Dr. Thomas J. "Tom" Fogarty (born February 25, 1934 in
Cincinnati, Ohio
Cincinnati ( ) is a city in the U.S. state of Ohio and the county seat of Hamilton County. Settled in 1788, the city is located at the northern side of the confluence of the Licking and Ohio rivers, the latter of which marks the state line wit ...
) is an American surgeon and medical device inventor. He is best known for the invention of the
embolectomy catheter
Embolectomy is the emergency surgical removal of emboli which are blocking blood circulation. It usually involves removal of thrombi (blood clots), and is then referred to as thrombectomy. Embolectomy is an emergency procedure often as the last re ...
(or balloon catheter), which revolutionized the treatment of blood clots (
embolus
An embolus (; plural emboli; from the Greek ἔμβολος "wedge", "plug") is an unattached mass that travels through the bloodstream and is capable of creating blockages. When an embolus occludes a blood vessel, it is called an embolism or emb ...
).
In 2008, Fogarty was elected a member of the
National Academy of Engineering
The National Academy of Engineering (NAE) is an American nonprofit, non-governmental organization. The National Academy of Engineering is part of the National Academies of Sciences, Engineering, and Medicine, along with the National Academy ...
for invention of the balloon catheter and devices that have revolutionized vascular surgery, and for creating companies to commercialize these inventions.
Early life and education
Fogarty was born in
Cincinnati, Ohio
Cincinnati ( ) is a city in the U.S. state of Ohio and the county seat of Hamilton County. Settled in 1788, the city is located at the northern side of the confluence of the Licking and Ohio rivers, the latter of which marks the state line wit ...
, on February 25, 1934. His father worked as a railroad engineer, but died when Fogarty was eight years old.
Fogarty cites his father's absence as being influential in his own creative nature as an inventor. He fixed things that needed to be fixed for his mother, and he worked with
soapbox derby
The Soap Box Derby is a youth soapbox car racing program which has been run in the United States since 1933. World Championship finals are held each July at Derby Downs in Akron, Ohio. Cars competing in this and related events are unpowered, ...
cars and
model airplanes
A model aircraft is a small unmanned aircraft. Many are replicas of real aircraft. Model aircraft are divided into two basic groups: flying and non-flying. Non-flying models are also termed static, display, or shelf models.
Aircraft manufactur ...
. "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
A centrifugal clutch is an automatic clutch that uses centrifugal force to operate. The output shaft is disengaged at low rotational speed and engages more as speed increases. It is often used in mopeds, underbones, lawn mowers, go-karts, chainsaws ...
.
Fogarty was not a good 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."
To help his family get by in the late 1940s, Fogarty started working at
Good Samaritan Hospital
Good Samaritan Hospital or Good Samaritan Medical Center may refer to:
India
*Good Samaritan Hospital (Panamattom), Koprakalam, Panamattom, Kerala
*Good Samaritan Centre, Mutholath Nagar, Cherpunkal, Kottyam, Kerala
United States
*Banner - Univer ...
, beginning with cleaning medical equipment while he was in the eighth grade at school.
He continued working during his high school summer vacations and was soon promoted to scrub technician, a person who handed medical instruments to surgeons – he witnessed his first surgery at a young age. It was during this time that he first met Dr. Jack Cranley, who would have a major influence on Fogarty's future career.
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
Xavier University ( ) is a private Jesuit university in Cincinnati and Evanston (Cincinnati), Ohio. It is the sixth-oldest Catholic and fourth-oldest Jesuit university in the United States. Xavier has an undergraduate enrollment of 4,860 studen ...
on probation.
Jack Cranley, one of the most prominent
vascular surgeons
Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty ...
in the United States became his mentor. Speaking of Cranley, Fogarty later stated: “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
University of Cincinnati College of Medicine
The University of Cincinnati Academic Health Center (AHC) is a collection of health colleges and institutions of the University of Cincinnati, Cincinnati, Ohio. It trains health care professionals and provides research and patient care. AHC has st ...
, where he graduated summa cum laude in 1960. From 1960 to 1961, he interned at the
University of Oregon Medical School
Oregon Health & Science University (OHSU) is a
public research university focusing primarily on health sciences with a main campus, including two hospitals, in Portland, Oregon. The institution was founded in 1887 as the University of Oregon Medi ...
in
Portland, Oregon
Portland (, ) is a port city in the Pacific Northwest and the largest city in the U.S. state of Oregon. Situated at the confluence of the Willamette and Columbia rivers, Portland is the county seat of Multnomah County, the most populous co ...
, 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
Forceps (plural forceps or considered a plural noun without a singular, often a pair of forceps; the Latin plural ''forcipes'' is no longer recorded in most dictionaries) are a handheld, hinged instrument used for grasping and holding objects. Fo ...
to remove the blood clots only after a huge part of an
artery
An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...
had been cut open, and the patient would be under
general anesthesia
General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general ...
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
urethra
The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra con ...
l
catheter
In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...
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
Saline may refer to:
* Saline (medicine), a liquid with salt content to match the human body
* Saline water, non-medicinal salt water
* Saline, a historical term (especially US) for a salt works or saltern
Places
* Saline, Calvados, a commune in ...
using a
syringe
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
, 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 may refer to:
Chemistry
* Polyvinyl chloride (PVC), a particular vinyl polymer
* Vinyl cation, a type of carbocation
* Vinyl group, a broad class of organic molecules in chemistry
* Vinyl polymer, a group of polymers derived from vinyl m ...
, 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 fishing techniques he learned as a child. Precise hand-tying was needed in 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 is an American brand offering a variety of powdered gelatin dessert (fruit-flavored gels/jellies), pudding, and no-bake cream pie mixes. The original gelatin dessert (genericized as jello) is the signature of the brand. "Jell-O" is a reg ...
, 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
Minimally invasive procedures (also known as minimally invasive surgeries) encompass surgical techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definition ...
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
Irvine () is a Planned community, master-planned city in South Orange County, California, United States, in the Los Angeles metropolitan area. The Irvine Company started developing the area in the 1960s and the city was formally incorporated on ...
, was assigned the patent to begin manufacturing the Fogarty embolectomy catheter.
Because of the decreased risk associated with the device, Fogarty's balloon catheter became the industry standard and remains the most widely used catheter for blood-clot removal. Before his invention the success rate for removing an embolus, or blood clot, was forty to fifty percent. The balloon catheter is now used in over three hundred thousand procedures every year all over the world, and is estimated to have saved the lives and limbs of approximately twenty million patients.
Other inventions
Numerous sequel applications of Fogarty's catheter came about. The first balloon
angioplasty
Angioplasty, is also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA), is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atheroscle ...
, 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
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...
techniques.
After completing his residency and becoming a cardiovascular surgeon, Fogarty continued to invent new medical devices. One of his most successful products is the
Stent
In medicine, a stent is a metal or plastic tube inserted into the lumen of an anatomic vessel or duct to keep the passageway open, and stenting is the placement of a stent. A wide variety of stents are used for different purposes, from expandab ...
-Graft, which dealt with the difficult problem of
abdominal aortic aneurysm
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. They usually cause no symptoms, except during rupture. Occasionally, abdominal, ...
s (a term referring to a weakened
blood vessel
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away ...
). 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.
Fogarty's other inventions include Fogarty surgical clips and clamps, which are used by cardiac and vascular surgeons to temporarily occlude vessels during surgery. Working with Warren Hancock, he is co-inventor of the Hancock tissue heart valve – the world's first porcine valve.
Fogarty's own inventions and the many others that resulted from his original embolectomy catheter heavily influenced the way surgery was performed. Considered one of the pioneers of minimally-invasive surgery, Fogarty has said: "I had no concept that
on-invasive surgerywould reach the magnitude that it has."
As a result of the embolectomy catheter and other inventions, Dr. Fogarty has won many prizes, including the
National Medal for Technology and Innovation in 2012,
and a Lifetime Achievement Award from the
Advanced Medical Technology Association (AdvaMed) in 2015.
He has published around 180 scientific articles and textbook chapters in the fields of general and cardiovascular surgery. He served as President of the
Society for Vascular Surgery
The Society for Vascular Surgery (SVS) is the major national academic society for vascular surgery in the United States. Its mission includes education, research, career development and advocacy. The SVS is the national advocate for more than 6,00 ...
from 1995-1996.
Innovation and entrepreneurship
Fogarty founded Fogarty Engineering, Inc. in 1980, to promote ideas for new medical devices, and has founded/co-founded and chaired the board for many business and research companies based on devices developed at the company.
In 1993, with Mark Wan and Wilfred Jaeger, he founded Three Arch Partners, a
venture capital fund
Venture capital (often abbreviated as VC) is a form of private equity financing that is provided by venture capital firms or funds to startups, early-stage, and emerging companies that have been deemed to have high growth potential or which hav ...
to invest in new technology and medical devices.
As a pioneer and supporter of innovation in medical technology, Fogarty has acquired over 160 patents for his medical work.
He is associated with numerous medical technology companies and was appointed as an independent director to the Board of Pulse Biosciences in 2017. He is managing director of early-stage life science
accelerator Emergent Medical Partners.
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
Mountain View is a city in Santa Clara County, California, United States. Named for its views of the Santa Cruz Mountains, it has a population of 82,376.
Mountain View was integral to the early history and growth of Silicon Valley, and is the ...
, he founded the Thomas Fogarty Institute for Innovation. It occupies forty-five hundred square feet of offices and engineering labs on the campus of
El Camino Hospital
El Camino Health is a non-profit hospital with 420 beds (Mountain View Main Campus) based on a campus in Mountain View, California. There is a second, smaller hospital campus, El Camino Hospital, Los Gatos, in Los Gatos, with additional satellit ...
. 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 or commercialisation is the process of introducing a new product or production method into commerce—making it available on the market. The term often connotes especially entry into the mass market (as opposed to entry into ear ...
.
Thomas Fogarty Winery and Vineyards
In 1969, when he began teaching surgery at the
Stanford University Medical Center
Stanford University Medical Center is a medical complex which includes Stanford Health Care and Stanford Children's Health. It is consistently ranked as one of the best hospitals in the United States and serves as a teaching hospital for the ...
, Fogarty was first introduced to wine. He helped out at a Stanford colleague's small winery. Later on, he purchased land in the
Santa Cruz Mountains
The Santa Cruz Mountains, part of the Pacific Coast Ranges, are a mountain range in central and Northern California, United States. They form a ridge down the San Francisco Peninsula, south of San Francisco. They separate the Pacific Ocean from ...
. He established a cellar there and began making wine with grapes bought from nearby growers. With help from founding winemaker Michael Martella, he planted his first vines in 1978 and set up a commercial winery, Thomas Fogarty Winery and Vineyards, in 1981, largely in order to share a business with his family. The estate now has thirty acres under vine, which are farmed organically.
The winery is run today by Tom Fogarty, Jr and the Fogarty family with production overseen by Winegrower Nathan Kandler. The younger Fogarty is widely credited for introducing a line of kosher-for-Passover sweet wines to the Portola Valley winemaking region. It has become well known as a top producer of single-vineyard
Pinot Noir
Pinot Noir () is a red-wine grape variety of the species ''Vitis vinifera''. The name may also refer to wines created predominantly from pinot noir grapes. The name is derived from the French language, French words for ''pine'' and ''black.' ...
and
Chardonnay
Chardonnay (, , ) is a green-skinned grape variety used in the production of white wine. The variety originated in the Burgundy wine region of eastern French wine, France, but is now grown wherever wine is produced, from English wine, Englan ...
wines. Thomas Fogarty Winery was named by ''Wine and Spirits'' magazine as one of its top 100 wineries in 2014.
Awards
* Distinguished Scientific Presentations,
American College of Surgeons
The American College of Surgeons is an educational association of surgeons created in 1913.American College of Surgeons Online "What is the American College of Surgeons?"/ref>
See also
*American College of Physicians
The American College o ...
, 1971, 1973, 1975, 1981
*Inventor of the Year, San Francisco Patent and Trademark Association, 1980
* Honorary Doctorate, Xavier University, 1987
*
Lemelson-MIT Prize, 2000
* AAMI Foundation Laufman-Greatbatch Prize, 2000
*
National Inventors Hall of Fame
The National Inventors Hall of Fame (NIHF) is an American not-for-profit organization, founded in 1973, which recognizes individual engineers and inventors who hold a U.S. patent of significant technology. Besides the Hall of Fame, it also opera ...
, 2001
* Medical Design Excellence Awards Lifetime Achievement Award, 2012
*
National Medal of Technology and Innovation
The National Medal of Technology and Innovation (formerly the National Medal of Technology) is an honor granted by the President of the United States to American inventors and innovators who have made significant contributions to the development ...
, 2012
*
AdvaMed
AdvaMed, or the Advanced Medical Technology Association, is an American medical device trade association, based in Washington, D.C. It is the largest medical device association in the world with U.S. and international members who are medical tech ...
Lifetime Achievement Award, 2015
Affiliated organizations
* American Association for Thoracic Surgery
*
American College of Surgeons
The American College of Surgeons is an educational association of surgeons created in 1913.American College of Surgeons Online "What is the American College of Surgeons?"/ref>
See also
*American College of Physicians
The American College o ...
, Fellow
*
American Surgical Association The American Surgical Association is the oldest surgical organization in the United States.
History
It was founded in 1880. Their publication, ''Annals of Surgery'', was started in 1885.
A collection of the association's papers are held at the Nat ...
* International Society for Cardiovascular Surgery-North American Chapter
* International Society of Endovascular Specialists
*
National Academy of Engineering
The National Academy of Engineering (NAE) is an American nonprofit, non-governmental organization. The National Academy of Engineering is part of the National Academies of Sciences, Engineering, and Medicine, along with the National Academy ...
, Member
* Pacific Coast Surgical Association
* Society for Clinical Vascular Surgery
*
Society of Thoracic Surgeons
The Society of Thoracic Surgeons is a Chicago, Illinois (US)-based medical specialty professional society in the field of cardiothoracic surgery
Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the ...
*
Society for Vascular Surgery
The Society for Vascular Surgery (SVS) is the major national academic society for vascular surgery in the United States. Its mission includes education, research, career development and advocacy. The SVS is the national advocate for more than 6,00 ...
* Society of Vascular Technology
* Western Thoracic Surgical Society
References
Selected patents
Fogarty, U.S. Patent 3,435,826, “Embolectomy Catheter”Fogarty, U.S. Patent 3,880,166, “Vessel Occluder”Fogarty, U.S. Patent 4,643,194, “Flexible calibrator”Fogarty, U.S. Patent 4,774,949, “Deflector guiding catheter”Fogarty, U.S. Patent 4,821,719, “Cohesive-adhesive atraumatic clamp”
{{DEFAULTSORT:Fogarty, Thomas J.
1934 births
Living people
Physicians from Cincinnati
American vascular surgeons
American inventors