s, fourteen-year old Fogarty started working at Good Samaritan Hospital
Good Samaritan Hospital
Good Samaritan Hospital may refer to:In the United States:*Good Samaritan Hospital — San Jose, California*Good Samaritan Hospital — Los Angeles*Advocate Good Samaritan Hospital — Downers Grove, Illinois...

 during a time when hospitals were still exempt from child labor laws. He began the job cleaning medical equipment in the eighth grade, but he continued working during his high school summer vacations and was soon promoted to scrub technician, a person who handed medical instruments to surgeons.

During his last year of high school, Fogarty discovered that he wanted to be a doctor. At the age of 17, he quit his boxing career after he broke his nose in a match that ended in a draw. A family priest gave him a recommendation, and because of his awful grades, he was admitted to Cincinnati’s Xavier University on probation.
In order to get through college, Fogarty took on three jobs and received financial assistance from Dr. Jack Cranley, Fogarty’s mentor and one of the most prominent vascular surgeons in the United States. Fogarty was Cranley’s private scrub technician at Good Samaritan Hospital. “I had a mentor who encouraged me and helped to persuade me to go to college…He had 10 kids and I became the 11th. He always told me, ‘You are smarter than you think.’”

Fogarty graduated from Xavier University with a bachelor’s degree in biology in 1956 and went on to attend the Cincinnati College of Medicine where he graduated in 1960. From 1960 to 1961, he interned at the University of Oregon Medical School in Portland, Oregon
Portland, Oregon
Portland is a city located in the Pacific Northwest, near the confluence of the Willamette and Columbia rivers in the U.S. state of Oregon. As of the 2010 Census, it had a population of 583,776, making it the 29th most populous city in the United States...

, and he completed his surgical residency at the same school in 1965.

Invention of the embolectomy catheter

During Fogarty’s years at Good Samaritan Hospital, he witnessed the deaths of many patients who died from complications in blood clot surgeries in their limbs. “Fifty percent of the patients died. I thought there must be a better way.” Before Fogarty’s invention, surgeons had to use forceps to remove the blood clots only after a huge part of an artery
Artery
Arteries are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries....

 had been cut open, and the patient would be under general anesthesia for hours. Blood flow is usually interrupted in the procedure, increasing the risk of the patient losing a limb.

At home, the ideas that went through Fogarty’s head concerned different ways of making the procedure better, and he especially concentrated on avoiding the risky incisions. He tinkered with a urethral catheter and a balloon in his attic. Because a catheter only required a small incision, it would be able to get to the clot without much trauma to the patient. The urethral catheter is also flexible yet strong enough to be pushed through a blood clot. As for the balloon, he basically cut off the tip of the pinky finger of a size 5 surgical latex glove and attempted to incorporate it onto the end of the catheter. The resulting balloon could be inflated with saline using a syringe
Syringe
A syringe is a simple pump consisting of a plunger that fits tightly in a tube. The plunger can be pulled and pushed along inside a cylindrical tube , allowing the syringe to take in and expel a liquid or gas through an orifice at the open end of the tube...

, and once it expands to the size of the artery, it is then retracted, withdrawing the clot through the artery and out the incision.

The main problem in building this device was the way the balloon could be attached to the catheter. Glue that could hold vinyl
Vinyl
A vinyl compound is any organic compound that contains a vinyl group ,which are derivatives of ethene, CH2=CH2, with one hydrogen atom replaced with some other group...

, the material making up a catheter, and latex, the type of glove used, was not available. Fogarty’s own take on the catheter came about because of fly fishing
Fly fishing
Fly fishing is an angling method in which an artificial 'fly' is used to catch fish. The fly is cast using a fly rod, reel, and specialized weighted line. Casting a nearly weightless fly or 'lure' requires casting techniques significantly different from other forms of casting...

 techniques he learned as a child. Precise hand-tying was needed in fly fishing, and with these techniques, he tied the balloon to the catheter. "I'd always tied flies and made lures so it was just a natural thing." His experimental balloon catheter, however, always seemed to burst when it was over inflated. It even broke when he dragged it through glass tubes filled with Jell-o
Jell-O
Jell-O is a brand name belonging to U.S.-based Kraft Foods for a number of gelatin desserts, including fruit gels, puddings and no-bake cream pies. The brand's popularity has led to it being used as a generic term for gelatin dessert across the U.S. and Canada....

, a model he thought simulated a clot within an artery. After some time, he figured out the type and thickness of rubber that was firm enough when inflated to extract a clot and still flexible enough to move through without breaking. The device, made before Fogarty even received his MD from University of Cincinnati in 1960, became the first minimally invasive surgical device.

Fogarty, however, came across difficulties in getting a manufacturer to produce it. From 1959 to 1961, nobody was willing to help. "Companies thought I was some stooge fooling around. I didn't have any credibility." Dr. Cranley continued to encourage him, and soon, during his fellowship training at the University of Cincinnati in 1961 and 1962, Fogarty started to make the catheter system by hand for himself and for other vascular surgeons.

At the University of Oregon, while Fogarty was completing his residency in surgery, Dr. Al Starr, head of the cardiothoracic division, used Fogarty’s balloon catheters. After he was informed that no company was willing to manufacture Fogarty’s device, he asked one of his acquaintances, Lowell Edwards, an electrical engineer and president of his own company, to give the device consideration in producing it. In 1969, Fogarty patented his device, and Edwards Life Sciences from Irvine, California, was assigned the patent to begin manufacturing the Fogarty embolectomy catheter.

Because of the decreased risk associated with the device, it became the industry standard. It is still the most widely used catheter for blood-clot removal today and has been used in over three hundred thousand procedures every year all over the world. It is estimated to have saved the lives and limbs of approximately fifteen million patients.

Other inventions

Numerous sequel applications of Fogarty’s catheter came about. The first balloon angioplasty
Angioplasty
Angioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size...

, for example, was performed with a Fogarty catheter in 1965, and has led to over six hundred fifty thousand such operations per year. Fogarty has also modified his catheter to less invasive biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...

 techniques.

After completing his residency and becoming a cardiovascular surgeon, Fogarty continued to invent new medical devices as a holder of more than 60 patents, with more still pending. Based on many of the devices founded in his own Fogarty Engineering, Inc., around twenty companies have been started.

One of Fogarty’s most successful products is the Stent
Stent
In the technical vocabulary of medicine, a stent is an artificial 'tube' inserted into a natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction. The term may also refer to a tube used to temporarily hold such a natural conduit open to allow...

-Graft. This dealt with the difficult problem of abdominal aortic aneurysm
Abdominal aortic aneurysm
Abdominal aortic aneurysm is a localized dilatation of the abdominal aorta exceeding the normal diameter by more than 50 percent, and is the most common form of aortic aneurysm...

s, which is a term referring to a weakened blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...

. The old method was to remove the bad part of a weakened blood vessel, but Fogarty’s idea was to support it with an implant. He used a stent, a thin polyester tube that grabs onto the blood vessels. A catheter transports the stent to the weakened blood vessel, and once the balloon is inflated, the stent expands to the size of the blood vessel, and blood flows normally.

Thomas Fogarty Winery and Vineyards

In 1969, when he began teaching surgery at the Stanford University Medical Center
Stanford University Medical Center
Stanford University Medical Center represents the Stanford Hospital and the Lucile Packard Children's Hospital and is located at 300 Pasteur Drive in Stanford, California. Stanford Hospital provides both general acute care services and tertiary medical care for patients locally, nationally and...

, Fogarty was first introduced to the wine industry. He helped out a Stanford colleague’s small winery with vineyard and cellar practices. Later on, he purchased land in the Santa Cruz Mountains. He established a cellar there and began making wine with grapes bought from nearby growers. He planted his first vines in 1978 and set up a commercial winery, Thomas Fogarty Winery and Vineyards, in 1981. The estate now consists of three hundred twenty-five acres. Fifteen thousand cases of wine are produced annually.

Fogarty’s basis for winemaking
Winemaking
Winemaking, or vinification, is the production of wine, starting with selection of the grapes or other produce and ending with bottling the finished wine. Although most wine is made from grapes, it may also be made from other fruit or non-toxic plant material...

 also stems from his explanation that certain elements in the extracts from grape skin relax the blood vessels and lower the affinity for blood to clot.

Of the wines produced in Fogarty’s vineyard, the 2004 SCM Lexington Meritage wine received “double gold” status in the San Francisco International Wine Competition in 2008, and the 2005 Santa Cruz Mountains Chardonnay was the gold medal winner and the “Best Chardonnay of Class” in the 2008 San Francisco Chronicle Wine Competition.

Three Arch Partners

Fogarty, along with Mark Wan and Wilfred Jaeger, co-founded a venture capital
Venture capital
Venture capital is financial capital provided to early-stage, high-potential, high risk, growth startup companies. The venture capital fund makes money by owning equity in the companies it invests in, which usually have a novel technology or business model in high technology industries, such as...

 firm called Three Arch Partners in Portola Valley, California, in 1993. Wan and Jaeger both had noteworthy experience in the venture capitalism field, but it was Fogarty’s prestige that caused the firm to grow.

Three Arch Partners focused on early stage medical device companies and has helped with the growth of more than fifty new healthcare companies. It manages over one billion dollars in capital.

In 2004, however, Fogarty was fired from the firm. He was let go due to issues pertaining to the amount of time Fogarty devoted to the firm. His time spent teaching, making wine, and working Fogarty Engineering, Inc. contributed to this decision. “It’s like giving birth to a child, but then having to leave it behind, which is hurtful, but I’ve been kicked of better places than [Three Arch], and I wouldn’t say that I wish them well.”

The Fogarty Institute for Innovation

Fogarty left Stanford Medical School after about fourteen years as a professor and practicing cardiovascular surgeon. In September 2007, at Mountain View, California, in Silicon Valley
Silicon Valley
Silicon Valley is a term which refers to the southern part of the San Francisco Bay Area in Northern California in the United States. The region is home to many of the world's largest technology corporations...

, he founded the Thomas Fogarty Institute for Innovation
Innovation
Innovation is the creation of better or more effective products, processes, technologies, or ideas that are accepted by markets, governments, and society...

. It occupies forty-five hundred square feet of offices and engineering labs on the campus of El Camino Hospital
El Camino Hospital
El Camino Hospital is a 395-bed hospital based in Mountain View, California.Located on a campus in the heart of Silicon Valley, El Camino Hospital serves residents in the El Camino Hospital District — Mountain View, Los Altos, Los Altos Hills, and portions of Sunnyvale and Palo Alto — as...

. The educational, non-profit organization mentors and trains medical innovators. The idea for the institution dates back to Fogarty’s early life when he received encouragement from Dr. Jack Cranley.

“We are teaching people (doctors and engineers) how to get their concepts and products into use. Very few have gone through the process of coming up with a concept and getting it funded. That does not come naturally. It comes through experience. We will teach how to address these challenges.” Physician innovators, including Fogarty, serve as the faculty of the Institute and make use of their networks and experiences in the private industry to help those with projects that are ready for commercialization
Commercialization
Commercialization is the process or cycle of introducing a new product or production method into the market. The actual launch of a new product is the final stage of new product development, and the one where the most money will have to be spent for advertising, sales promotion, and other marketing...

.

Awards

  • Inventor of the Year, San Francisco Patent and Trademark Association, 1980
  • Distinguished Scientific Presentations, American College of Surgeons, 1971, 1973, 1975, 1981
  • Honorary Doctorate, Xavier University, 1987
  • The Lemelson-MIT Prize, 2000
  • AAMI Foundation Laufman-Greatbatch Prize, 2000
  • National Inventors Hall of Fame, 2001

Affiliated organizations

  • American Association for Thoracic Surgery
  • American College of Physician Inventors
  • American College of Surgeons, Fellow
  • American Surgical Association
  • International Society for Cardiovascular Surgery-North American Chapter
  • International Society of Endovascular Specialists
  • Pacific Coast Surgical Association
  • Society for Clinical Vascular Surgery
  • Society of Vascular Technology; The Society for Vascular Surgery
  • The Society of Thoracic Surgeons
  • Western Thoracic Surgical Society

See also

  • Jerome H. Lemelson
    Jerome H. Lemelson
    Jerome "Jerry" Hal Lemelson was a prolific American engineer, inventor, and patent holder...

  • National Inventors Hall of Fame
    National Inventors Hall of Fame
    The National Inventors Hall of Fame is a not-for-profit organization dedicated to recognizing, honoring and encouraging invention and creativity through the administration of its programs. The Hall of Fame honors the men and women responsible for the great technological advances that make human,...

  • Surgical technologist
    Surgical technologist
    A surgical technologist, also called "scrub tech," "surgical technician," or "operating room technician", is an allied health professional working as a part of the team delivering surgical care in some countries. They possess knowledge and skills in sterile and aseptic techniques...

  • Vascular surgery
    Vascular surgery
    Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery...


Selected patents


External links

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