Transforming Spare Parts into a Ventilator
The pandemic hit New York like a tidal wave in March 2020, as the number of coronavirus cases in the United States rose from an estimated 300 to more than 200,000 — and the death toll skyrocketed from one to 3,000. Stony Brook University locked down with virtually all classes going online, and Stony Brook University Hospital quickly found itself facing a dangerous prediction — there would be a shortage of at least 1,000 ventilators if the virus kept spreading at its then-current rate. This could mean hundreds, if not thousands, of preventable deaths.
Something had to be done.
Under the guidance of New York State Assemblyman Steve Englebright (D-Setauket), an interdisciplinary team was established to take on the task of creating an easily produced ventilator that could supplement the hospital’s reserves. Ventilators – commonly known as breathing machines or respirators – enable patients to breathe if they are unable to do so on their own. A typical hospital-grade ventilator can cost between $25,000 and $50,000 — and estimates showed that Stony Brook University Hospital might need an additional 25,000 machines.
This project would come to be named CoreVent 2020.
The team leader was Jon Longtin, then associate dean of research and entrepreneurship in Stony Brook’s College of Engineering and Applied Sciences as well as a professor of mechanical engineering. Now interim dean, Longtin had experience in other high-profile collaborative COVID-related projects such as the design of the Clear-Vu Medical Face Shield, thousands of which are now in use at the university’s hospital as well as other area hospitals.
John Britelli – a clinical professor in the respiratory care program in the School of Health Technology and Management – was brought in by Englebright. With more than 30 years of experience, he has a host of certifications, including as a registered pulmonary function technologist and a specialist in neonatal and pediatric respiratory care.
Dimitris Assanis, an assistant professor of mechanical engineering, had just started at Stony Brook two months before. His research focuses on vehicles – specifically their engines and how to make them more environmentally friendly. He came to Stony Brook in 2020 after completing all his degrees in mechanical engineering – bachelor’s, master’s and doctorate – at the University of Michigan and spending 12 years working for his mother’s Ann Arbor-based information technology consulting company.
Together, these three formed the core of the CoreVent team, which also included Dr. Brian Margolis, a pulmonary disease specialist at St. Catherine of Siena Medical Center in Smithtown; Dr. Gerald Smaldone, chief of pulmonary medicine at Stony Brook’s Renaissance School of Medicine and Dr. Christopher Page, chief of the acute pain division of the medical school’s Department of Anesthesiology.
“It was quite a project, we worked 10 days straight, day and night,” Britelli says. Ten days was all it took for them to create a device that ended up never being needed – but that remains a one-of-a-kind model of teamwork.
It all started with a late-night phone call between Britelli and Longtin on March 27, 2020. The next day – a Saturday – they were face to face in Britelli’s office at Stony Brook. “We talked for five, maybe six minutes,” Britelli recalls, “and then we went into my laboratory. And we just started writing on the board, figuring things out. All of a sudden two hours went by – I had no concept of time – and we had a ventilator that was easy to build and easy to reproduce.”
The team quickly took advantage of Assanis’s engineering skills to help create the first prototype. That first night they worked in Longtin’s Port Jefferson garage. Then the project moved to Britelli’s respiratory therapy teaching lab in the Renaissance School, where they tested it and developed a second prototype. As they worked, the team took “an abundance of care” with safety procedures, Assanis explains, spending what felt like “16 to 20 hours a day” just a few floors below the hospital emergency department.
“We would get daily reports of how many people were on vents,” Assanis recalls. “You’re on day four, five, six and you’re trying to perfect a design and you realize that perfection is the enemy of good. The longer it takes to perfect it, it’s safe and reliable – but upstairs there are people dying from COVID. You ask yourself, ‘Can I get this done 10 hours sooner?’ because it needs to go on a patient and save someone.”
The ventilator was designed to be easily replicated for mass manufacturing, being created from what Assanis described as “spare parts.” Britell noted that a spigot from a garden hose was used to control oxygen flow at one point. “We had to use parts that were available in Home Depot, Lowe’s, mail-order, eBay,” he says. “The parts couldn’t be specialized.” And all the parts were available from multiple vendors to eliminate delivery delays in case replacements were needed.
On April 6, the project was finished. And the team unveiled what was officially announced as a “computer-controlled, pressure-cycled, time-limited ventilator” – complete with “assisted-breathing mode, visual status indicators and low- and high-pressure alarms.”
Fully functioning as an emergency ventilator, it was tested on an advanced lung simulator provided by Smaldone, the medical school’s chief pulmonologist, as well as lab mice. It was ready to be used on human COVID patients.
As it turned out, the hospital managed to get through the peak of coronavirus cases without running out of ventilators, thanks to donated machines and other financial contributions. As Britelli put it, they “just squeezed it.”
Today, the CoreVent 2020 remains in storage, never used – and likely to never be mass-produced while professional ventilators are available. The trio of scientists are working on a new project to design a self-powered mask that filters air to the wearer. The goal is a mask that leaves the wearer’s face completely visible and doesn’t need to be connected to an external power source.
“The problem is, it’s very scary for the patient,” Britelli says of face masks. The design he and his team are working on has benefits for medical workers and patients. “It’s comfortable,” he explains. “You can see the whole health care worker, you can see their eyes, their mouth, their facial expressions. One of the big complaints that we got from the patients was that they felt so isolated because they weren’t seeing their loved ones, because they weren’t allowed to. And the people they were seeing were all gowned and gloved — they were hidden. They weren’t seeing their faces. And people have a need to see faces.”
Other projects the team has worked on or plan to work on include ventilators that don’t require respiratory therapy training to use and infant incubators for emergency use.
“You make these great things and nothing happens to them,” Britelli says. “You just have to accept that. But with the CoreVent we were tickled pink that it wasn’t used. … It was scary knowing that human beings could go on this and that their breath would depend on this ventilator. So, it’s not a feeling of discouragement, it’s not a feeling of emptiness – it’s a feeling of relief. It’s a good feeling. We were looking for the vent to collect dust and never get used.”