Simple invention targets blanket problem for surgical patients

In a state steeped in advanced research that spawns biomedical companies by the dozen, Apricity LLC is preposterously low-tech.

Its founders—Mark Kyker and Steve Isenberg—are medical doctors, not university or Fortune 500 scientists. And its latest product is nothing more than a warm blanket.

As unremarkable as it sounds, the blanket has the potential to reach more patients than the latest laser spectroscopy gadget.

That’s because it’s not just any warm blanket. It’s a 3-foot-by-5-foot version of the pocket hand warmer used by hunters and skiers. The doctor duo’s "Heat Treat" blanket is manufactured through a partnership with that Titan Helios of hand warmers, Grand Rapids, Mich.-based Grabber Performance Group.

Despite stunning advances in medicine, the way surgeons warm patients before, during and after surgery is practically medieval.

Typically, the stripped-down patient is heaped with blankets, warmed by air hoses attached to something like a shop vacuum working in reverse. They’re noisy, they gobble electricity, and they can blow pathogens through the air. Sometimes, patients get hose burns. From pre- to postsurgery, a patient may go through eight or nine blankets.

The Heat Treat, on the other hand, starts heating when removed from its vacuum-sealed bag. Oxygen causes a chemical reaction among the blanket’s stuffing of iron, charcoal, salt and water.

Within 20 minutes, the blanket radiates at 102.2 to 105.8 degrees for up to 12 hours, according to Apricity.

"There are no attachments. There’s no noise. It’s simple and effective. We just open it up and put it on the patient," said Kyker, an anesthesiologist at Community Hospitals and inventor of the blanket, sounding like TV pitchman Billy Mays.

It’s something perhaps only an anesthesiologist would feel so compelled to develop. Kyker and his colleagues spend a good amount of their time monitoring a patient’s core body temperature, which can drop to around 85 degrees under the effects of anesthesia.

If hypothermia sets in, chances increase for infection, bleeding and heart problems. Or drugs may not metabolize at the intended rate. Mild hypothermia is frequent among those having colon surgery, for example.

"We don’t really warm people, pre-op, really well" in particular, Kyker said.

Even if complications don’t arise from the cold, the discomfort can mar a health care provider’s patient satisfaction scores.

"So many patients are cold. It adds to their anxiety," he added.

"I think all of us realized there was a weakness in this product area, but nobody had come up with a better answer," said Isenberg, CEO of Apricity and a head and neck doctor who practices in the Community system.

Here, "it was a physician in his daily routine, looking for a solution. It just became a doable business."

Doctor, invent thyself

Medical practitioners who pound the hospital floor are an often-overlooked source of medical-device innovation. Creating a business is often tough for physicians.

"The biggest issue that they typically face is the time it takes to bring their product to market," said James A. Coles, co-chairman of the intellectual property group at local law firm Bose McKinney & Evans. Coles has represented a number of Dr. Gadgets over the last 30 years.

Usually, the products successfully launched are of a non-invasive variety, as they don’t face the same regulatory hurdles an invasive product does, he said.

One advantage doctors have is that they in some cases can test their inventions on patients—assuming patients agree and sign a release, of course. Apricity is testing its blanket in the Community Hospitals system.

It also doesn’t hurt that doctors have friends with money and expertise.

For Kyker, that person was Isenberg, who himself has helped develop devices and has invested in startups over the years. His principal business now is MedInvent, which operates out of St. Paul, Minn., and sells a nasal irrigator device known as the NasoNeb. The company is run by William Flickinger, a former medical-devices executive who worked for Minneapolis-based Medtronic Inc.

Isenberg also is co-founder of locally based StepStone Business Partners, which recently formed to help match investors with promising life sciences companies.

Apricity, which means "warmth of the winter sun," is internally funded to this point. It has filed patents on Heat Treat.

Kyker, who’s also president of the Indiana Society of Anesthesiologists, got the idea for how to create a hot blanket from his daily routine.

"When I run and it’s cold out, I use hand warmers," said Kyker, 45.

He got engineering help from Joe Vergona, a chemical engineer. Grabber, the manufacturer, made prototypes, including one Kyker used when he underwent knee surgery. The blankets can be brought home after surgery and used to keep a patient comfortable as they recover. Putting the blanket back in the bag and sealing it will stop the chemical heating reaction.

‘Value’ proposition

But what’s the market for something like this? Potentially huge, given that there are more than 40 million surgical procedures in the United States each year alone. That doesn’t include other settings where the blanket could be useful, such as during chemotherapy or kidney dialysis.

As for price, the Apricity partners won’t elaborate. They’re still conducting a cost-benefit analysis. How do you quantify the value in quality of care, for example? On an operating basis, a hospital in theory would also use less electricity if it dumps the portable blowers. It wouldn’t need to buy as many blankets, nor would it have to launder as many.

"There’s also a value proposition," said Oscar Moralez, a StepStone co-founder who is involved in Apricity.

Whatever the ultimate price, the blanket will be inexpensive relative to the overall cost of surgery, Kyker said. The device also should play well with the American Society of Anesthesiologists, which recently made management of post-operative hypothermia one of its five evidence-based performance measures. The American Medical Association and the National Quality Forum have also asked Medicare to evaluate prevention of hypothermia as a performance measure.

That, according to Apricity, could ultimately link temperature maintenance to reimbursements for facilities and physicians. Apricity points to studies that demonstrate that even relatively minor below-normal temperatures can add $2,500 to $7,000 to a surgical patient’s hospitalization costs.

Kyker sees uses outside of the hospital, as well.

"I’d love to see this blanket used in the military," he said. "I was in the reserves for several years."