Practice makes perfect

Houston company is using 3D printing to enhance surgeon training and prevent avoidable patient deaths

Lazarus 3D is using 3D printing to help advance surgeons' skills. Photo via laz3d.com

It is no surprise that, when a company offered life-like bladders for medical training, Houston urologists jumped at the opportunity — many had to learn the surgery by operating on bell peppers.

This sort of produce practice is the traditional method for teaching surgeons. Before a doctor ever makes an incision on a living person, they'll practice surgery on food — slicing bananas open and sewing grapes back together.

But for a pair of Baylor College of Medicine-educated doctors, that didn't seem like sufficient prep for working with living bodies; fruit surgery was not fruitful enough. In 2014, Drs. Jacques Zaneveld and Smriti Agrawal Zaneveld founded Lazarus3D to build a better training model — and layer by layer, they created models of abs and ribs and even hearts with a 3D printer.

"We adapted pre-existing 3D printing technology in a novel proprietary way that allows us to, overnight, build soft, silicone or hydrogel models of human anatomy," says Jacques, who serves as CEO. "They can be treated just like real tissue."

This isn't 3D printing's foray in medicine. In 1999, doctors in North Carolina implanted the first 3D-printed bladder in human bodies — they covered the synthetic organs in the patients' cells so that their bodies accepted them. Since, researchers have continued to find uses for the technology in the field, printing other organs and making prosthetic limbs.

But the Lazarus3D founders felt like medical training was lagging behind. Even cadavers, which medical schools also use to prepare doctors for surgery, don't represent a healthy human body or the diseased state of a hospital patient, said Smriti, who works as the research director.

The pair turned their kitchen into a printing lab and set to work, creating life-like models of human organs. They didn't have to go far after their first successes to find potential buyers — they just went to Starbucks. In a coffeeshop in the heart of the Medical Center, they talked loudly about their product until the neighborhood doctors and researchers took interest and gathered around.

Over the next few years, the Lazarus3D team pooled resources and contacts and, a summer after opening, they moved out of their kitchen and into an office. They now are a Capital Factory portfolio company and have partnerships with Texas Children's, Baylor College of Medicine, MD Anderson Cancer Center, and others, providing organs for specialized training — and the more they expand, the more they're able to prepare doctors for invasive, sometimes dangerous procedures.

"There are over 400,000 deaths annually in the U.S. due to medical error," Smriti says. "Not all of them are due to surgical mistakes, but all of these, nonetheless, were preventable."

The models can also be used for explaining to patients in a visual way what surgeries they're about to receive — the black and grey smears on an MRI scan might not actually help a patient understand much about what a surgeon is going to do to their body. In 2018, Lazarus3D won a contest with NASA on the potential for 3D printing organs in space, so that major surgeries might be performed there. And the printed organs can also be used by researchers to safely develop new surgery methods.

This year, the company grew to seven people and aims to expand even more to add to its sales and manufacturing teams. Having been funded mostly by friends and family investors, Lazarus3D plans enter its first equity round this year. They're raising $6 million.

"Every generation in medicine, people look back at what was done before and think 'Man, that was barbaric,'" Jacques said. "Fifty years from now, we're going to look back and think, 'Man, back then we used to just give someone a patient to learn how to do physical skills on? That seems crazy.'"

Everlywell says it will prioritize giving its at-home COVID-19 tests to healthcare professionals. Photo by Siri Stafford/Getty Images

The on-again, off-again launch of a coronavirus test from Austin startup Everlywell is on again — sort of.

On March 23, Everlywell was supposed to start shipping 30,000 test kits to U.S. consumers. But before a single test was sent, the U.S. Food and Drug Administration (FDA) blocked the distribution of at-home, self-administered tests from Everlywell and other companies.

Now, the Austin-based company is making the tests available primarily to hospitals and other healthcare providers in the U.S. to meet a "desperate need" for front-line medical professionals to be tested.

"In this evolving health crisis, our highest priority is to ensure that the people at highest risk get the accurate testing and care they need," Michelle Davey, CEO of Wheel Health, says in a March 23 release.

Everlywell says that effective March 23, its test is available only to hospitals and healthcare providers that offer it at no cost to their front-line workers, along with high-risk patients who exhibit coronavirus symptoms.

The company, which produces a variety of at-home lab tests, says its shift from testing of consumers to testing of healthcare workers and high-risk patients is "critically important" to help prevent the spread of what's known as the novel coronavirus. The virus causes the highly contagious and potentially deadly COVID-19 respiratory illness.

It's been a confusing few days since Everlywell announced it was making at-home tests for consumers. On March 20, the FDA said it hadn't authorized at-home, self-administered coronavirus tests from Everlywell or any other company. Three days later, on March 23, Dr. Deborah Birx, coronavirus coordinator for the White House, announced the federal government was clearing the way for self-swabbing coronavirus tests such as those made by Everlywell.

In a series of tweets March 23, Everlywell said it's working with the FDA on "a path forward" for at-home coronavirus tests of consumers.

"The FDA sees the public health value in expanding the availability of COVID-19 testing through safe and accurate tests that may include home collection," the federal agency says, "and we are actively working with test developers in this space."

Everlywell unveiled a $1 million program design to spur labs to speed up development of an at-home coronavirus diagnostic test. Many labs answered the call, allowing Everlywell to set up a coronavirus testing and diagnosis system in a matter of days. For consumers, each test will cost $135. Some providers of health savings accounts and flexible spending accounts will cover these tests.

Eventually, Everlywell wants to ship 250,000 tests per week.

At the same time, another Austin startup, Wheel Health, and Houston-based Microdrop have unveiled a partnership that will provide at-home coronavirus testing administered by licensed healthcare professionals, rather than consumers themselves, and supported by telemedicine technology. The federally approved product is geared toward people at high risk of the coronavirus or people with limited access to testing. For now, it's available only in Texas.

The test from Wheel, a telehealth provider, and Microdrop, a producer of at-home health tests, also costs $135. At the outset, the companies will roll out 5,000 test kits in Texas. After that, they plan to sell 10,000 test kits per week. Nationwide, the companies hope to offer 100,000 test kits per week by the end of April.

"Providing accurate medical guidance to people who are concerned about, or may have been exposed to, COVID-19 will determine the way this pandemic plays out in our country — and collaboration is essential to mobilizing toward this common goal rapidly and efficiently," says Dr. Rafid Fadul, chief medical officer of Wheel.