Jarvik, Robert Koffler

Citation metadata

Editor: James Craddock
Date: 2013
Encyclopedia of World Biography
From: Encyclopedia of World Biography(Vol. 33. 2nd ed.)
Publisher: Gale, part of Cengage Group
Document Type: Biography
Pages: 4
Content Level: (Level 4)

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About this Person
Born: May 11, 1946 in Midland, Michigan, United States
Nationality: American
Occupation: Medical scientist
Other Names: Jarvik, Robert K.; Jarvik, Robert Koffler
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Page 154

Robert Koffler Jarvik

American medical scientist, inventor, and businessman Robert K. Jarvik (born 1946) helped pioneer artificial heart technology.

Robert Jarvik's name is linked to artificial heart technology. A layman might get the impression that Jarvik—a creative and manually dexterous individual—came up with the concept. He built upon previously developed artificial heart designs, however, and, in the process, resolved several significant problems related to those earlier designs. His innovations moved the artificial heart technology beyond experimentation with animal models. Indeed, with colleagues, he helped design and construct the first artificial heart that was implanted in a human. Throughout his career, he gained numerous patents for medical device technology, and his efforts resulted in the first permanently implantable artificial heart.

Despite the controversy that his work sometimes generated, Jarvik gained fame, awards, and medical industry plaudits for his efforts.

Early Interest in Medicine

Jarvik was born on May 11, 1946, in Midland, Michigan, to Norman Eugene Jarvik, a physician, and Edythe (Koffler) Jarvik. His parents later moved to Stamford, Connecticut, where he was raised.

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Jarvik, Robert Koffler Jarvik, Robert Koffler © Karen Bleiera/AFP/Getty Images

As early as his elementary school years, Jarvik became interested in mechanics, and he demonstrated manual dexterity, building model planes and ships. He also liked to take things apart (such as home appliances) and reassemble them, to better understand how they worked. He developed his interest in medicine when, as a teenager, his father let him watch as he performed surgeries.

Specifically, Jarvik became interested in medical tools. While still in high school, he came up with his first invention which earned him a patent: an automatic surgical stapling machine. It was an innovative, time-saving device that replaced physicians' manual method of sewing blood vessels together during surgery.

But Jarvik had diverse interests. Art, especially sculpture, greatly intrigued him. In 1964, he entered Syracuse University, where he took courses in drawing and architecture, and he seriously considered a career in art. He ultimately majored in zoology, however, and graduated in 1968 with a bachelor's degree in that discipline.

His life and career direction significantly changed when his father suffered an aortic aneurism that nearly killed him. The circumstanced led Jarvik to alter his educational path toward pre-medicine. (Heart surgeon Michael DeBakey, who developed the concept of mobile army surgical hospitals [MASH units] treated Norman Jarvik.)

Denied Entrance into Medical Schools

Robert Jarvik applied to American medical schools, but his college grades were not good enough for acceptance (he later revealed that he was turned down by about 25 schools). Not a person to be denied, Jarvik opted to enroll at the medical school at the University of Bologna, in Italy. After two years of study, he returned to the United States and again applied to medical schools. Rejected yet again, Jarvik entered New York University, where he studied occupational biomechanics. In 1971, he received his masters of arts degree.

Meanwhile, during this period, Jarvik married his first wife, journalist Elaine Levin (on October 5, 1968). The couple had two children, Tyler and Kate. The marriage ended in divorce in 1985. In 1987, Jarvik would marry again, to writer Marilyn vos Savant. His second wife was listed in the Guinness Book of World Records for possessing the world's highest IQ (228).

Career Strategy Works Out

After earning his degree, Jarvik worked at Ethicon Inc., a surgical supply company. But he still had ambitions of becoming a doctor. To that end, he applied for a job at the University of Utah's Institute for Biomedical Engineering and Division of Artificial Organs, which was directed by Dr. Willem Kolff, who was a pioneer in the areas of hemodialysis and artificial organs. Jarvik hoped this move would help improve his chances for admission into a medical school. In 1971, he was hired as a laboratory assistant.

Jarvik became an assistant design engineer for Kolff, who had began working on an artificial heart in the 1950s. That effort became the main focus of his division at the university in 1967. Jarvik's strategy worked: He was accepted into Utah's medical school. He earned his degree in 1976. That same year, his father died of an aneurysm, a tragedy that strengthened his ambition to help people suffering heart disease.

Became Involved in Artificial Heart Research

Well before Jarvik entered the Utah university, early iterations of artificial heart technology had been developed. In 1957, Kolff had experimented with models in animals. Efforts generated optimism, but significant challenges remained. Later, Jarvik, with his substantial mechanical skills, would help hurdle existing artificial heart-related problems.

The driving idea behind artificial heart technology involved the need for transplants. In many cases, patients suffered heart disease so severe that they would die before a donor heart became available. Technology such artificial hearts might offer could potentially prolong their lives as they awaited the donor organ.

A major problem that medical investigators faced was developing a pump with a sufficient power source. To leap that hurdle, researchers tried to design a single unit that combined a heart pump—which would recreate the two lower heart ventricles (the pumping area)—and an adequate power source. Such a unit would be implanted into the patient. Kolff first experimented with a nuclear power source and then tried an option that involved a machine, located outside of the body, which used compressed air to Page 156  |  Top of Articleprovide power. While the solution seemed workable, the patient would have to be attached to the machine by tubes, and so it did not seem practical. Researchers considered creation of a permanent, implantable heart model—something that would not be merely a temporary arrangement.

At University of Utah's Institute for Biomedical Engineering and Division of Artificial Organs, researchers had already developed the “Kwann-Gett” heart, based on the designs of institute's Dr. Clifford Kwann-Gett. The device had an inherent flaw: a rubber diaphragm. This diaphragm served as the pumping component that moved blood in and out of the artificial heart. The device reduced risk of mechanical failure (animals implanted with this early version of the artificial heart survived for two weeks); however, the diaphragm caused excessive clotting, and in a heart patient, that clotting condition could be fatal. Jarvik improved upon the design by replacing the rubber diaphragm with three layers of biomer, an elastic polyurethane. This innovation solved the clotting problem.

This improved version was called the Jarvik-3, and it was developed in 1972. In an experiment, it was placed inside a calf, and the animal survived for ninety days. Jarvik then developed an even better version, called the Jarvik-7. In 1976 (the year Jarvik completed medical school), it was tested inside another calf, which lived for 268 days.

The Jarvik-7 was comprised of Dacron, polyester, plastic and aluminum, and it was driven by an internal power system that regulated the pump through a system of compressed air hoses that entered the heart through the chest. This new ôheartö model, Jarvik and his fellow researchers ensured, could beat at least 100,000 times a day.

Also that year, Jarvik joined Kolff's company, Kolff Associates (which later became known as Kolff Medical Inc.). In 1979, he became research assistant professor of surgery and biomedical engineering at the University School of Medicine. By this time, he was anxious and ready to move beyond animal models to a human subject.

Historic Application of Artificial Heart Technology

In 1979, Kolff made an initial request to the United States Food and Drug Administration (FDA) to use the Jarvik-7 on a human subject. The request was denied. But in 1981, the agency finally provided approval. However, the FDA made certain stipulations: The patient had to be more than eighteen years old, and the patient must be one that could not survive after being removed from a heart-lung machine following open-heart surgery. The most suitable patient was Barney Clark, a retired Seattle, Washington dentist and heart patient, whose health was in critical condition.

History was made on December 2, 1982, when Dr. William Castle DeVries implanted the Jarvik-7 into Clark. At sixty-one years old, Clark was afflicted with advanced cardiomyopathy, which is described as a degenerative heart disease that affects the heart muscles. The illness was terminal; death was inevitable. Clark's attitude was heroic. He essentially gave himself over to an unknown science, but he believed he would help advance heart treatment. And, obviously, he believed that this experimental procedure was his only hope.

Jarvik assisted DeVries and his surgical team in the procedure. The team had high hopes. They envisioned the implantation as a permanent replacement organ, as they perceived certain advantages. There would be no wait for an available donor heart and, very significantly, there would be no risk that the body would reject foreign tissue.

It was a marathon procedure. The operation, which took place at the University of Utah Medical Center, lasted seven-and-a-half hours.

For his efforts, in 1982, Jarvik was named “Inventor of the Year” by the Intellectual Property Owners Association. The following year, he was honored by the National Inventors Hall of Fame. During that decade, Jarvik received honorary doctorates from Syracuse University (1983) and Hahnemann School of Medicine (1985).

Subsequently, Jarvik became internationally famous. As for Barney Clark, he lived for 112 days after the Jarvik-7 implantation. Although he succumbed to multiple organ failure, the ensuing autopsy revealed that the Jarvik-7 artificial heart was still working. Another patient, Howard Schroeder, was implanted with the Jarvik-7 in 1985, and he survived for 620 days, despite suffering strokes, hemorrhages and infections. Obviously, the Jarvik-7 was not a heart-disease panacea. Still, by the end of the 1980s, about 70 Jarvik devices had been implanted in patients awaiting heart transplants. From there, researchers worked on improving the technology to make it a permanent option.

Controversies

While artificial heart technology represented a significant medical advancement, it also generated controversy–involving costs (which many in the medical industry considered too high) as well as ethics (some considered the technology still experimental and, thus, made patients human “guinea pigs”). Others said that the procedure substantially reduced a patient's quality of life. Jarvik argued that the surgery could only make a patient's quality of life better. After all, the patients served by the procedure faced inevitable death. Artificial heart implantation prolonged life. Still, it only served as a temporary solution for people awaiting heart transplants. It was no cure for heart disease, and implantation also produced complications such as strokes.

Jarvik himself would later come under intense critical fire when, in 2008, he endorsed the cholesterol-lowering medication Lipitor and appeared in television advertisements touting the drug's benefits. As Time magazine reported, Pfizer, the company that produced Lipitor stopped its advertising campaign (valued at $139 million) after a Congressional committee raised questions about Jarvik's qualifications as an endorsee.

The main problems, the news magazine indicated, was that Jarvik, while a medical school graduate, was not licensed to practice medicine and, thus, was not legally certified to write prescriptions for medications. In the advertisements, Time writer Alice Park pointed out, Jarvik said that he took Lipitor and gave the impression that he was a practicing physician offering medical advice.

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Compounding the problem, the ads depicted Jarvik rowing a boat on a lake, to underscore Lipitor's benefits. This was a distortion of reality. Jarvik was never actively engaged in such a sport, and the “Jarvik” portrayed in the advertisement was actually a “body double” (or a standin). Indeed, the “body double” later described his experience substituting for Jarvik in rowing club newsletter.

The controversy compelled Pfizer to release a defensive public relations statement: “The way in which we presented Dr. Jarvik in these ads has, unfortunately, led to misimpression and distractions. Going forward, we commit to ensuring there is greater clarity in our advertising regarding the presentation of spokespeople.”

Jarvik also defended his participation. Offering a website clarification, Jarvik, as Time reported, wrote, “I do not practice clinical medicine and hence do not treat individual patients. My career is in medical science. I have the training, experience and medical knowledge to understand the conclusions of the extensive clinical trials that have been conducted to study the safety and effectiveness of Lipitor.”

Despite the defensive posturing by both the company and Jarvik, Pfizer ended this ad campaign.

Further Artificial Heart Development

Jarvik's website statement correctly characterized his career. His milieu wasn't the traditional doctor's office where patients were seen and treated. And even though he assisted in implant operations, the operating room was not his territory. He was not a cardiologist, and he was not licensed to practice medicine. Rather, Jarvik's environment was the science laboratory, where he conducted research to ever improve artificial heart technology.

In 1998, Jarvik developed a new artificial heart model called the Jarvik 2000. It is a left-ventricular assist system, and its placement did not require that a patient's natural heart be removed from the body. This small device could be implanted in the natural heart's left ventricle. This insertion allowed for pumping action and power source, enhancing output of the natural heart regulating blood flow. It also reduced infection risk—and, of course, it was pioneering heart-care technology.

By September 2002, three United States institutions had deployed the device in human subjects. That year, at the University of Maryland Medical Center, Jarvik assisted Chief of Cardiac Surgery Bartley Griffith, MD, during a procedure. On the center's website, Jarvik described, “[The Jarvik 2000 is] a miniature rotary pump, it's electrically powered and is approximately a pacemaker-sized booster pump for the heart. We call it a flowmaker. The Jarvik 2000 boosts the work that the left side of the heart can do. It goes inside the left ventricle, and that's very important because that indicates it's very tiny. It's also silent and it moves with the natural heart as the heart beats. So it doesn't interfere with the motion of the natural heart, and that helps the natural heart recover.”

The goal of the device, he explained, is to rehabilitate patients suffering severe congestive heart failure so that they can enjoy more mobility and a more normal lifestyle. Ultimately, the device would not be used as a “bridge” to a transplant device but serve as a lifetime device, he envisioned.

But the device did receive FDA approval as a “bridge.” This led to another important development in this direction: In 2006, researchers at Abiomed received FDA approval for their AbioCor replacement heart. Their softball-sized, three-pound artificial heart, had an internal power source (unlike the Jarvik-7) that allowed it to work for up to thirty minutes. Power was supplied by batteries attached to a belt. Jarvik's earlier work made such improvements possible.

Appropriately, Jarvik has been recognized and awarded for his work. His pioneering work created a vibrant area of research and led to innovations and new directions in the realm artificial heart technology.

Periodicals

The New York Times, February 7, 2008.

Time, February 26, 2008.

Online

“Great Lives from History: Inventors and Inventions (Robert Jarvik,” Salem Press.com, http://salempress.com/store/samples/great_lives_from_history_inventors/great_lives_from_history_inventors_jarvik.htm (December 1, 2012).

“Inventor of the Week,” Web.mit.edu, http://web.mit.edu/invent/iow/jarvik.html (November 5, 2012).

“Robert Jarvik, MD,” Jarvikheart.com, http://www.jarvikheart.com/basic.asp?id=43 (November 5, 2012).

“Robert Jarvik on the Jarvik-7,” Jarvikheart.com, http://www.jarvikheart.com/basic.asp?id=69 (November 5, 2012).

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Source Citation   

Gale Document Number: GALE|CX3705000079