Go for It! by Raymond P. Niro

Author:Raymond P. Niro [Niro, Raymond P.]
Language: eng
Format: epub
ISBN: 9781449032715
Publisher: AuthorHouse
Published: 2009-11-04T05:00:00+00:00

TAKING A DEFENSE TO ABSURDITY—PRACTICING THE PRIOR ART WILL KILL THE PATIENT

Sakharam D. Mahurkar v. C.R. Bard, Inc.,

Civil Action No. 92 C 4803 (N.D. Ill., Aug. 1994)

This case was about hemodialysis catheters—the medical devices that connect people with failed kidneys to a dialysis machine that cleanses their blood of impurities and keeps them alive. Unfortunately, the average life-expectancy of a dialysis patient is ten years. Without dialysis, it is a matter of days before the toxins become fatal. I actually saw patients getting dialysis treatments at a Veterans Administration Hospital in Chicago (which was not a nice experience).

Dr. Mahurkar was an Indian immigrant who worked at Cook County Hospital in Chicago. He specialized in nephrology (the treatment of kidney disease) and recognized the huge problems in removing and returning blood to the body. This was necessary to prevent the lethal build-up of toxins that normal kidneys remove, but failed kidneys don’t. The key to Dr. Mahurkar’s catheter design was a double-D cross-section that allowed blood to be removed and returned efficiently without damaging the cells or creating blood clots.

Bard had copied Dr. Mahurkar’s catheter design. But they also had prior art—French Granger Patent No. 2297640 that disclosed a double-D cross-section—and a prominent expert from the University of Chicago, Dr. Woodle, who would testify about it. Woodle testified the French patent showed Dr. Mahurkar’s design. Hemodialysis catheters are inserted into veins, however, not into the smaller arteries that can be blocked. Both, of course, are blood vessels. This is how I undid Dr. Woodle and the prior art all at once:

Q. You mentioned the manner in which you place the catheters and what veins you use. I believe you said that you can pick any number of veins.

A. Yes.

Q. But your preference is—overwhelmingly your preference is to insert the catheter into the jugular vein; isn’t that right?

A. Either the external jugular or internal jugular veins.

Q. All right. And when it’s inserted through the external or internal jugular vein—and excuse me because I don’t know very much about medicine—

A. Okay.

Q. —the catheter actually rests inside the vena cava?

A. Actually—can I just show you?

Q. Sure.

A. What happens—let’s just say we bring it from the left side, left eternal jugular, it will come through there, go through the innominate vein, through the vena cave, and we actually have our tips sitting in the upper portion of the atrium.

Q. So the catheter feeds itself way through the vena cava?

A. Yes, sort of makes it an S-like curve.

Q. Is that true if you insert it through the other jugular as well?

A. The internal jugular, yes. They both have to negotiate the amount of vein here, which forces it to make a bit of an S turn.

(Transcript, August 23, 1994, pp. 1749-1750). Now I set the hook—1/4 to 1/2 of your blood passes through the vena cava vein:

Q. And [the] vena cava is a major vein in the body, correct?

A. Yes.

Q. It supplies about one-fourth of the blood to the heart?

A. Actually probably more like a half of the cardiac output goes through the superior vena cava.

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