Our 34th year of providing med-tech news & analysis BIOMEDICAL The Inside Formerly Newsletter TECHNOLOGY
❏ Cleveland area seen as hotbed of medical innova- tion. Story on page 5.
❏ Braunstein sees promise in 2011, but notes that chal- 7KH %% 7 LQWHUYLHZ lenges still abound. Story on page 9.
❏ Biosense completes first clinical cases using Chris Rivera ThermoCool, Smart- President of Washington state life sciences associationInternational sees local gains from having a global health perspectiveReport, page 15. Boston Scientific to By JIM STOMMEN, BB&T Contributing Editor acquire Atritech. Acquisi-
Chris Rivera has been president of the Seattle-based Washington Biotech-
tons & Agreements. page 17.
nology & Biomedical Association (WBBA) since January 2009. Prior to joining
the WBBA, he was the founder and CEO of Hyperion Therapeutics, a specialty
❏ Sapien trial data prod FDA, firms to review
biopharmaceutical company focused on the development and commercializa-
valve studies. Market
tion of therapies for gastroenterology and hepatology diseases. Developments, page 18.
Prior to starting Hyperion, Rivera was senior vice president of commercial
❏ Pretzel-shaped tube may
operations at Tercica, where he was responsible for developing and overseeing
help deliver bladder dis- ease drug. Product Briefs,
Tercica’s global commercialization strategies and was intimately involved in
the development and consummation of an international cross-licensing col-
As senior vice president of Genzyme Therapeutics, he was largely respon-
sible for building the company’s U.S. renal division and assisted in the launch
of Renagel (sevelamer hydrochloride) globally. Earlier in his career, he helped
build the initial commercial organizations at Centocor and Cephalon. Now available online: Go to www.medicaldevicedaily.com for details Copyright 2011 by AHC Media. Unauthorized photocopying or distribution is strictly prohibited by law.Biomedical Business & Technology FEBRUARY 2011
in particular, “We’re going to set up shop in those coun-
Cleveland area
tries where we know we’re going to have to file first.” So FDA regulation really has some long-term implications
seen as hotbed of
that may be very negative if not really thought through strategically. medical innovation BB&T: Is there a question I haven’t asked that you By JEFFREY BERG, PhD wish I had? BB&T Contributing Writer
CLEVELAND – The medtech community in Cleve-
Rivera: Not so much a question as a comment in
land and the surrounding region is experiencing dy-
closing. One of the things we’re trying to work on and
namic growth from its expanding network of world-class
hopefully can get out is that the citizens of Washington
research and clinical facilities along with financial firms
that aren’t a part of this industry hopefully can see the
and government programs that collectively support
value and benefit that it brings and has the potential to
the creation and growth of companies in many medical
bring. This is potentially like having a Boeing emerge in
fields, most notably cardiovascular, imaging, neurology
the 1940s and 1950s, or having Microsoft in the 1970s and
1980s. We’re at that stage where we can as an industry be-
Today, the region is home to 600+ biomedical busi-
come the next Boeing or Microsoft or Weyerhaeuser and
nesses with more than 230,000 healthcare and bioscience
workers. The origin of many of these companies can be
We already are one of the top five industries in the
traced to research programs initiated at the nationally
state and fastest-growing, but we really have an oppor-
ranked medical institutions, hospitals and universities
tunity here in Washington, especially with where things
in northeastern Ohio which encompasses Cleveland and
are going with global health and personalized medicine,
Akron (see Table 1). As evidence of its growing medi-
we really do have an opportunity to become the next
cal community, sixteen cardiovascular companies have
huge industry and job-creator for the citizens of the
moved into the region in the past two years. The region
state. It’s an exciting time to be here, but it’s also a time
attracts more that $150 million a year in healthcare invest-
where decisions that are made in Washington, DC, and
Olympia are going to have a long-term impact one way
The Cleveland Clinic, a world renowned health
system, established in 2007 the Global Cardiovascu-
The challenge with life sciences is that we usually are
lar Innovation Center (GCIC) which was formed after
not manufacturing consumer products that people are
receipt of a $60 million grant from the State of Ohio’s
going to see on the shelves of a store, so you don’t know
Third Frontier Program. It is a cardiovascular product
us and what we do unless you’re taking Enbrel or unless
development consortium that is focused on the forma-
you’re having an ultrasound treatment. That’s a matter of
tion, attraction, expansion and retention of cardiovas-
education – we’re working to increase that kind of aware-
cular companies and whose aim is to create jobs and
facilitate economic development in the State of Ohio. It has resulted in the construction of a new incubator facility to house start-up companies developing in-novative solutions for the diagnosis and treatment of cardiovascular disease. GCIC’s portfolio comprises 21
The Cleveland Clinic hosts the annual Medical In-
novations Summit, a major conference that features pre-sentations by the CEO’s of the largest medical device
companies and attracts more than 1,000 investors, entre-preneurs, business development executives, clinicians
The Cleveland Medical Mart and Convention Center
is expected to transform Cleveland and the surrounding
For advertising opportunities in
area into a globally competitive location for attracting
Medical Device Daily, please contact
and growing biomedical companies. It is scheduled to
Stephen Vance at (404) 262-5511 or
open in 2013 and will be one of the only facilities in the
[email protected]
nation targeted specially to the medical and healthcare industries, housing 120,000 sq. ft. of permanent show-
Copyright 2011 by AHC Media. Unauthorized photocopying or distribution is strictly prohibited by law.Biomedical Business & Technology FEBRUARY 2011 Hospitals and Research Universities in Cleveland and Akron
search services. Its 20-member profes-sional staff provides ongoing assistance
Cleveland
and guidance in a wide range of areas to these portfolio companies but does not
assist that have strong growth potential.
It assists these companies in developing their businesses and specifically in their
fund raising efforts, but is itself not an
rooms for major medical manufacturers and service pro-
viders. The showrooms will focus on cardiology, surgery,
and environs a national center for medical innovation.
imaging, orthopedics, Ob/Gyn, sterilization, healthcare
The region can be compared to the established med-tech
furnishings, patient care, and healthcare IT. The center is
community, known as Medical Alley, around Minneapo-
expected to host more than 50 healthcare-related confer-
lis and the drug and biotechnology hub around Research
BioEnterprise’s portfolio includes several Israeli
Biomedical engines of innovation
med-tech companies which it has attracted for setting up
BioEnterprise (Cleveland) is a leading institution that
operations in Cleveland and for using local hospitals to
is driving the development of the biomed and medtech
conduct clinical trials. BioEnterprise partners with sev-
industries in Cleveland’s metro area. BioEnterprise is a
eral venture funds that are housed within its facility. The
business formation, recruitment and acceleration initia-
Bridge Investment Fund, which also has an office in Tel
tive designed to grow healthcare companies and com-
Aviv, specifically invests in Israeli medical device compa-
mercialize bioscience technologies. Its founders and part-
nies that have completed their initial clinical trials and are
ners are: Case Western Reserve University, Cleveland
looking to the U.S. market for further clinical validation
Clinic, University Hospitals, Summa Health System
and to establish a U.S. sales and marketing organization.
and the Austen BioInnovation Institute in Akron. Ben-
Additional on-site venture firms at BioEnterprise include
efited by a team effort with these institutions, and sus-
Arboretum Ventures, RiverVest Venture Partners, Medi-
tained by an entrepreneurial ecosystem, BioEnterprise
cal Growth Fund and Johnson & Johnson’s COSAT (Cor-
has succeeded in accelerating more than 100 companies
porate Office of Science and Technology).
of which half are medical device companies and the re-
Twelve of the Cleveland region’s health care compa-
Cleveland Region Healthcare Acquisitions Since 2008 Acquirer
Fund II. It has made investments in 30 companies and currently
fills an important niche as first round investors of seed capi-
Integra LifeSciences (Plainsboro, New Jersey)
Boston Scientific (Natick, Massachusetts)
based Simbionix, a leading pro-vider of medical education and
Copyright 2011 by AHC Media. Unauthorized photocopying or distribution is strictly prohibited by law.Biomedical Business & Technology FEBRUARY 2011
The Austen BioInnovation Institute in Akron (ABIA)
Centers of Innovation within
is also contributing to the growth in the Cleveland-Ak-
Austen BioInnovations Institute
ron corridor. It was launched in 2008 with an announce-ment of $80 million in commitments, as follows: $20 mil-
lion from the John S. and James L. Knight Foundation;
$20 million from the State of Ohio ; $20 million from oth-
• Center for Clinical and Community Health Improvement
er founding members (Akron Children’s Hospital, Ak-
• Center for Simulation and Integrated Healthcare Education
ron General Health System, Northeastern Ohio Uni- versitiesColleges of Medicine and Pharmacy, Summa
ment to stimulate the economy and create jobs.
Health System, and the University of Akron); $10 mil- BioEnterprise’s medical device companies
lion from First Energy; and $10 million from other sourc-
A diverse sample of medical device companies with-
es including federal agencies and private foundations.
in the BioEnterprise portfolio are reviewed below:
ABIA is focused on patient-centered innovation and
• MDG Medical (Aurora, Ohio and Lod, Israel) mar-
commercialization at the intersection of biomaterials and
kets systems that automate the dispensing of medications
medicine. It is comprised of four Centers of Innovation
by health professionals in hospitals. Some sales are also
(see Table 3) that are interrelated in that they are designed
made to long-term care and correctional facilities. MDG’s
to accelerate translational research to biomedical innova-
flagship product, ServRx, is a complete medication man-
tion and commercialization as well as community trans-
agement system consisting of automation software, med-
formation, thereby encompassing the entire life cycle for
ication cabinets, supply cabinets, bedside solutions and
computerized order entry devices. This system provides
In September 2010, ABIA received a $2.6 million re-
a closed loop solution for medication management by
search and commercialization grant for biomedical sen-
tracking from the order entry to the actual administration
sor technology at Cleveland State University’s Wright
of medication. Its modular design allows for the instal-
Center for Sensor Systems Engineering through Ohio’s
lation of individual components. The principal benefits
Third Frontier initiative, a technology investment pro-
of MDG’s systems are increasing patient safety by reduc-
gram which grants funds to companies that have also
ing human error when medicating patients and greater
received private capital and have a partnership with an
cost efficiencies by reducing paperwork and improving
Ohio institution. Grants are typically $1 million.
medication inventory management. MDG can be distin-
ABIA was also the recipient, together with the Uni-
guished from its competitors, CareFusion (San Diego)
versity of Akron Research Foundation, of the i6 Challenge
and Omnicell (Mountain View, California), because its
which is awarded by the U.S. Department of Commerce
systems allow for the patient’s safety to be taken directly
for research programs that epitomize innovation and
minimize the time from ideation to commercialization of
• Quality Electrodynamics (QED ; Mayfield Village,
Ohio), established in 2006, is an engineering and manu-
The University of Akron has an established reputa-
facturing company that is an OEM supplier of radio fre-
tion as an innovator in biomaterials and polymer science.
quency coils used in MRI scanners. The coils translate sig-
Several of the nearby large chemical and industrial com-
nals received from patient anatomies into images used for
panies are utilizing the university’s polymer technology
diagnostic purposes. QED produces state-of-the-art ad-
and getting involved in medical devices such as Lubrizol
vanced clinical coils that are dedicated for use in imaging
and Parker Hannifin. Additional beneficiaries are the
the head, neck, knee, heart, shoulder, foot, spine and ab-
medical companies, Steris (Mentor, Ohio), a provider of
domen. QED works closely with its two main customers,
sterilization and sanitation products, Invacare (Elyria, Siemens Healthcare (Erlangen, Germany) and Toshiba
Ohio), a marketer of rehabilitation equipment, and Nor- Medical SystemsCorporation (Tochigi, Japan). The com- man Noble (Highland Heights, Ohio), a contract manu-
pany has 66 employees. It will achieve sales of $16 mil-
facturer of medical devices including stents and orthope-
lion in 2010 and has been profitable from year two (i.e.,
2007). More than 90% of products are shipped outside the
JumpStart is a nationally recognized non-profit or-
U.S. and they are distributed worldwide by Siemens and
ganization that offers intensive entrepreneurial develop-
Toshiba. QED plans to enter the renewable energy mar-
ment assistance to Northeast Ohio entrepreneurs leading
ket with the launch of eQED in 2011 and with the intro-
high potential, early-stage companies. It is funded by the
duction of next-generation inverters that change sunlight
state, corporations and hospitals and provides early stage
energy from DC to AC and are integrated in solar pan-
companies with grants of $500,000, which have been
els. QED was named 11th in the nation in 2009 by Forbes
awarded so far to 50 companies. This program exists in
magazine’s American Most Promising Top 20 companies
several other states and was created by the U.S. govern-
and was also cited by Inc magazine as one of America’s
Copyright 2011 by AHC Media. Unauthorized photocopying or distribution is strictly prohibited by law.Biomedical Business & Technology FEBRUARY 2011
Top 500 Fastest Growing Private Companies and 13th in
life. The Smartpatch system consists of a skin-mounted
external stimulator, percutaneous lead and small adhe-
• CardioInsight Technologies (Cleveland) is de-
sive patches that contain the power source for the sys-
veloping the first non-invasive, real-time, beat-to-beat
tem. It delivers peripheral nerve stimulation (PNS) for
simultaneous mapping and localization solution for the
up to 30 days after placing the lead through the skin
treatment of cardiac arrhythmias and heart failure. The
into the muscle in an outpatient procedure. The patches
company’s electrocardiographic mapping technology are replaced regularly, based on the prescribed dosage. was licensed from Case Western Reserve University. It is
A 510(k) submission is pending for the Smartpatch PNS
being developed for intra-procedural guidance of abla-
system. Also under development is the fully implant-
tion therapy for arrhythmias and cardiac resynchroniza-
able SPR long-term system which is being investigated in
tion therapy for heart failure. Its targeted conditions are
for treating atrial fibrillation and congestive heart failure.
• AxioMed Spine (Garfield Heights, Ohio) devel-
The patient wears a disposable multi-electrode vest that
ops devices designed for restoring function to patients
is used in conjunction with a CT scan to provide a 3-D
who have symptomatic degenerative spine disease.
map of the heart’s electrical topography and enables the
The company’s Freedom lumbar disc is the first one-
physician to determine where to ablate. The company
piece elastomeric total disc replacement. It is based on
plans to launch its product in Europe in June 2011 and
an invention of surgeons at the Cleveland Clinic and is
anticipates receipt of 510(k) clearance by the end of 2011.
cleared under an IDE for ongoing clinical trials random-
The regulatory approval is not expected to be onerous be-
ized against the ProDisc-L from Synthes Spine (West
Chester, Pennsylvania). The Freedom one-piece design
• NDI Medical (Cleveland), established in 2002, has
utilizes a proprietary metal-polymer bonding technol-
a 22-member staff that focuses on generating ideas for in-
ogy. The company has an exclusive license for the Car-
novative neurodevices that can be used to inhibit, accel-
boSil polymer, a proprietary polymer that is supplied by
erate or restore lost neurological function. It holds 150 is-
the Polymer Technology Group (Berkeley, California),
sued or pending patents and has raised $25 million from
a subsidiary of DSM Biomedical (Geleen, the Nether-
about 20 research grants and private investment. NDI’s
lands). The Freedom lumbar disc has the CE mark and
objective is to spin off individual companies and to assist
is being marketed in the UK, Germany and Switzerland.
these companies in the areas of research & development,
In the U.S., the company needs a 2-year follow up before
manufacturing and quality assurance. NDI also is an in-
filing for a PMA with the FDA. AxioMed is developing
vestor in the companies that it creates. Its first product,
the Freedom cervical disc that is more anatomically cor-
the MedStim bladder pacing system for control of uri-
rect in fit and function than existing commercial cervical
nary urge incontinence, was acquired in April 2008 by
discs. Both devices incorporate titanium endplates and
Medtronic (Minneapolis) for $42 million. NDI continues
their viscoelastic mechanical properties mimic the natu-
to create high-growth companies. Its 2nd and 3rd operat-
ral disc. It plans to file for the CE mark in the fall of 2011
ing companies, Checkpoint Surgical and SPR Therapeu- tics, are housed on-site at NDI.
• Checkpoint Surgical has developed a single-use
stimulator/locator for applying electrical stimulation to exposed motor nerves and muscle tissue to locate and evaluate nerves during surgery. The stimulation intensity can be varied, allowing for the activation of nerves and muscles at different depths and through surrounding tis-
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during surgery on upper extremities such as the shoul-der and elbow, ENT and oncology procedures, and for nerve and tendon transfers. The Checkpoint stimulator/locator received 510(k) clearance from the FDA and has been used in a pilot launch by 40 surgeons in the U.S. in
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over 300 procedures. The company plans to expand its U.S. sales and launch its device in Canada, Europe and Australia in 2011.
• SPR Therapeutics is commercializing the patented,
short-term Smartpatch system to reduce or eliminate pa-tient’s severe pain and improve their overall quality of
Copyright 2011 by AHC Media. Unauthorized photocopying or distribution is strictly prohibited by law.
Overview on emission scenarios From the SRES family of emission scenarios (IPCC 2000, Nakicenovic et al. 2000), only three were used in the CMIP3 climate change simulation runs for the IPCC Fourth Assessment report: SRES-B1, SRES-A1B and SRES-A2. The following information is from the Special Report on Emission Scenarios (Nakicenovic et al. 2000): Figure 1: Schematic illustration of
RÉSISTANCE DES PRINCIPAUX GERMES RESPONSABLES D’INFECTIONS, ISOLÉS AU LABORATOIRE D’ANALYSE DE BIOLOGIE MÉDICALE DE L’INSTITUT LOUIS MALARDÉ (année 2003) Les souches bactériennes testées proviennent des dispensaires de Tahiti et des îles et des hôpitaux périphériques. Ils représentent un échantillon représentatif de la sensibilité des germes de l’ensemble de