January 24, 2007 News & Views » Cover

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Pimp my arm 

Tackle Design is innovating the world of prosthetics -- and sharing the love

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Kuniholm, Messer and Crossen picked up the software-savvy Webb and founded Tackle Design. They worked out of a rented house in Raleigh while Kuniholm was still in the biomedical engineering program at Duke. They began to take on clients with the help of cheap online text-search advertising. "We started off with the low-hanging fruit of the design world," Messer explains, "which are small inventors; independents that are looking for prototypes and design work to further their inventions." The team gained experience and paid the bills.

In the summer of 2004, Tackle moved into their current office, a former diner with a concrete floor and glass brick facade facing the Durham courthouse. In the back is a room that seems close to the professional fantasy they described: hand tools, power saws, lab ovens, electronics, plastic-casting equipment and piles of wood and metal. There are even Lego pieces neatly stored in hardware drawers on a work bench.

Right about the time they moved into this office, Kuniholm, a Marine reservist, was shipped off to Iraq.

By now, the stories of families taking up collections to pay for Kevlar vests for their sons and daughters are becoming all too familiar. Kuniholm and his colleagues went further: They made a robot. The crew bought an off-the-shelf, remote-controlled toy truck, added an aluminum deck, a wireless video camera and a mechanism for remotely dropping an explosive charge to destroy landmines, unexploded bombs and improvised explosive devices. The parts and materials cost just over $1,000. Kuniholm took the bomb-busting robot with him to Iraq, where it served the platoon in the field until their return home.

click to enlarge Kuniholm (left) and Messer create a rough prototype of a prosthetic device using Legos - DEREK ANDERSON
  • Derek Anderson
  • Kuniholm (left) and Messer create a rough prototype of a prosthetic device using Legos

But on New Year's Day 2005, Kuniholm encountered a situation beyond the robot's capabilities. While on patrol in palm groves along the Euphrates River, his group was attacked by insurgents. An IED detonation knocked him to the ground, broke his rifle in half and nearly severed his right arm below the elbow. One of his fellow marines later died of internal injuries. Unable to help in the firefight that ensued, Kuniholm pulled himself out of harm's way and was tended to by a medic who applied a tourniquet. By the time a boat returned him to the base, he knew what was likely to happen.

He awoke in a hospital to find his right arm amputated. "I was just psyched that I was alive," he says. "I unplugged myself from a bunch of stuff and went down and had a Whopper in the Burger King in the hospital. I was having a blast doing that."

When word of Kuniholm's injury reached the Tackle partners, they immediately hit the Web to find out everything they could about the prosthetic devices he would be able to choose from.

"We were just shockingly disappointed at everything that was out there," Messer says. "We know technology and we know what is available in other things, so it was surprising to see the complete lack of innovation in the field [of prosthetics]. At first we were very frustrated. We blamed it on the industry -- what are these slackers doing? How come there's nothing good out there?"

They soon realized why. According to a recent study conducted by Johns Hopkins University and the Amputee Coalition of America, approximately 1.9 million Americans have lost a limb. The typical amputee is over the age of 50 and has lost a leg or foot due to diabetes or some other disease. Upper-extremity amputees -- those who've lost an arm or hand -- make up a small fraction of the total.

"Even if every single one of us were to be interested in the same product -- not likely -- and all of our insurance companies would pay for that same product -- also not likely -- the total number would be less than 100,000," Kuniholm says, "which is like a prototyping run. Oh, and by the way, that would include left and right variations and different sizes. By that time, you've reduced the upper extremity to what it is: custom work."

In short, there's no money in prosthetics. "And if it's not commercially appealing," Messer says, "there's not going to be a lot of innovation."

Kuniholm is quick to add that he has been well provided for, with three prostheses made at Walter Reed Medical Center. Wars, and the government's care of its wounded, have historically brought what little advancement there has been made in prosthetic design.

It's not that Tackle Design ever intended to go into the prosthetics business (and they aren't, exactly). But they are in the business of solving problems. The thing about problems is that solving one often requires solving many others that relate to it. That doesn't faze these guys.

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See also Innovations in Open Design.

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