The Radial Assist RADBOARD™: Created and Launched by a CVT

Can you tell us about your own background and how you came to co-found Radial Assist? I am an echo tech by training, and also spent 22 years as a Navy hospital corpsman, which is where I got my original cardiology training. I started in the cath lab in 1997, in a diagnostic lab, and then started doing interventions in 2004 at a large Atlanta hospital. Around this same time, there were a few doctors who would do a couple of radial procedures each day. They soon saw the benefits of performing catheterizations in this manner and before long, they were doing radial procedures the majority of the time. What was your reaction as you saw these physicians doing more and more radial access?

I realized that the radial approach offers increased comfort for the patient and lower complication rates as compared to femoral access. Many patients who have had the procedure performed radially say that they wouldn’t have it done any other way, and then spread the word to friends and family. Patients came in to the hospital specifically requesting radial access catheterizations and we all know that patient satisfaction is something that hospitals strive for.

From a staff perspective, we also like the reduced complications, quicker turnaround times and increased patient comfort. Patients can get off the cath table, move right over to a wheelchair or a stretcher, and we can put the head of the stretcher upright. We roll them over to our recovery area, and they can ambulate immediately. Patients are encouraged to put on their street clothes, so when they ambulate, they are not ambulating in a hospital gown. All of this results in a more comfortable and stress-free experience for the patient.

There is a learning curve for doing radials for staff and physicians. Sometimes the staff is not comfortable with it initially, but quickly come to see the benefits.

What sparked the creation of the RADBOARD^™?

I think many of the initial difficulties of performing radial access involved the set up. When we began doing radial access at our facility, we used these flimsy little boards from our x-ray equipment vendor. These boards were very narrow and didn’t provide an adequate work space for necessary supplies. Wires could become contaminated because of the lack of space and blood would drip off the end of the board. These boards also placed additional mass under the patient’s chest, in the field of radiation exposure, which can increase radiation dose to the patient.

I quickly saw a need for a wider and longer board that would hold wires and equipment to keep them from falling off the table. I went home, drew some quick sketches, and consulted with some of the physicians, asking them where they liked to stand, how much room they needed and how they faced the patient when performing the procedure.

Do you have a history of being someone who creates things?

No, and that’s the funny thing about it. I didn’t set out to invent anything. I’m a handyman around the house and that’s about it. I’ve never built anything like this before. I just looked at what we were using and saw the need for an improved design. We needed something with edges to contain blood and equipment, which was the first idea I came up with.

I worked on my initial design for two or three weeks, making numerous trips to Home Depot to look at different materials. I ended up using a thin sheet of plywood with formica on both sides. I attached small metal uprights on the edge of the board to create a reservoir with the drape. This design served a dual purpose by helping hold the equipment in place and to contain blood spillage.

As I was bringing this prototype board back and forth to the hospital for physician input, some of the cardiologists stated that they didn’t perform radials because of the increased radiation exposure. With encouragement from one of our doctors, I went back to the drawing board and designed a way to put a lead-free, radio-protective material inside the board for additional protection from radiation scatter exposure.

I would make a revised prototype and bring it in, and then the doctors would tell me that they liked a certain aspect of the board but did not like another part. I would then go back to my garage to make another modification until, after several dozen prototypes, I finally came up with the one that seemed to fit all the needs requested by the physicians.

There were times when the cath lab staff would put a patient on a table and use the old flimsy board, and the doctor would say, “Break scrub, I want Gary’s board under there.” He would make them take all the equipment off the table, take the old-fashioned boards out and put my board underneath. They did that so many times that we finally threw the other boards away, and that was when the hospital ordered 3-4 more boards from me. It kept me busy for several months, building boards in my garage.

After further investigation and discussions with physicians and my partners we realized that there may be times when a physician may want to access from the left side as opposed to right. So we next designed the board to fit any cath lab table and go on either the right or left side of the patient.

How is the RADBOARD used?

The board is placed on the bed, underneath the mattress, with the hanging leaded shield brought down to the level of the board. The leaded table drapes go underneath the board. The added radiation protection in the RADBOARD is located under the company logo, providing the physician and staff with increased protection from unnecessary radiation scatter. When I originally brought in my prototype, physicians kind of raised their eyebrows and said, “Hey, this is a great idea.” They liked the utility of the board and the added protection it provided.

The hospital I worked at had bought several boards to outfit their labs, and more and more doctors started performing radial approach catheterizations. Word seemed to get out, and then other Atlanta area hospitals started calling me to order boards. My first garage-built board was finalized in 2008, and shortly thereafter, I patented the design, now called the RADBOARD.

In the fall of 2009, I was approached by Dr. Van Crisco and Brad Hess about the possibility of starting a business. Dr. Crisco helped fund my business and helped me with product modifications. Dr. Crisco has been doing radial procedures for over 10 years. Brad has 27 years of experience in the medical device industry and together we used our experience to form Radial Assist as a company in the summer of 2010.

Once we found a manufacturer, we sat down with an engineer, and experimented with different materials and designs to create our final product. A lot of time and money was put into research and development, and test marketing the board. The RADBOARD is FDA registered and has a patent pending. Our company is called Radial Assist, and we have a website at www.radialassist.com.

We are now getting orders from around the country. Representatives from companies that support the radial procedure have been a big help. As they visit other hospitals, they see the struggles the cath lab staff have encountered trying to use improvised arm supports. They then suggest our product, and explain the benefits of using the RADBOARD. Our product has been a great asset to both experienced and novice staff and physicians utilizing the radial approach. We feel that we have covered all of the important design features needed to perform radial and other upper extremity vascular procedures safely, efficiently, and effectively.

How does the RADBOARD work into procedure set up? Is it just wiped down from last use?

Yes, it’s now made out of a lightweight, sturdy and non-porous material. The RADBOARD is a very easy product to clean. Because it is lightweight, anyone can carry it and set it up. The board has handles on it as well and can stand upright on its own, making storage easy. You simply place the extended area of the board under the mattress and patient’s hip area, then adjust the board along the length of the table for perfect arm position. Slide the board all the way under the patient until the bottom bumpers stop advancement. The patient’s weight stabilizes and secures the board. Putting a chucks or an absorbent pad down on top of the board and under the patient’s arm will minimize clean up. Also, you could put a towel up underneath the patient’s arm to hyperextend the patient’s wrist to help the physician gain access. Once the procedure is done and the drape is pulled back, if any blood has seeped through the drape, it can be wiped down with regular hospital antiseptic wipes.

Can you summarize the RADBOARD features?

The RADBOARD fits any cath lab procedure table. Benefits of the RADBOARD include: additional scatter radiation protection to the physician and staff, a large area to accommodate supplies for radial procedures, it can be used on either the right or left side of the table, and it accommodates both short and tall patients. The 90˚ angles on the board facilitate the drape to create a containment area to prevent fluids from spilling and equipment from falling off the table. The RADBOARD is registered with the FDA, guaranteed by our company and has a pending patent.

Are you full-time with the company?

No, I am still a CVT. I work in a cath lab full time. At the present time, the company is part time for me. In between cases or when I go home at night, I make phone calls and answer e-mails pertaining to the RADBOARD. Brad Hess has done a great job setting up the company and running the day-to-day business. We have other radial products in the pipeline, the next of which should be out in a month or so. Sales have been very promising so far and we plan to expand our offering of products for upper extremity vascular access, such as offering a disposable arm support.

I saw a need out there and I filled it by inventing the RADBOARD. I ended up with two great partners, along with some industry representatives who have seen the board’s advantages and are helping me get the word out. I really appreciate all the help that everyone has given me. I am proud of what I have accomplished by conceiving and designing the RADBOARD. It wasn’t my intention to start a business, but it’s been an amazing journey the past two years.

Physicians have frequently come to our hospital for transradial training courses, and I would often hear them say, “This is exactly what I needed!” The RADBOARD fixes all the problems with contamination of wires and the fumbling that sometimes occurs with the radial procedure. The RADBOARD can make doing radials a pleasure for the physician, staff and patients. They love hearing the story, especially after they see the RADBOARD and say, “You made the first ones in your garage?” It really gets people excited.

The RADBOARD^™ is available at www.radialassist.com or by email at: contact@radialassist.com. Call: 1-888-RAD-BORD (1-888-723-2673) Gary Goff can be contacted at ggoff@radialassist.com