Prolific Alum Offers Students Roadmap for Success

George Truskey, Robert Fischell and Dean Kristina Johnson

A prolific innovator and entrepreneur who Dean Kristina Johnson calls “one of Duke’s most successful alumni” offered Pratt School of Engineering students a roadmap for finding fun and profit while also benefiting humanity at a Distinguished Alumni Seminar held in the Fitzpatrick Center on Jan. 11. Robert Fischell (’51) invented drug-eluting stents that keep heart vessels open in those prone to heart attacks and a series of other medical devices poised to prevent seizures, forewarn of impending heart attacks and erase migraine headaches.

“Give yourself the opportunity to get lucky,” Fischell told the packed house of students and faculty. “You have to sense failures when they occur, come up with a solution and then do something about it.”

Fischell received his bachelor’s in mechanical engineering at Duke followed by a master’s and doctor of science from the University of Maryland. He went on to become chief engineer of the Space Department at Johns Hopkins’ Applied Physics Laboratory, where he worked on more than 50 spacecraft. His interests then turned to the invention of new medical devices, such as pacemakers and implantable heart defibrillators. He now holds more than 200 U.S. and foreign patents.

Pratt alum Robert Fischell

Fischell presented some of his latest successes, implantable devices which address debilitating conditions – including heart disease, epilepsy and migraines -- that affect a large and growing number of people. The devices each demonstrate one of Fischell’s mottoes: “Big problems create excellent opportunities for innovation.”

Several years ago, Fischell recognized one such problem -- the tendency of vessels propped open with stents to react to the foreign material by forming scar tissue, a process that led to a 50 percent six month failure rate for early stents, he said. While Fischell’s first attempt at a solution, a radioactive stent, failed to work, in the process he created a stent better able to turn corners. Johnson & Johnson bought his small company and began producing the flexible stents.

Fischell and his collaborators later found that coating the stents with a drug called sirolimus effectively prevented arteries from filling up with scar tissue, an advance which cut the failure rate to 6 or 7 percent. Worldwide stent sales now amount to about $6 billion per year, and the Johnson & Johnson implants, called Bx VELOCITY™ coronary artery stents, represent more than 50 percent of the market share, Fischell said.

Fischell next turned to his “Neuropace” device that, when implanted on the surface of the brain, senses epileptic seizures and turns them off with electrical stimulation before symptoms appear. Clinical trials so far have indicated that the brain implant can cut seizure rates by about 50 percent and reduce the severity of seizures in “the world’s worst patients,” those for whom other epilepsy treatments have failed, he said. Moreover, he said, the device’s benefits come with virtually no side effects.

“It’s amazing, medical devices in general have very few side effects in comparison to drugs,” Fischell said. More than a million people with epilepsy suffer serious adverse effects of their seizure medications, he added.

Another of Fischell’s inventions is the “Angel Med Guardian,” an implant that keeps tabs on the electrical activity of the heart to allow detection of a heart attack within seconds. The device vibrates under the patient’s skin to alert them, while simultaneously contacting EMS and a physician.

“With this device, patients can bypass the emergency room and go straight to the cath lab for treatment,” he said.

The final highlight detailed a device Fishell likens to a hair dryer, which migraine sufferers can use to deliver a magnetic pulse to the brain, erasing migraine headaches before they take hold. The device has so far shown the most promise for people who experience an aura, visual symptoms that begin before the onset of headache pain.

Fischell said he attributes the success of his medical devices first and foremost to their ability to help patients. His medical implants also make money for prescribing physicians, while saving money for the healthcare system as a whole, he noted.

Despite his many spectacular successes, Fishell closed his lecture with a useful reminder: “Great inventions are always preceded by failure.”