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Dr. Larry Miller demonstrates the EZ-10 Intraosseous Infusion System on September 6, 2012. Photo: Tom Reel, San Antonio Express-News
By Patrick Danner, San Antonio Express-News
As an emergency room physician, Dr. Larry Miller knew firsthand the difficulties of trying to insert an IV in a patient who had gone into shock or who had suffered a heart attack.
The body shuts off circulation to the legs and arms in those circumstances, collapsing the veins. Injured and ill patients have died in emergency situations because medical personnel couldn't find a vein to hook up an IV for the delivery of medication.
The problem led Miller, founder of San Antonio's Vidacare Corp., to develop a battery-powered drill that inserts a needle directly into the bone to provide access to the body's largest noncollapsible vein.
For his life-saving invention, Miller was chosen to receive BioMed SA's Julio Palmaz Award for 2012. The award honors innovation in health care and the biosciences. He will receive the award at BioMed's seventh annual award dinner on Sept. 20.
"I struggled every day to save lives, one at a time," said Miller, 73, who specialized in emergency medicine for more than 30 years. "With the creation of the EZ-IO (Intraosseous Infusion System), I was able to place this tool in the hands of thousands and thousands of paramedics and doctors so that we could save hundreds of lives a day."
The Palmaz award is named after San Antonian Julio Palmaz, best known as the inventor of a revolutionary cardiovascular stent that shores up the walls of an artery after an angioplasty to prevent a collapse and blockage of the artery. The stent spawned a multibillion-dollar industry.
Seven members of BioMed SA's executive committee culled through 15 to 20 nominations before choosing Miller for the award, said Dr. Steven A. Davis, who chaired the selection committee.
"This is something that is obviously having a dramatic impact, a life-saving impact," Davis said of the EZ-IO. Miller "fits the profile of the kind of person who has an innovative spirit and the wherewithal to push it through to the marketplace."
Davis is CEO of San Antonio's StemBioSys LLC.
Privately held Vidacare doesn't disclose its financial results. But Miller, who is the company's chief medical officer, said it sells more than 40,000 needles a month at $99 each. The EZ-IO drill sells for $250 and can be reused more than 500 times, Miller said.
Miller likened Vidacare's business model to a razor company's, which sells razors inexpensively and makes up for it on the blades.
"We're rapidly growing and highly profitable," he added. Vidacare now employs about 150 people.
Miller said he learned about intraosseous while at another company, which was looking at injecting treatment in the bone marrow of cancer patients.
"The idea came to me that so many people are dying because they can't start an IV, yet inside the bone there's a huge vein that's connected to the central circulation and it never collapses," Miller said.
Miller pondered how to get a needle into the bone, trying different methods.
He recalled awakening in the middle of the night to his "ah ha moment." He remembered a little hollow drill his father once used in his tool-and-die shop in Detroit.
"So I went into my dad's old tool box - he had passed away - and found his little hollow drill," Miller said. "I tried it out in the lab, and it worked great."
Commercial sales of the EZ-IO started in late 2004. But there were hurdles, such as convincing paramedics that it's fine to drill into somebody's bone.
"It's looks painful, and looks way more painful than it is," Miller said. On a pain scale of one to 10, with 10 the most severe, he said, most people only rate it a two or a three. The EZ-IO has been used on Miller a few times for demonstrations.
Today, the EZ-IO is used by 90 percent of U.S. advanced life support ambulances and nearly 80 percent of U.S. emergency departments, he said. It's in 60 countries.
Vidacare has introduced other products, including its OnControl System for bone marrow biopsies. Miller called it a "souped up" EZ-IO, with bigger needles.
Miller said he's humbled by being chosen for the Palmaz Award, and credited his colleagues for helping make it happen.
"For me, it's living a dream," he said. "When I first started this project, I knew that it would be a lifesaver. But I had no idea that it would be adopted so rapidly around the world and to such an extent."