This is an archived article that was published on sltrib.com in 2008, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
As Barney Clark lay in a Utah hospital bed in January 1983, clinging to life with a Jarvik 7 artificial heart, medical pioneer Willem J. Kolff sat in a truck in the parking lot of the Utah Artificial Heart Institute and sobbed.
Veterinarian Don Olsen, an expert at implanting versions of the heart in calves, remembers Kolff recounting how he felt Robert Jarvik, the latest designer, was monopolizing the media and overplaying his role.
Kolff feared recognition of his original work and that of about 247 other researchers was lost, Olsen remembers.
Twenty-five years later, Jarvik's lucrative stint promoting blockbuster cholesterol-lowering drug Lipitor has reignited frustration about who has - and deserves - credit for the medical device.
Pfizer Inc. halted the Jarvik campaign Feb. 25 amid a congressional investigation into whether its ads were misleading. Among the concerns: Jarvik is not licensed to practice medicine but appeared to be giving medical advice. He skipped a residency and went into research after graduation from the University of Utah School of Medicine in 1976.
Earlier versions of the ad dubbed Jarvik the "inventor of the artificial heart," drawing objections from Olsen, Kolff's son and other researchers who feel the 97-year-old Kolff, if anyone, deserves the title. Kolff was already recognized as the inventor of the first working artificial kidney in 1957 when he began work on a heart with a series of researchers.
Clifford Kwan-Gett, a Kolff colleague who designed a predecessor to the Jarvik 7, wants Congress to probe Jarvik's invention claim. Olsen said he is planning to write a book, hoping to influence how history sees the heart's creation.
"I'm not saying all of the credit should be taken away from Dr. Jarvik, not at all," Olsen said. "But now seems to be the time to clear the air and record for history the appropriate contributions."
Jarvik's Web site says he is "widely known as the inventor of the first successful permanent artificial heart, the Jarvik 7." Despite that and the wording of the 2006 Pfizer ad, Gary Lewi, Jarvik's publicist, said Jarvik has never claimed to be the sole inventor.
"While proud of the artificial device that bears his name, he has acknowledged repeatedly the role that others played to make a difference in presenting this breakthrough invention," Lewi said in an e-mail to The Salt Lake Tribune.
"The timing of this recent criticism - for an event that occurred decades ago - seems cynical at best, rather bitter and ill-founded," he said.
The first human implant of the Jarvik 7 was a pivotal moment in medical research at the U., catapulting the university, the state and Jarvik into national consciousness. Behind that success, however, tensions among competitive researchers have been simmering for decades.
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A heart's origins: Kolff started work on a heart at the Cleveland Clinic in Ohio and moved in 1967 to the U., launching its Division of Artificial Organs and putting it in the national race for an implantable artificial heart. He was joined by Ohio colleagues Kwan-Gett, a surgeon, and Tom Kessler, a prosthetic technician.
In Utah, Kwan-Gett's hearts set records for animal survival. "The heart and the driver were actually built by me and tested in animals before Jarvik arrived," said Kwan-Gett, now 73 and living near San Diego.
But Kwan-Gett and Kolff began to disagree about the heart's development. During one dispute over materials, Kwan-Gett said, he worked on heart models at home, curing silicone in his kitchen oven and buying parts at Grand Central, a discount department store. He left the program in 1971.
By then, Jarvik had met Kolff while working for Ethicon, a New York manufacturer that provided materials for the hearts.
Jarvik had graduated from Syracuse University with a degree in zoology; he then studied medicine in Italy for two years after American medical schools rejected him.
Back in New York, he earned a master's degree in occupational biomechanics from New York University in 1971. Kolff hired him that year, and he started medical school at the U. in 1972. Kessler said Jarvik wasn't an engineer, but he understood engineering principles; he wasn't a practicing doctor, but he understood anatomy. Kolff, then his enthusiastic mentor, singled out his ability to "make nearly anything with his own hands."
Jarvik made significant changes in materials, Olsen said. An example: he removed a metal ring at the heart's base, where it attached to the air compressor that drove the heart, and replaced it with a hard plastic ring. He could then use an adhesive to attach the heart to the base, replacing the wiring previously used, Olsen said.
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Jarvik's innovations: On jarvikheart.com, Jarvik says he was hired to solve two issues with the Kwan-Gett heart: improving the flow of blood from the lungs to the heart and improving the diaphragm that pumped blood through the heart.
Jarvik says he changed the shape of the heart to more closely mimic a human heart to solve the first problem, and invented a "multilayer blood pump diaphragm" to address the second. His diaphragm was made of three layers of polyurethane, replacing the silicone rubber, his site says.
Olsen and Kwan-Gett question Jarvik's claim. Kwan-Gett said he designed such a diaphragm, but he left before it was completed. Olsen argues multilayered diaphragms were already being used by mechanical engineers and that Jarvik simply applied the concept to the heart.
Still, the U. made note of Jarvik's diaphragm in a 1982 statement about the heart's development.
"Jarvik's improvements to the Kwan-Gett heart did not alter its basic function or operation," it said, "but provided superior fit, larger stroke volume and a novel multiple-diaphragm design."
Many researchers - in both the medical and engineering fields - worked on the heart throughout its development in Utah, the statement stressed.
"We were changing [the Jarvik hearts] all of the time. Some of [the changes] were huge," said Kessler, who helped build heart models in Ohio and at the U. from 1967 to 1983.
But Jarvik "was the person who knew the most about it and really was recognized as the person in charge of that particular project," said Kevin D. Murray, a cardiothoracic surgeon at Reid Hospital in Richmond, Ind., who was a National Institutes of Health fellow at the heart program from 1982 to 1984.
"It's a multitude of people always contributing that was the strength of the lab, but Rob was in charge," Murray said.
To motivate young researchers to keep improving the heart - and keep them in his lab - Kolff had a policy of putting their names on new versions. The Jarvik 7 was the model approved for clinical use by the Food and Drug Administration in 1981, although debate about the rules for selecting a patient continued for months.
Olsen said he had lobbied Kolff to change the name to the "Utah Heart" long before Clark's surgery in December 1982. Kolff refused.
After the implant, "suddenly it was successful and suddenly everybody wanted to have their name put on the heart," Murray said.
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'There was jealousy': Clark's surgery made history - and headlines. Reporters and photographers from around the globe descended on University Hospital, intrigued by the audacity of replacing a man's heart with a machine and by the Seattle dentist, nearing death from his failing heart, who had volunteered.
The U. had underestimated the media's interest.
"It was a very, very intense time for all of us," said John Dwan, executive director of public affairs for the U.'s Health Sciences Center from 1978 to 2001.
Jarvik, who had observed Clark's surgery by William C. DeVries but played no role in it, appeared at the subsequent press conference in scrubs.
While spokesman Chase Peterson, then the vice president of Health Sciences, stood at a podium, Jarvik sat square in front of it.
"You couldn't miss him," Dwan said.
Kolff stayed in the background while Jarvik continued to attend the regular press conferences about Clark's progress. In the public mind, the image of the youthful doctor became tied to the heart that bore his name.
Dwan said he tried to direct reporters to Peterson and the surgeons, feeling Jarvik "was trying to use it to get ahead." Peterson, later the U.'s president, diplomatically recalls: "It was a job to keep very able people in the same corral."
Kwan-Gett remembers going to Kolff and Peterson to demand recognition for his work. Today, he calls the heart implanted into Clark the "Jarvik-7 model of the Kwan-Gett heart" and said Jarvik has the credit because "he's got a big mouth."
Peterson said he doesn't recall meeting with Kwan-Gett, but remembers that among the researchers "there was jealousy. . . . You hate to see people working in the lab and not getting as much credit as they should."
Lewi, Jarvik's publicist, addressed Kwan-Gett's claim in his statement to The Tribune. The U. reviewed the issue, he said, and "determined that nothing improper had been done, while acknowledging the team effort involved in a large program."
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'Stamp out . . . Kolff': After Clark's death in March 1983, a second implant was delayed by ethical concerns about his quality of life and other issues. DeVries eventually left Utah to continue implants at the Humana Heart Institute in Kentucky, and the U.'s artificial heart effort faded.
But Jarvik's name stayed in the spotlight, with the name "Jarvik 7" used throughout medical literature and Jarvik serving as CEO of Kolff Medical, created by Kolff in 1976 to develop the heart.
In 1983, Kolff resigned from the company after an executive committee excluded him from major decisions. The next year, Jarvik - who had sculpted Kolff and kept the bust in his office - changed the name of the company to Symbion Inc.
Kolff objected, saying the name reminded him of the Symbionese Liberation Army, the group that kidnapped Patty Hearst. In a 1984 letter about the change, he wrote: "Dr. Jarvik wants to stamp out everything that is Kolff," according to Kolff's papers at the U.
Jarvik was later ousted by Symbion and started Jarvik Heart Inc., which manufactures his Jarvik 2000 FlowMaker, a heart pump used by patients awaiting heart transplants.
Kolff's son, Jack, said his father's decision to let Jarvik's name stay on the heart - and his efforts to advance Jarvik's career - were among his father's greatest regrets in his life.
"I think my father realized at the time the cat was out of the bag, and what could he do now? It was too late," said Jack Kolff, a retired cardiothoracic surgeon who assisted in the research by implanting the Jarvik 7 in brain dead patients in Philadelphia.
Yukihiko Nosé, former president of the American Society for Artificial Internal Organs, said researchers initially acquiesced to Jarvik's celebrity to protect their field. Early on, few cardiac surgeons and cardiologists believed the artificial heart could work, Nosé noted.
"Among our small group of people, [we] unified together [to] defend or support whatever one of us did," he said.
Nosé, who worked on predecessor hearts with Kolff at the Cleveland Clinic, is now a professor of transplant surgery at the Baylor College of Medicine in Texas. While Jarvik made significant contributions, his prominence has unfairly eclipsed Kolff's work, Nosé said.
"Without Kolff, Jarvik is nobody. . . . he stole the name and fame from Kolff," Nosé said. " . . . It should be called the Kolff heart."
But Murray said some of Jarvik's fame was "thrust upon him." He was named "Inventor of the Year" in 1983 by the Intellectual Property Owners Association, and the media continued to cover his career - once in a 10-page Playboy spread. That "makes for easy interpretation by the public and by advertisers," he said.
He also points out that of all the researchers once on Kolff's team, only Olsen and Jarvik remain focused on artificial hearts.
Jarvik "really had a commitment and a talent in this area," Murray said. "He has been persistent in his contribution to both science and [at his] company."
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'The inventor': The 2006 Lipitor ad touting Jarvik as the inventor of the artificial heart drew protests to Pfizer from Jack Kolff, Olsen, Nosé and others. In an April 2006 e-mail, Jack Kolff objected to the ad, writing that the work of numerous researchers had culminated in the implantation of the Jarvik 7.
"A number of physicians with knowledge of these details have been surprised and frankly, infuriated, by your inaccurate advertisement," he wrote.
Pfizer's corporate counsel initially defended the ad, saying its depiction was "consistent with his [Jarvik's] representation throughout the scientific community as inventor of the first successful artificial heart for humans." But the ad was later altered to refer to Jarvik as "inventor of the Jarvik artificial heart."
Kolff now lives in a nursing home near his son in Pennsylvania. Time has helped him put the limited public recognition of his achievements behind him, Jack Kolff said.
"The glass is still half full," the younger Kolff said. "That is his attitude."