Combilift does the heavy lifting to ease worldwide ventilator shortage
The company, which was founded in 1998, revolutionised the way in which companies handle and store materials, specialising in solutions for challenging situations such as long or awkward loads, or where space is limited.
Its decision to apply the same kind of ‘outside the box’ thinking to one of the most intractable challenges caused by the Covid-19 pandemic was made by the company’s CEO and co-founder, Martin McVicar, during a period of self-isolation.
“I had been in the US in the early stages of the outbreak there and had no choice when I returned home but to put myself into quarantine for 14 days,” he explains.
During that period he saw rolling news coverage of the struggles medics were faced with, including having to make nightmarish choices about which Covid-19 patients to ventilate.
“I made a conscious decision to do something about it,” says McVicar.
Having emerged safely from his quarantine period, he called a local hospital, in Cavan, to offer Combilift’s services to develop a solution.
On 25th March 2020 he and three colleagues from Combilift met with medical device experts from the Health Services Executive, Ireland’s public healthcare agency.
A ventilator was made available for his team to study and its function and importance as vital weapon in the battle against Covid-19 explained.
Ireland is one of the world’s top centres for medical devices, producing half of all ventilators found in hospitals worldwide. A global surge in demand however has put pressure on traditional supply chains.
“The penny dropped with me that as one ventilator produces enough oxygen and airflow to support multiple patients, there was no need to reinvent the wheel here in terms of ventilators. What if, instead, we could create an attachment to split the flow and monitor it individually?” says McVicar.
Attempts had been reported of desperate clinicians ‘in the field’ splitting ventilators but the results were not ideal, lacking individual ventilation monitoring for each patient, among other issues.
Within five weeks Combilift’s team had developed the Combi-Ventilate, a splitter device that turns one ventilator into multiple ventilator stations.
The device supports a much higher level of care for patients than previous attempts to split ventilators, and much greater levels of assurance for clinicians.
It moved into laboratory testing under Professor Gerard Curley, Professor of Anaesthesia and Critical Care at the Royal College of Surgeons in Ireland and Consultant in Anaesthesia and Intensive Care at Dublin’s Beaumont Hospital.
It was developed in collaboration with the HSE, led by Dr Michael Power, National Clinical Lead of the HSE’s Critical Care Programme.
In his previous career as an ICU consultant, “the furthest thing from my mind was that we wouldn’t have enough ventilators,” says Dr Power.
The Combi-Ventilate will be of incalculable value in health systems which are ‘out of resource’. “It does away with that horrible, clinical dilemma of ‘the last ventilator’, the scenario where a patient might not have access to a ventilator because there is just one left,” he says.
The Combi-Ventilate system uses standard pipes and fittings for easy assembly. Its individual patient filters prevent cross contamination. Other features include non-return valves, HEPA filters, flow sensors and an automatic flow control valve.
Each patient has a dedicated digital screen which allows medical professionals to individually monitor their vital information. This includes live values, data on patient history, statistics and adjustable alarm settings. Any abnormalities detected by the system trigger only a specific patient’s alarm.
The Combi-Ventilate also has automatically adjustable flow control valves which allow the health service professional to control the tidal volume to each patient electronically, without having to make manual adjustments.
“The Combi-Ventilate is safe and reliable. It is an engineered solution which delivers the correct volume of air to each patient safely and reliably,” says Dr Power.
Monaghan based Combilift employs 700 staff and sells into 85 countries. Though it specialises in materials handling equipment, in fact analysing problems to come up with effective solutions is its stock in trade.
“Manufacturing medical devices is not our core business. When we are developing equipment, we listen closely to our customers in order to perfect and improve the product. That approach in our collaboration with the HSE is what has really got us where we are today,” says McVicar.
Ventilators are very complex and very hard to manufacture. “It’s difficult to make reliable and safe solutions, and a lot of companies are trying that have never done it before. What we decided to do instead was provide a solution that works with existing ventilator brands which have been proven over many years, and create an automated splitter system which is very reliable and safe.”
The Combi-Ventilate system is being developed on a not for profit basis and will be of particular benefit to healthcare systems in the developing world.
“This is very much designed as an attachment which can be added to any brand of ventilator. It costs a fraction of a standard ventilator and can be installed very easily into an ICU unit environment. This is a not-for-profit activity which we hope will open up more opportunities for Combilift in the medical device area in future,” says McVicar.
The life saving device is only the latest in a series of virus-related innovations to have emerged from Ireland in recent weeks, according to Julie Sinnamon, CEO of Enterprise Ireland, the country’s trade and innovation agency.
“Irish companies are innovating in response to the Covid-19 pandemic and it is exciting to see Combilift, who have always been at the forefront of innovation in the forklift and handling sector, use its manufacturing expertise to develop the Combi-Ventilate, which will help address the urgent global demand for ventilators,” she says.