“It’s like a portable ICU in a box”: This Toronto company is massively scaling up production on its unique ventilators

Ventilators, artificial breathing machines that deliver oxygen to the lungs, are among the most critical and coveted pieces of equipment for helping Covid-19 patients who, in advanced cases, might have such difficulty getting enough air that they feel like they’re drowning. In Italy, where ventilators are scarce, doctors have had to make gut-churning deathbed decisions about who gets one. In the U.S., governors are outbidding each other, eBay-style, to get their hands on them. And in New York City, the virus’s current epicentre, there has been speculation about ventilator lotteries if more aren’t procured soon. To prevent a similar crisis in Canada, Justin Trudeau has promised to up the country’s ventilator count from 5,000 to 30,000, and he’s called on a Toronto medical tech firm to help make them. Toronto Life spoke to Lesley Gouldie, CEO of Thornhill Medical, about producing 500 ventilators a month—10 times her company’s usual output.

I’m guessing your job has been intense lately. What does your work life look like right now?
I’m exceeding all my previous records for hours worked in a day. I do three shifts: I start with early-morning emails around 6:30 a.m., then I’m at work for meetings by 9 a.m. We’re an essential service, so the team is still at the Toronto office, practising good Covid-19 social distancing. Then I go home for dinner and do the third shift, which ends around 9 p.m. or 10 p.m. And it’s not just me. Everyone on the team has been working flat-out to get these devices built.

The federal government approached Thornhill Medical to help in the fight against Covid-19. What was the ask?
The federal government ordered 1,020 ventilators, and the Ontario government put in an order for 40 more. We’re working to deliver the bulk of the order in June.

Your company typically produces 50 ventilators a month. What changes have you made to increase your output tenfold?
Thornhill Medical is a small company, with a staff of 40. We’ve added another 20—the Covid surge team—and every day we’re bringing on more people across all disciplines: engineering, web support, sales management, business partnerships. In short order, we had to find a manufacturing partner that had the capacity, capability and the financial wherewithal to help us scale up. Linamar, an industrial and automotive manufacturer in Guelph, approached us because they’ve just started to expand into medical device manufacturing, and they could work quickly.

Can you describe the device you’re producing?
Its trade name is the Moves SLC, and it was invented in 2004 by Joe Fisher and Ludwik Fedorko, the U of T researchers who founded Thornhill Medical. It’s quite innovative in that, unlike standalone ventilators, it’s like an ICU in a box, integrating four crucial functions in one light, compact, portable unit: a ventilator, plus an oxygen concentrator, a patient monitor and suction. And you don’t need to plug it in: it runs on batteries. In the Covid-19 environment, the device allows front-line health care workers to maintain ICU-level care anywhere in the hospital and during transport. For example, if all of the ICU rooms are full, this device can be attached to a stretcher, and if patients need to be in a hallway or a temporary hospital, such as an outdoor tent, they can still be treated.

So where are they being manufactured?
Some of them are being made in our facility in Toronto, but the bulk will be produced at the Linamar plant in Guelph. Our devices don’t require specialized robotics for assembly, so we haven’t had to make major technology investments to get Linamar’s facilities ready. What we do need is trained people, and Linamar has a team of 100 highly skilled technicians. As we speak, our staff are training them on our technology, and we have detailed work instructions for every aspect of the build.

What’s the toughest challenge you’ve faced as you’ve ramped up production?
There are over 1,500 components in each device, so getting all the parts we need took a lot of work in a short amount of time. For example, the weekend after we received the letter of intent from the federal government, I tried to reach the GM of a key supplier based on the west coast, but I only had the sales manager’s cell number. He refused to put me in touch because it was the weekend. I countered that lives were at stake, to no avail. I managed to track down the office manager on WeChat, who eventually tracked down the GM, who was out walking his dog. To his credit, he called me back immediately and dashed to his office to activate his global supply chain.

We’ve all read stories about ventilator shortages: doctors in Italy, for example, deciding which critically ill patient gets one and which has to go without. What goes through your mind when you read the news?
I hope we’re never in this situation again. I can’t imagine how horrific it must be for people on the front line who can’t save lives because they don’t have the tools to do their jobs. Going forward, I hope there can be an infrastructure and a strategy in place, not just in Canada but globally, so health care workers can have access to this technology when they need it.

Any global ambitions for Thornhill Medical?
We’ve been approached by countries in South America and Europe, as well as Australia, to produce ventilators. We’re addressing the needs of Canadians first. Once we’ve delivered our ventilators to the federal and provincial governments, we’ll determine if we can meet the needs of other countries.

What are you doing to stay sane through all of this?
I’m trying to sleep well, eat healthy and go for walks so I can stay on my game. But my life is very narrow at the moment because I’m working all the time.

So you don’t take breaks for fun?
The most fun I’ve had recently is supervising my partner cooking dinner while providing unsolicited advice. That’s the sum of it.