Vitalograph Celebrates 50 Years of Service to Primary Care

Respiratory care has come a long way since treatment for breathing obstructions involved rolling the unfortunate patient over a barrel or dangling them from a horse. What we now term ‘COPD’ was referred to in 1679, by Swiss physician Bonet as ‘voluminous lungs’. The Italian anatomist Giovanni Morgagni used the term ‘turgid’ lungs and in1814 British physician Charles Badham was the first person to refer to ‘catarrh’

In 1821 René Laënnec, the inventor of the stethoscope, identified emphysema as a component of COPD, citing environmental and genetic factors as the principal cause of the development of COPD. In 1846, John Hutchinson invented the spirometer, a device for measuring vital lung capacity, an invention that was to be further developed around 100 years later by Robert Tiffeneau, a French pioneer of respiratory medicine. The term ‘COPD’ was first used by Dr. William Briscoe at the 9thAspen Emphysema Conference in 1965.

Contrary to current medical opinion, past wisdom considered oxygen therapy, steroid treatment and exercise to be dangerous for COPD sufferers and was therefore to be avoided. Inhalers and mechanical ventilators were introduced in the early 1960s.

For half a century Vitalograph Ltd has played a key role in the development of respiratory devices, including an award-winning range of spirometers, monitors and screeners. From small beginnings in the Garbe family home Vitalograph has grown into a multi-national organisation with offices in England, Ireland, Germany and the United States, plus a distributor network spanning 88 countries. ‘As we celebrate 50 years in the field of respiratory care we are proud of our contribution to improving the quality of life for patients with respiratory conditions and I am sure that my parents, who founded our company in 1963, would be amazed to see how far we’ve come’ says Vitalograph Managing Director, Bernard Garbe.

Vitalograph continues to be a family owned company whose origins go back to 1949 when Margaret Gardiner, a social worker from Wallingford, Berkshire visited war-ravaged Düsseldorf to help in post-war rehabilitation. There she met Dietmar Garbe, a gymnastics coach looking for work following years of hospitalisation.

The young couple married in 1950 and settled in Farnborough, Kent, where they started their first business ‘Gardiner’s Translation & Direct Mail Services’. One of their commissions was a series of technical manuals for medical equipment such as blood-gas analysers from the company Eschweiler. They discovered that several German medical device companies were seeking distributors in the UK. Having translated the manuals, the Garbe’s had a working knowledge of the equipment and decided that medical device distribution would be a good business for them.

Founded initially from a partnership between the Garbe’s and a medical technician called Thurston in 1951, Garthur (London) Ltd was Dietmar and Margaret’s first medical technical services company. Garthur also acted as a distributor for a range of medical products.

In the 1950’s, with rationing still in force and money tight, sales of new equipment were rare so most of Garthur business was the repair and adaption of existing equipment. The polio epidemic of the early 1950’s led to Garthur developing a special interest in helping victims of polio.

Garthur quickly established a reputation for pioneering products in the field of cardio pulmonary resuscitation (CPR) and launched the first portable pulmonary ventilator in 1955. Developing the first ‘iron lung’ in the UK was a real coup for Garthur and earned the company some welcome publicity when this device was rushed from Buckingham to Devon under police escort in a successful attempt to save the life of Elizabeth Taylor in 1957.

In 1962 Dietmar Garbe was asked by the Medical Research Council Pneumoconiosis Panel whether he could develop a simple, mobile spirometer to screen coal miners for what was commonly called ‘Black Lung’. Up until this point spirometry could only be done in laboratories using large spirometers that took up to half a day to set up. Quick to respond to market needs Dietmar developed the world’s first mobile spirometer, a design that eventually made it possible to undertake spirometry within primary care, previously it could only be performed in a lung function laboratory. This low cost spirometer made fast, accurate assessment and early diagnosis of respiratory disease possible. A very similar version of this volume displacement spirometer with wedge bellows was still in production right up to 2012.

By now Garthur had moved to the site of its current head office, Maids Moreton in Buckinghamshire, thanks to a very generous gift from Margaret’s mother, Joy. The village of Maids Moreton was chosen for its central England location and the availability of a large, and at that time, nearly derelict Victorian property with many outbuildings, Maids Moreton House.

In 1963, with drifts of snow up to 10ft high hampering business across the country the team at Maids Moreton were busy planning the manufacture of a new spirometer, having failed to find a medical device company to manufacture it under licence. With a strong belief in the value of the new invention, Dietmar and Margaret formed Vitalograph Ltd. to manufacture the device and to exploit the sales potential of the pioneering spirometer.

The children’s horses were turfed out of the stable block at Maids Moreton House and it was converted into a workshop to make ‘Vitalograph’ devices. Acceptance of the robust, portable spirometer was fast and widespread in the UK. Within a very short time such testing became a routine part of patient care and for many people the Vitalograph name is synonymous with spirometry.

With the success of the Vitalograph Spirometer the distribution activities of Garthur Ltd gradually became secondary and Vitalograph Ltd became the primary business. Garthur, however, continued trading into the 1970s and is still a registered company today.

Within Vitalograph thoughts now turned to expansion by export. This was not an easy thing to do in the 1960’s with currency controls and low growth, as well as import barriers in many countries. The acquisition of international distributors was led by Margaret Garbe who continued in this role until her death in 1974. Today Vitalograph exports to over 113 countries around the world.

In the late 1960s and ‘70s Vitalograph offices were opened in Hamburg and Kansas City. In 1972 Dietmar started to develop the concept of a low-cost Peak Flow Meter after being inspired by seeing a ski anemometer strapped to a skier’s shoulder. The ‘Peak Flow Monitor’ was brought to production and is now regarded by many physicians as an essential tool in the home management of asthma.

The following year saw the launch of the ‘The Royal Free Hospital Intubation Trainer’ The RFH Intubation trainer was a part of the successful Garthur range of resuscitation equipment manufactured by Vitalograph. This successful training model, the brainchild of Dr Hilary Howells, who had a long association with Vitalograph, taught anesthetists and other specialist how to insert endotracheal tubes into the airways of anaesthetised or unconscious patients.

In 1976 the Vitalograph manufacturing plant opened in Ennis, Co Clare, Ireland where it remains to this day. The late ‘70s and early ‘80s saw the launch of several innovative and award-winning respiratory devices including the ‘Airways Interrupter’ – a device for measuring airways resistance during tidal breathing, Vitalograph Spirotrac Software and the Aerosol Inhalation Monitor (AIM). The recognition that a full electronic spirometer was required to compete with Japanese competition, led to the development of the Vitalograph COMPACT.

1985 was a champagne year for Vitalograph, starting with a Design Council Award for the Emergency Aspirator presented by Prince Philip. 1985 also saw the creation of the holding company Vitalograph Medical Instrumentation Ltd in Ireland and the opening of the new factory in Ennis. More awards followed in 1986, this time for the COMPACT which won both a Design Council Award and a gold medal for design from the Leipzig Messe.

1986 also heralded the launch of the first ALPHA spirometer– a low-cost desktop spirometer designed to complement the successful COMPACT and compete on price with the low-cost Japanese spirometers.

The nineties brought more success with the launch of several new products including the Peak Flow Whistle, the Escort, the 2120,the TUT (a new bespoke inhaler trainer device) and the micro and PEF/FEV Diary.The purpose of the Diary was to give Vitalograph an entry into electronic diaries for clinical trials and was hugely successful, tens of thousands being used in clinical trials during the next decade.

Booming spirometer sales led to the further expansion of the Ennis factory in 2001. 2002 saw the launch of the Pneumotrac, one of Vitalograph’s most successful products followed in the latter part of the year with the news that Vitalograph had won a contract became the main contractor in a major respiratory clinical trial on a new respiratory medicine with centralised electronic data capture. This included a sophisticated QA over-read system. At this time most clinical trials were still paper based, being fully electronic was unusual and perceived by company management as a major strategic advantage for Vitalograph.

In 2003 the first multi-centre ‘centralised spirometry’ clinical trial for Vitalograph began with the data management outsourced to Varigon, the best and most experienced service provider in this emerging sector of secure medical data in Europe.

In 2007 Vitalograph expanded into a new purpose built facility in Buckingham designed to accommodate the growing business.The 4000 series of respiratory monitors and screeners was launched this year and won a Design Award in 2008. The 4000 series was expanded to include the highly successful Bluetooth versions in 2009.

Vitalograph’s heritage of innovation continues unabated with the recent launches of the ALPHA Touch Spirometer and the pioneering new COMPACT Medical Workstation which can provide any or all of the following: Spirometry; ECG; BP; SpO2; and several other physiological measurements.

Respiratory care has come a long way since the days when asthma was treated with owl’s blood mixed with wine. For the last half century Vitalograph has been at the vanguard of innovation and service, committed to empowering physicians and protecting quality of life.