Giving Hospitals Room to Breathe
Giving Hospitals Room to Breathe
Shadakshari DC and the team at Advanced MedTech. The home-grown medical device company has received emergency approval to start producing ventilators to mitigate the global shortage.
It weighed just 4kg when it came off the production line at Advanced MedTech’s (AMTH) Tuas plant at the end of June. But the small white box that engineer Shadakshari DC held in his hands was hefty in significance.
Dubbed Alpha, the innocuous-looking box represented a critical breakthrough in the fight against COVID-19: it was the first working ventilator produced locally at a time of great need and severe shortage, and one that — critically — could be operated remotely. Medical staff would be able to monitor settings, and make real-time adjustments without needing to be in the immediate vicinity. The Alpha was also produced at less than half the cost of traditional ventilators, making it affordable to more hospitals and countries.
This would not only mean saving more lives, but also protecting those on the frontlines from a disease that was infecting thousands globally each day.
“It was a moment of both relief and satisfaction. We had worked so hard and it was great to see the first working unit being powered on and successfully pumping up a test lung,” recalls Shadakshari, Director of Research and Development of the Temasek-owned company.
In a war against a virus that seemed to have the upper hand, it felt like hope.
Engineers at AMTH hook the Alpha ventilators to a test lung to check the device.
The idea for Alpha emerged at a time when COVID-19 was tightening its grip on its victims, causing extensive lung damage, and sometimes, death. For the hospitals that had them, ventilators would buy patients the precious time they needed to fight the infection and recover. Too often, however, they were in short supply, leaving doctors around the world with an impossible decision: who to treat, and who to let die.
“Ventilators are expensive, difficult to produce and complex to operate, so hospitals typically hold limited numbers. Because of this, there was a severe shortage of ventilators when COVID-19 cases climbed globally,” says Yeoh Keat Chuan, Senior Managing Director of Enterprise Development Group and Deputy Head of Singapore Projects at Temasek.
“Having built extensive relationships across the healthcare sector over the years, we decided to tap on them to secure more ventilators for Singapore and for hospitals around the region.”
However, there was no fast fix. After Temasek reached out to AMTH, Shadakshari spoke to scores of manufacturers but emerged empty-handed due to a shortage of both ventilators and ventilator parts, and export restrictions.
Pushed to think laterally, AMTH’s team contacted start-up ABM Respiratory Care’s CEO Vinay Joshi to explore if any of its existing products could be adapted.
They agreed that ABM’s Biwaze Cough, which helped patients who could not cough do so through forced mechanical inhalation and exhalation, held the greatest promise.
But fast-tracking its evolution would still be a leap of faith, since ventilator manufacturing was neither AMTH’s area of expertise nor part of ABM’s short term design and development plan.
Nevertheless, Temasek believed in the AMTH-ABM team and took a chance by underwriting the Alpha’s first orders.
The Alpha captures our spirit of innovation and shared determination — we saw a problem and were committed to finding a solution or, failing that, creating one. And, together, that’s what we’ve done.
Yeoh Keat Chuan
Senior Managing Director, Enterprise Development Group
Deputy Head, Singapore Projects
Temasek
For 12 intense weeks, a group of 15 engineers, technologists, and supply chain specialists spent long days and even longer nights adapting Biwaze — a small device designed for home use, for two to three minutes at a time — into a hospital-grade ventilator that had to cope with continuous use for days or weeks on end.
AMT, AMTH’s manufacturing arm, began by renovating part of its metal injection moulding plant in Tuas to support ventilator production. Despite the lack of manpower during the Circuit Breaker, it managed to turn 120 m2 of space into an assembly room with 15 stations and a room for testing and material storage.
It also sourced for equipment and tools for ventilator assembly and testing, and trained 15 of its staff for the task.
“We started with a ventilator core that was quite similar to the one being built, dismantled it, and practiced putting it back together over and over again,” reveals AMT’s Manager for Engineering Support Tan Eng Seng. “Our team memorised manuals, and even took parts home to practice with.”
The entire transformation also had to be done with only remote support from ABM’s India-based R&D team, which could not travel to Singapore due to travel restrictions.
Engineers from AMT, AMTH’s manufacturing arm, assembling Alpha ventilators.
“We used video conferencing to help the team from AMT. Before COVID-19, I would not have thought that possible — R&D and manufacturing teams usually work closely together in the same location to ensure a product’s design is correctly translated into product specifications. But we still manage to connect daily,” says Shadakshari, who helped closely coordinate the work of the manufacturing, R&D and supply chain teams.
By the end of June, he had the first working device in his hands.
A design and development process that typically took 18 to 24 months had been achieved in under three months, and resulted in a product that met stringent quality requirements — Alpha has already received approval from Singapore’s Health Sciences Authority, and is in the process of receiving approval from the US Food and Drug Administration for emergency use.
“We have a chance to save lives, prevent infections among frontline workers, and make a real difference,” says Shadakshari.
The first 25 units were ready for sale by the end of August, and there are plans for production to be ramped up to 200 units a month until the end of 2020. A number of countries, including India, Indonesia and the Philippines, have already expressed interest in placing orders.
“The Alpha captures our spirit of innovation and shared determination — we saw a problem and were committed to finding a solution or, failing that, creating one,” says Yeoh. “And, together, that’s what we’ve done.”
Advanced MedTech is a wholly owned subsidiary of Temasek.