15 Dec This wheelchair will save lives
Pascal Malassigné, a professor of industrial design at the Milwaukee Institute of Art and Design, or MIAD, has made a shower-and-commode wheelchair that will assist people with spinal damage with their toileting activities.
The help is badly needed. Spinal cord patients who are paralyzed from the neck or the waist down can spend up to an hour and a half each day moving their bowels. Since they have no sensation in the areas that are paralyzed, they don’t know how hard their pelvic bones are pressing against the toilet seat.
This is one of the ways they can develop pressure ulcers, which can lead to secondary infections such as septicemia. In certain cases, septicemia can lead to septic shock, which can cause cardiac arrest and even death.
An infected pressure sore, for example, led to Christopher Reeve’s death this October.
The best way to prevent this downward spiral from occurring is to prevent the pressure ulcers in the first place. Doctors at the Veterans Administration asked industrial designer Malassigné to develop a wheelchair that would allow spinal-cord patients to complete their toileting activities in comfort and safety.
“We have to keep in mind that the user, especially if they have a spinal-cord injury, has no feelings below the level of the injury,” Malassigné said. This means that the user does not feel the need to shift position when pressure starts to build up. “If you do not have adequate cushioning on the chair, the patient may be susceptible to pick up redness in the skin, and pressure on their skin, and that can lead to pressure ulcers that are very nasty,” Malassigné said.
The collaboration between Malassigné, the Veterans Administration, and ActiveAid, the company that manufactures the chairs, represents an excellent model for other entrepreneurs to follow. Instead of dreaming up his own invention and then scrambling to find a market, Malassigné responded to complaints and cries for help from patients and caregivers at VA hospitals. After identifying a serious problem that badly needed to be solved, Malassigné performed a formal evaluation of several existing shower-commode wheelchair designs to find out why they were considered unsafe.
“We learned the pros and cons of these existing shower commode wheelchairs,” Malassigné said. “From there, we were able to generate criteria for redesign, and then go on to design new prototypes of a new shower-commode wheelchair.”
When the prototypes were designed, Malassigné brought them to spinal cord patients and caregivers for feedback.
“This is not a product that you can design being in the ivory tower,” Malassigné said. “This is a product that has to be closely designed with the users in mind. We would get feedback from patients and caregivers, and we would make modifications, if necessary, to finalize the design.”
One of the things Malassigné’s users asked for was a folding wheelchair, which could be stowed on airplanes or trains or stored in a back closet. They requested larger, rubber-covered wheels, which would make it easier to move the wheelchair in and out of the shower. But the main thing the users wanted was a soft, comfortable seat that would not cause pressure ulcers.
Malassigné satisfied these requests by incorporating two different densities of foam into his chair’s seat cushion, and testing the cushion’s effectiveness with a pressure mapping device supplied by Curative Rehabilitation Services at Froedtert Hospital’s Spinal Cord Injury Center.
The two patents that Malassigné and the Veterans Administration received for the chair were filed by the technology licensing office at the Medical College of Wisconsin. The college also helped Malassigne and the VA license their chair design to Minnesota-based ActiveAid, which will handle manufacturing and sales.
ActiveAid spokesman Charles Nearing said that the company’s new Model #922, the Advanced Folding Shower Commode Wheelchair, will be available through his company’s 2500 dealers in January, 2005. The company has started to produce the chairs, and they are starting to supply purchasing information to people who request it. The chair’s price has not yet been determined.
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Teresa Esser is a contributing columnist for the Wisconsin Technology Network and author of the book, The Venture Café. She can be reached at teresa@wistechnology.com.
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