Rice University engineering students, from left, Lemuel Soh, Peter Jung, Glenn Fiedler and Kevin Jackson show the AutoSyP, which they intend to be a reliable, portable, automated drug delivery system for the developing world. (Credit: Jeff Fitlow/Rice University)
A device without a need, and a global need without an inexpensive solution have brought together experts from Rice University and the Medical School, whose collaboration may have an impact on the health of patients worldwide.

A dinner for global health leaders of the Texas Medical Center was the start of this partnership, led by Dr.  Rohith Malya, assistant professor of emergency medicine, and Dr. Rebecca Richards-Kortum, director of the Rice 360˚ Institute for Global Health Technologies.

“She invited me to her lab, and when I was over there we threw around ideas.  They were working on a timing mechanism but did not have a clear application for it.  I saw the need for thrombolytics in STEMI (ST segment elevation myocardial infarction) and stroke, recognizing the limited access to drips in the field.  Their technical expertise and our medical need came to each other’s assistance,” Malya explained.

Richards-Kortum’s engineering students developed a durable spring-loaded device, which regulates the progress of standard syringes.  Called the AutoSyP, it is designed for patients in developing nations who need quick access to a slow and steady supply of medication.

The students have already been honored for their work, placing third in the 2013 University of Minnesota Design of Medical Devices student competition earlier this month. But the real payoff will come when their mentors from the Medical School will take their device to Fiji for evaluation with heart attack and stroke patients.

“Fiji happens to be the epicenter for coronary disease in the modern world.  They have a STEMI rate that is 5 to 10 times that of the United States, and their STEMIs tend to have a higher sudden cardiac death rate,” Malya explained.  “This device was geared to making a difference where it matters most — giving to a part of the world that doesn’t have much, but is vitally dependent on thrombolytics, unlike the United States, which has opted for mechanical revascularization via angioplasty suites.”

Malya said that Fiji has essentially the same process for clinical trials as the United States, with an institutional review board and human subject protection.

Rice students Glenn Fiedler, Peter Jung, Lemuel Soh, and Kevin Jackson designed their device to run for 24 hours using very little battery power as it delivers a measured dose of drugs or saline to a patient more accurately than an IV drip would. Though it can help treat patients with many needs, the first are likely to be cardiac patients like those under the care of Malya and stroke patients of Dr. Amy Noland, an assistant professor of emergency medicine.

Fine control of the drug delivery is critical, and the AutoSyP delivers, Jackson said. “Our device accommodates syringe sizes from 5 to 60 milliliters, and the flow rate varies depending on the syringe size. It can be 60 all the way down to 5 milliliters per hour,” he said.

The AutoSyP delivers force to syringes of various sizes through a spring-driven ratchet-and-pawl escapement system, like those found in timepieces. “The idea is to regulate something that wants to unwind quickly,” said Jung, also a future medical student, explaining why the team used a battery-driven stepper motor to disengage the two pawls from the ratchet in turn.

“The spring wants to unwind the ratchet, but it’s opposed by the pawls,” Jung said. “So to knock these pawls up one at a time and allow the release in spring tension, we need to input some energy.”

Every step pushes the syringe plunger a tiny bit forward. A few simple adjustments allow a clinician to adapt the device for various syringe sizes.

Malya hopes to have one or more AutoSyP prototypes in Fiji for evaluation by health officials within the next six months.

“If this works in Fiji, it’s very expandable to much of Africa and Southeast Asia,” he said. “We are aiming to build the first international STEMI system-of-care, and this device is the crux of it.  If we can cut STEMI mortality in half in Fiji, we have a powerful tool for ameliorating the burden of coronary disease in much of the world without access to cath labs.”

– Mike Williams, Rice University, with Darla Brown, Medical School