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Health
Car Mechanic Dreams Up a Tool to Ease Births
Diego Giudice for The New York Times
With Jorge Odón’s device, a plastic bag inflated around a baby’s head is used to pull it out of the birth canal.
By DONALD G. McNEIL Jr.
Published: November 13, 2013 264 Comments
The idea came to Jorge Odón as he slept. Somehow, he said, his unconscious made the leap from a YouTube video
he had just seen on extracting a lost cork from a wine bottle to the
realization that the same parlor trick could save a baby stuck in the
birth canal.
Diego Giudice for The New York Times
Mr. Odón’s got the idea from a method to retrieve a cork from a wine bottle.
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Mr. Odón, 59, an Argentine car mechanic, built his first prototype in
his kitchen, using a glass jar for a womb, his daughter’s doll for the
trapped baby, and a fabric bag and sleeve sewn by his wife as his
lifesaving device.
Unlikely as it seems, the idea that took shape on his counter has won the enthusiastic endorsement of the World Health Organization and major donors, and an American medical technology company has just licensed it for production.
With the Odón Device, an attendant slips a plastic bag inside a
lubricated plastic sleeve around the head, inflates it to grip the head
and pulls the bag until the baby emerges.
Doctors say it has enormous potential to save babies in poor countries, and perhaps to reduce cesarean section births in rich ones.
“This is very exciting,” said Dr. Mario Merialdi, the W.H.O.’s chief
coordinator for improving maternal and perinatal health and an early
champion of the Odón Device. “This critical moment of life is one in
which there’s been very little advancement for years.”
About 10 percent of the 137 million births worldwide each year have
potentially serious complications, Dr. Merialdi said. About 5.6 million
babies are stillborn or die quickly, and about 260,000 women die in
childbirth. Obstructed labor, which can occur when a baby’s head is too
large or an exhausted mother’s contractions stop, is a major factor.
In wealthy countries, fetal distress results in a rush to the operating
room. In poor, rural clinics, Dr. Merialdi said, “if the baby doesn’t
come out, the woman is on her own.”
The current options
in those cases are forceps — large, rounded pliers — or suction cups
attached to the baby’s scalp. In untrained hands, either can cause
hemorrhages, crush the baby’s head or twist its spine.
Although more testing is planned on the Odón Device, doctors said it appeared to be safe for midwives with minimal training to use.
Along the way, it has won research grants from the United States Agency
for International Development and from Grand Challenges Canada. “We’ve
given out $32 million for 61 different innovations, and this one is the
farthest along,” said Dr. Peter A. Singer, the chief executive of Grand
Challenges Canada.
The device will be manufactured by Becton, Dickinson and Company, or BD,
of Franklin Lakes, N.J., which is better known for making syringes.
“My first reaction, as soon as I saw it, was positive,” said Gary M.
Cohen, the company’s executive vice president for global health. It was
at the World Economic Forum in Davos, Switzerland, that Dr. Merialdi
asked him to consider taking it on.
“Many inventions get to the prototype stage, but that’s maybe 15 percent
of what needs to be done,” Mr. Cohen said. “There’s finalizing the
design for manufacture, quality control, the regulatory work and
clinical studies. Absent that, they don’t see the light of day.”
So far, the device has been safety-tested only on 30 Argentine women,
all of whom were in hospitals, had given birth before and were in normal
labor.
“I was glad they asked me, because it was for a good cause,” said
Luciana Valle, a kindergarten teacher who was 31 two years ago when her
son, Matteo, was one of the first babies extracted with the device.
Because Matteo weighed almost nine pounds, “it really helped,” she said
in a telephone interview. “His head came out on my second push.”
The W.H.O. will now oversee tests on 100 more women in normal labor in
China, India and South Africa, and then on 170 women in obstructed
labor.
In a telephone interview from Argentina, Mr. Odón described the origins of his idea.
He tinkers at his garage, but his previous inventions were car parts.
Seven years ago, he said, employees were imitating a video showing that a
cork pushed into an empty bottle can be retrieved by inserting a
plastic grocery bag, blowing until it surrounds the cork, and drawing it
out.
That night, he won a dinner bet on it.
At 4 a.m., he woke his wife and told her the idea that had just come to
him. (His own children were born without problems, he said, but he has
an aunt who suffered nerve damage from birth.)
His wife, he recalled, “said I was crazy and went back to sleep.”
The next morning, a somewhat skeptical friend introduced him to an
obstetrician. “You can imagine these two guys in suits in a waiting room
full of pregnant ladies,” he said.
The doctor was encouraging, so he kept working. Polyethylene replaced
the bag his wife had sewn, and the jar was replaced by a plastic uterus.
With the help of a cousin, Mr. Odón met the chief of obstetrics at a
major hospital in Buenos Aires. The chief had a friend at the W.H.O.,
who knew Dr. Merialdi, who, at a 2008 medical conference in Argentina,
granted Mr. Odón 10 minutes during a coffee break.
The meeting instead lasted two hours. At the end, Dr. Merialdi declared the idea “fantastic” and arranged for testing at the Des Moines University simulation lab, which has mannequins more true-to-life than a doll and a jar.
Since then, Mr. Odón has continued to refine the device, patenting each
change so he will eventually earn royalties on it.
“My daughter said, ‘And now I can have my doll back,’ ” he said.
It is too early to know what BD will charge, Mr. Cohen said, but each
device should cost less than $50 to make. While the company expects to
profit on all sales, it will charge poor countries less.
Dr. Merialdi said he endorsed a modest profit motive because he had seen
other lifesaving ideas languish for lack of it. He cited magnesium
sulfate injections, which can prevent fatal eclampsia, and corticosteroids, which speed lung development in premature infants.
“But first, this problem needed someone like Jorge,” he said. “An
obstetrician would have tried to improve the forceps or the vacuum
extractor, but obstructed labor needed a mechanic. And 10 years ago,
this would not have been possible. Without YouTube, he never would have
seen the video.”
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