In the Gulf War in the early 1990s, US soldiers fighting on the Middle Eastern battlefield sometimes found themselves using dressings dated from World War II to patch up their wounds. In the present Iraqi conflict, however, American forces are now using an advanced new bandage, developed in Israel, that can save lives by stopping traumatic hemorrhaging wounds, and can also be used as a tourniquet, or a sling.
The new bandage, called the Emergency Bandage, was developed by First Care Products, a tiny four-man Jerusalem start-up. The bandage marks the first major alteration to field dressings since the 1940s, and has already established its worth.
One of the major causes of death for soldiers at war is not the injury itself, but loss of blood on the battlefield. In the Vietnam war, for example, one in four soldiers died from hemorrhage bleeding or injuries to their extremities. In the current Iraqi war, only one in 10 deaths are attributable to this. One of the main reasons for this is that the US military has changed tactics. In the past, soldiers were taken off the battlefield and then treated for their injuries. Today, they are treated on the spot, which improves a victim’s chances of survival. Often it is the soldier himself who takes responsibility for dealing with his wounds.
The Emergency Bandage fits well into the new philosophy of military medicine. In the past, soldiers or medics treating wounds would have to use three or four different dressings to bandage a wound. It was time consuming and often it was difficult to achieve the right pressure on a wound to stop the bleeding.
Ofer Molad, First Care’s VP of marketing in the US, remembers how he and fellow soldiers serving in the Israel Defense Force (IDF), would wrap a rock into the bandage to maintain the right pressure.
The Emergency Bandage, however, is an elasticized bandage with a non-adhesive bandage pad sewn in. The bandage has a built-in pressure bar, which allows the soldier to twist the bandage around the wound once, and then change the direction of the bandage, wrapping it around the limb or body part, to create pressure on the wound. Aside from this, the pressure bar also makes bandaging easier. A closure bar at the end of the bandage means that it clips neatly into place and will not slip.
The pressure bar also enables a soldier to use the bandage on complicated injuries like the groin and head, which require wrapping in different directions.
The bandage can be put on with one hand, as Molad deftly demonstrates. “It’s a very versatile bandage,” he says. “It can be applied quickly and easily by an injured soldier or non-medical personnel for immediate hemorrhage control. It saves time in an emergency situation where every second is crucial.”
Certainly the US military thinks so. Last year, the US Army purchased nearly 200,000 bandages for its troops. This year, the US Army purchased 800,000.
The Emergency Bandage, nicknamed the Israeli bandage by US troops, was created by American-Israeli Bernard Ben-Natan, a former combat medic in the IDF, who was located for some time at the Jerusalem Software Incubator (JSI), which is now owned by Jerusalem Venture Partners (JVP).
In 1997, Molad, who is also the president and CEO of Performance Systems, a US company that markets innovative Israeli technologies, was on a visit to JSI to look for interesting new software technologies. Instead, he discovered the bandage. “It was not high-tech, it was not a software project, it was not even sexy in terms of those days, but I fell in love with it for its simplicity and genius,” says Molad.
Molad brought angel investors to First Care, who pumped $150,000 of investment into the product. This was followed by a further $450,000 from other angel investors including Persys Investment, Performance Systems ? which markets and distributes the product in the US, and Molad himself, bringing the total investment in the company to $900,000, with the $300,000 invested initially by the Office of the Chief Scientist.
In 1998, Molad began marketing the bandage in the US. The feedback was excellent, but First Care was told that the US Army procures new products only once every four years, and it had just completed this process. First Care then turned to the civilian market. Again, the feedback was positive, but Molad soon realized that in the civilian market, price is the primary consideration. First Care could not compete because the Emergency Bandage is more expensive than most existing options.
Molad continued to push the product, showing it at exhibitions across the US. Finally, the four-man company got its first break in 2000, when Robert Miller, a medic and trainer for the elite 75th Ranger Regiment, based in Ft. Benning, Georgia, took an active interest in the product. Miller, who was one of the first US soldiers parachuted into Afghanistan, began using samples of the bandage on bullet wounds at an emergency room (ER) in Houston, where the Rangers trained during peacetime.
The same year, Miller took the bandages to Bosnia and began using them on the battlefield. The reports were good, says Molad, and the bandage was found to save lives. “Battle conditions in Bosnia were very difficult,” says Molad. “When soldiers were injured they could not be removed immediately for treatment, and there was often a lapse of time before they saw a medic. This was the critical time to use the bandage.”
In 2001, the 75th Ranger Regiment began to buy the bandages from First Care, and in December 2002, it became standard for every ranger to receive his own Emergency Bandage in his emergency kit. As First Care discovered, this was the ideal route into the mainstream US army. Special forces like the Rangers, the marines, and the Navy Seals have their own budgets, and can buy whatever products they choose.
The rangers were followed by the Navy Seals, the CIA, the FBI, and other special units, who all began purchasing the Emergency Bandages.
When the next round of standard US Military purchasing began, First Care had already got its foot in the door, and had also received its National Stock Number (NSN), without which it cannot sell to the mainstream US military.
Aside from the US Army, today First Care sells its bandages to military and government organizations worldwide, including the Canadian forces, the French Army, and the Belgium Army. The company hopes to start selling to the IDF in 2005.
First Care expects to close 2004 with about $2.5-3 million in sales. This will be the company’s first profitable year.
Next year, projected revenues are $3.5-4m.
First Care currently sells three main products, a 4 inch Emergency Bandage, a 6-inch one, and a mobile bandage pad that can treat patients who have both entrance and exit wounds. The company is now exploring new potential products to enlarge its product offering.
“We have established ourselves in an extremely positive position right now with the US government and military, and we need to take advantage of that to bring in additional products in the same field,” says Molad. “The hardest thing is to start selling products to the US military when you are a small start-up. We have already achieved that.”
Already there are ideas in the pipeline, and First Care is also examining the idea of collaborating with a company that has developed a medication that can help stop bleeding. The plan, says Molad, is to introduce this medication to its pads, to help stem the flow of blood.
At present, First Care sells mostly to the US market. Some 90 percent of sales are to the US, and 10% to the rest of the world. The company now hopes to increase its overseas sales. “Most of the world is looking at the US market to see what they use,” says Molad. “Success in the US will spread to the rest of world.”
Most of the company’s sales are to the military, with just 10% of sales to the civilian market. Molad, however, believes that this will change in coming years, because the US government has placed more emphasis on homeland security, and police and emergency units are seeing increased budgets. The company’s goal is to take the same route into the US police force as it took with the military. Target the elite units first, and then penetrate the mainstream police forces.
Molad is pleased with the way First Care is developing. After difficult early years, the company is now flourishing. “First Care has a wonderful combination of a great life-saving product, clear demand, and the persistence to stick it out over a number of years,” says Molad. “We couldn’t have achieved this success in two years, but many Israeli companies simply do not have the patience to stick for any longer than this. First Care did, and it is now reaping the benefits.”(See Exclusive Video report on First Care from IsraelHighTech.TV).