Prosthetics businesses getting creative to grow ‘tiny’ industry

HANDS-ON: Jonathan Teoli, owner of Rhode Island Limb Co. in Cranston, works with some of the prosthetics he produces. He designs and fits each device by hand.  / PBN PHOTO/­MICHAEL SALERNO
HANDS-ON: Jonathan Teoli, owner of Rhode Island Limb Co. in Cranston, works with some of the prosthetics he produces. He designs and fits each device by hand. / PBN PHOTO/­MICHAEL SALERNO

Jonathan Teoli is the third-generation owner of Rhode Island Limb Co. His grandfather purchased the business decades ago after returning from the Pacific theater of World War II as an amputee.

Interest in prosthetic limbs, he said, waxes and wanes, but prosthetic-engineering businesses are riding the latest crest of a popularity wave that began after Sept. 11, 2001.

Teoli, who has worked in the family business since age 13, said it’s not “a-typical” for the industry to see increased interest in jobs and research during times of international conflict: “sadly, this is when a lot of money and technology is thrown at prosthetics.”

But veteran amputees are not the bread and butter of his or the industry’s work. Teoli’s time is split between meeting with patients, most of whom are severely ill or diabetic, talking them through the impact of wearing a prosthetic and engineering the devices in his on-site laboratory. He continues the practice of designing and fitting each prosthetic device by hand.

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And the reality of the job, the physical and emotional impact on patients and prostheticians, culls those unable to handle the toll. Teoli estimated 40 percent of his classmates no longer practice.

“It’s a teeny, tiny little field,” he said.

In an effort to grow the industry and further involve professionals in the development of emerging prosthetics technology, Teoli serves as a research assistant in a Providence VA Medical Center program that brings together area business owners with experts from Brown University and Massachusetts Institute of Technology in Cambridge, Mass.

He is grateful industry professionals are included, and calls university research “progressive-minded,” but wants more.

David Borton, Brown University professor of engineering, does not believe a disconnect exists because academic research goals do not align with businesses’ aims. In fact, he said, the two are inherently connected via one common goal: helping improve the lives of others.

Brown’s current prosthetics-engineering research, which was recently boosted by a $19 million four-year Defense Advanced Research Projects Agency grant, does not involve creating prosthetic devices, rather neuro-engineering and the extraction of information from the brain to control devices such as those engineered by Teoli and others.

“I don’t know what’s holding up the innovation and cross-pollination of this space,” said Borton, who suggested network-based funding opportunities, such as the BRAIN Initiative co-launched by federal organizations and nongovernmental organizations in 2013, which are few and far between in Rhode Island, might be the key.

James Wagner, CEO of Coventry-based BI Medical LLC, which developed a cleaning system to prevent bacterial contamination of prosthetic devices, is broadening the depth of the state’s industry and hoping to attract investment capital with a medical technology small-business incubator.

‘The goal is to get creative minds to stay in Rhode Island and not have them flee.’
JAMES WAGNER, BI Medical LLC CEO

“The goal is to get creative minds to stay in Rhode Island and not have them flee to Palo Alto,” he said.

The current interest in prosthetics is “a massive opportunity” for a state such as Rhode Island, said Wagner, because it’s home to “a lot of intellectual horsepower” at Brown, University of Rhode Island and Rhode Island Hospital.

As Teoli explained, Rhode Island’s prosthetic-engineering industry is facing a wave of renewed interest, but involved players may jeopardize its success by not reconciling their expertise. What worries Teoli, and other local prosthetics-engineering businesses, is the increasing commonality of 3-D-printed prosthetic devices – many of which come from universities.

New England Institute of Technology engineering department chair Dean A. Plowman said 3-D prosthetics printing – what he considers a faster, more comfortable, less expensive alternative – has been an NEIT focus for five years.

Because these are not “FDA-approved” nor “[Occupational Safety and Health Administration]-compliant,” Teoli said, they “cannot necessarily be commercially deliverable.”

“You cannot 3-D print a lower-limb prosthetic that is safe enough for an adult to take 10,000 steps per day for five years,” he said.

Joshua R. James, owner of South County Artificial Limb & Brace Co. in the Wakefield village of South Kingstown, is happy to continue engineering prostheses by hand. He understands high-tech devices are the future, but said their benefit to patients such as his, 80 percent of whom use low-tech prostheses, is “in its infancy.

“That’s not just me, that’s the industry,” he said, counting two high-tech devices placed this year and more than 20 low-tech.

More students interested in jobs and the recent creation of a master’s degree are encouraging for the field, said James, but he hopes future students do not forget to balance their focus on both anatomy and ­technology.