World War II Accelerates Interaction
As the nation mobilized for war in the 1940s, the federal government became involved in many activities previously left to the private sector. Government leadership in the war effort changed the public perception about its basic role in science and medicine.
Wartime Innovation
The federal government had an effect on all stages of the innovation process in medical devices during the war. Government spending promoted basic science as well as technological invention and development. Government also became a major consumer of both medical technology and military technology, greatly expanding the market for products produced by firms with medical technology expertise.
President Roosevelt established the Office of Scientific Research and Development (OSRD) in 1941, and it had two parallel committees on national defense and medical research. The Committee on Medical Research (CMR) mounted a comprehensive program to address medical problems associated with the war. The government gave 450 contracts to universities and 150 more to research institutes, hospitals, and other organizations. In total, the office spent $15 million and involved some 5,500 scientists and technicians. Government supported achievements included a synthetic atabrine for malaria treatment (which replaced the quinine seized by Japan), therapeutically useful derivatives of blood, and the development of penicillin.[63]
Ibid., 340.
The OSRD was unique because it was organized as an independent civilian enterprise and managed by academic and industrial scientists in equal partnership with the military. In contrast with World War I, where scientists served as military officers under military commanders, the work of OSRD was fully
funded by the government, but scientists worked in their own institutional settings. The research contract model proved to be a flexible instrument in the subsequent partnership between government and private institutions during the postwar period.[64]
Harvey Brooks, "National Science Policy and Technological Innovation," in Ralph Landau and Nathan Rosenberg, eds., The Positive Sum Strategy: Harnessing Technology for Economic Growth (Washington, D.C.: National Academy Press, 1986), 119-167, 123.
Government also let contracts for development of wartime technologies. Some of these efforts benefited device companies directly because they had technologies that could be channeled for military use. Other government efforts promoted technologies that would later prove useful in medical device technology. In addition, the government was a ready market for military and medical supplies. Government purchasing enriched many companies in the instrument business, such as Beckman and GE. Government policy helped to establish a technology base for postwar development and allowed firms to take advantage of the postwar boom.
In addition, federal government spending and greater need for health care for service personnel injured in combat stimulated the medical technology market. The federal government provided medical services for all military personnel—60 percent of all hospital beds were used by the military. Thus government also became a large consumer of medical supplies and equipment.
Medical Device Successes in Wartime
The war provided an impetus to innovation in medical device technology. Three profiles of successful firms—Beckman Instruments, Baxter Travenol, and General Electric—illustrate the effect of government on innovation.
Beckman
Beckman Instruments provides an excellent example of the impact of the war on medical device technology. The National Technical Laboratories, as the firm was called at the time, did not make weapons but did make important military products. Its contribution to the war effort is reflected in sales data: gross sales were thirty-four times larger in 1950 than in 1940.
One key product was Beckman's "Helipot," a unique instrument
for use in radar systems. The U.S. military requested meters built to military specifications for the radar program and able to withstand strong mechanical shocks. Beckman recalled, "I began to get calls from lieutenants and captains and finally from generals and admirals. There were ships that couldn't sail because they didn't have Helipots for their radars."[65]
Stephens, Golden Past, 34.
Beckman himself redesigned the instrument. In the first year of production, the new model accounted for 40 percent of the firm's total profits.Because wartime disrupted supplies of essential products, new markets opened and creativity was welcomed and rewarded. Beckman's spectrophotometer, which used a quartz prism and a newly developed light source and phototube, is a good example. This model, introduced in 1941, could accurately measure the vitamin content of a substance. The war had cut off the supply of cod liver oil, which was a rich source of vitamins A and D, from Scandinavia. Before the Beckman instrument, there was no way to efficiently measure the vitamin content of other foods to plan healthy diets. The Beckman spectrophotometer determined vitamin content precisely in one or two minutes.
Rubber supplies had been cut off by the bombing of Pearl Harbor, and the nation desperately needed a substitute. Supported by the federal Office of Rubber Reserve, Beckman developed infrared spectrophotometers that could detect butadiene, a major ingredient in synthetic rubber. Later on, Beckman was also involved in a government project with the Massachusetts Institute of Technology, working under the Atomic Energy Commission, to develop a recording instrument to monitor radioactivity levels in atomic energy plants.
These new technologies frequently proved to have medical applications. With friends from the California Institute of Technology, Beckman produced oxygen meters for the navy. An anesthesiologist heard about the meter in its development stage and was interested in its use to measure oxygen in infant incubators. If oxygen supplies to a baby are too low, the infant will not thrive; if oxygen levels are too high, it can become blind. This doctor treated his own grandchild with a Beckman meter, feeding oxygen from a tank into a cardboard box and thereby saving the baby's life. However, during the war, hospitals could not
afford oxygen meters. It was twelve years later that hospitals began to purchase them in large numbers.
Baxter Travenol
Baxter Travenol provides another wartime success story. Although the medical theory underlying intravenous (IV) therapy was clearly understood at the outset of the twentieth century, only large research and teaching hospitals could prepare solutions and equipment properly. Even carefully prepared solutions caused adverse reactions, such as severe chills and fevers, because pyrogens produced by bacteria remained in the solutions after sterilization.
In 1931, Idaho surgeon Ralph Falk, his brother, and Dr. Donald Baxter believed they could eliminate the pyrogen problem through controlled production in evacuated containers. When reactions continued to occur in patients, the doctors discovered that pyrogens were present in the rubber infusion equipment used by hospitals. They used disposable plastic tubing to eliminate this source of bacteria and worked with a glass manufacturer to produce a coating that resisted the contamination caused by the deterioration of the bottles that held the solutions.
In 1939 the fledgling company pioneered another medical breakthrough—a container for blood collection and storage. It was the first sterile, pyrogen-free, vacuum-type blood unit for indirect transfusion. It allowed storage of blood products for up to twenty-one days, making blood banking practical for the first time. The enormous demand for IV equipment and blood transfusions during World War II was a boon for Baxter. Its solutions were the only ones approved for wartime use by the U.S. military. Sales dropped dramatically after the war and rose again several years later during the Korean War. These fluctuating fortunes stabilized, and twenty-five years of uninterrupted company growth occurred after 1955 onward.[66]
This information comes from Baxter Travenol Laboratories Public Relations Department. The publication is entitled "The History of Baxter Travenol" and is unpaginated.
General Electric
General Electric was involved in every facet of the war, including building engines for planes, tanks, ships, and submarines. It
provided electrical capacity for large-scale manufacturing and also built power plants, testing equipment, and radio equipment.[67]
John Anderson Miller, Men and Volts at War: The Story of General Electric in World War II (New York: McGraw-Hill, 1947).
GE's activities extended to medical care for combat forces. Innovation was integral to that effort, as well as to the engines of war. "All along the story was the same. The war production job was one of prodigious quantities of all kinds of equipment. But it was also a job of constantly seeking ways to improve that equipment. Only the best was good enough, and the best today might be second best next week."[68]Ibid., 11.
General Electric's war-inspired medical equipment innovations included portable X-ray machines for use on ships and relatively inaccessible stations such as Pacific island hospitals. X-ray machines were also used to screen inductees for tuberculosis, and GE created cost-saving features, including machines that used smaller films. In addition, it built refrigeration and airconditioning systems for blood and penicillin storage. Government purchasing expanded market size. The army bought hundreds of electrocardiograph machines, ultraviolet lamps, and devices for diagnosis and therapy treatments.[69]
Ibid., 189.
The war affected innovation in dramatic ways. At the discovery stage, medical device innovation was stimulated and encouraged. Many technological innovations in materials science, radar, ultrasound, and other advancements had significant medical implications in the postwar period. Government purchasing stimulated the distribution of devices as well. The number of device producers and the value of their shipments grew in every SIC code.
Just as important, but less visible, were the institutional changes that occurred. Before the war, major public institutions had been formed that presaged government intervention in the discovery phase, most notably the NIH and the FDA. Wartime demands also accelerated the general public's acceptance of government involvement in scientific research and new technology. All these forces led to significant government activity in all phases of medical device innovation. The patient soon received extensive treatment.