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Web Page Review

Death of an Anesthesia Company

Toronto, Ontario

http://www.uwm.edu/People/foregger/

This well-illustrated web site, written by Richard Foregger MD, reviews Richard von Foregger's contributions to the development of anesthesiology during early to mid 20th century, with special emphasis the many technical developments his company made. The site also chronicles the tragic decline and fall of the company following some lamentable design misadventures and the mental decline of the company's founder. The author, a son of von Foregger, spins a fascinating tale of one man's passion for invention in a setting of personal and business intrigue.

Richard von Foregger PhD (1872-1960), was a chemist and manufacturer of anesthesia equipment who "contributed to numerous practical and scientific endeavours that have benefitted the development of anesthesiology in the United States and throughout the world." He came to the USA in 1898, and in 1914 he set up his own manufacturing firm. The Foregger Company specialized in the manufacture of equipment for the administration of anesthesia gases. The development of the company was Foregger's one true obsession and he devoted his entire being to it. For many years the business thrived from his effort and ingenuity.

Foregger's early work concentrated on the generation of oxygen for clinical purposes. The Foregger Company later brought into the commercial realm such valuable contributions as Waters to-and-fro carbon dioxide absorber (ca 1923), a circle breathing system with carbon dioxide absorber (ca 1927), and the Guedel rubber/plastic pharyngeal airway (ca 1933). Magill style tubes and other endotracheal tubes began to appear in the Foregger catalog, along with laryngoscopes, around 1935. Foregger introduced the "Copper Kettle Vaporizer" in 1952.

Regretfully, The Foregger Company later ran into design troubles that contributed significantly to the decline of the company. In the summer of 1940 Dr. Clayton Wangeman, a Major in the US Army Medical Corps Reserve, reported that a Foregger Military Model anesthetic apparatus that he had been using had tipped over and could not be subsequently used owing to the resulting malfunction of the water flowmeter. As a result of this report, Foregger sold very few machines to the US military. Later, delays in the manufacture of a better (waterless) rotameter, delays in marketing a large capacity carbon dioxide absorber, and the failure to develop an anesthesia ventilator cost the company their leadership position.

Also contributory to the decline of the company was the later mental decline of von Foregger, who was eventually given a diagnosis of paranoid psychosis. During this time he married his young housekeeper with an eighth grade education, "who took control of the firm and replaced long standing, experienced employees with inexperienced friends and relatives." This all lead to a competency trial that was aggressively contested by von Foregger's new wife. A jury of 12 individuals declared von Foregger to be incompetent. An attorney was later appointed by the court to supervise the management of the company.

Later, matters got even worse, as patients were harmed as a result of design flaws in some Foregger products. In 1984 a committee of the United States Congress presided over by the then Congressman Albert Gore, carried out a hearing following a number of deaths. The hearing disclosed that Foregger anesthesia machines had been responsible for the deaths of four surgical patients as a result of an overdose of anesthetic agents from malfunctioning valves. It was shown that the company had failed to appropriately investigate the problem and was remiss in fulfilling its safety responsibilities. Following the hearings the Foregger Company was liquidated.

All anesthesia history buffs will enjoy this site. Highly recommended.

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This Article Full Text (PDF) Submit a scholarly reply View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Doyle, D. J. Search for Related Content PubMed Articles by Doyle, D. J.