In time, his surgical innovations were credited with saving millions of lives, and publications hailed him for his supreme skill and accomplishments as the “Thomas Edison” and even the “Mickey Mantle” of medical device inventors.
But long before Thomas J. Fogarty drew such renown, he was a tinkerer — a boy growing up in Cincinnati in the 1940s, fixing things around the house for his widowed mother. He built a soap box derby car, too, and model airplanes that he sold to neighbors. He devised an automatic clutch for a friend’s motor scooter.
In eighth grade, he took a job cleaning stomach pumps and hauling oxygen tanks and oxygen tents at a nearby hospital to help his mother make ends meet.
At 15, he was promoted to scrub technician and, while handing sterile instruments to surgeons, he saw operations firsthand and was fascinated but also appalled. He was troubled by the amputations and deaths that frequently arose when surgeons would struggle to remove blood clots from patients’ arms and legs by making large incisions in arteries and then using forceps.
“When people had a blood clot in their arm or leg, they usually ended up having three operations,” he told Stanford Medicine magazine in 2006. “Fifty percent of the patients died. I thought there must be a better way.”
Fogarty, who died at 91 on Dec. 28 in Los Altos, found a solution while a student at the University of Cincinnati College of Medicine, from which he graduated in 1960. There, he conceived a device that would revolutionize vascular surgery — a balloon catheter that removed blood clots from patients’ limbs through a minimally invasive technique that became an industry standard.
His solution combined ingenuity with his love of fly-fishing.
During medical school, he experimented in his attic by cutting the pinkie finger from a surgical glove to use as a balloon, and then attaching it to a urethral catheter by using fly-tying techniques. He had learned to tie fly knots as a boy, when he would fish, at least part of the time, in a cemetery pond.
For the first balloon-catheter procedure — in 1960 or 1961, according to various accounts — Dr. John J. Cranley, a vascular surgeon who was Fogarty’s mentor, first made a small incision in an occluded artery in a patient’s leg. He inserted the catheter — with the balloon deflated — past the blood clot. The balloon was then inflated with saline solution and retracted, pulling the clot along with it.
His response was, “Holy cow!” Fogarty told the publication Endovascular Today in 2004. Cranley exclaimed, “Wow, this really works!”
Not everyone was impressed. Fogarty recalled that the chair of the University of Cincinnati’s surgery department (who was also the president of the American College of Surgeons) later presented a critique of the procedure, saying, “Only one so inexperienced and uneducated as a medical student would think of this.”
It took several years for Fogarty to generate broader interest in his balloon embolectomy catheter, which was patented in 1969. Thinking outside the box should be considered a strength, not a weakness, in a profession where “physicians are taught to do what is safe,” he told the Los Angeles Times in 2003.
“We don’t spend enough time teaching people how to think rather than what to think,” he said.
Six-plus decades after its invention, the Fogarty catheter is used hundreds of thousands of times a year around the world in vascular, cardiac and thoracic surgeries. According to the American College of Surgeons and Fogarty Innovation, a nonprofit he founded, it remains the most widely used catheter for removal of blood clots and is credited with having saved an estimated 20 million lives globally.
It was a precursor to techniques developed by other surgeons, including catheters used for angioplasties, the minimally invasive procedure used to treat blocked coronary arteries.
In 2000, Fogarty received a $500,000 prize funded by the Lemelson Foundation and administered by the Massachusetts Institute of Technology for invention and innovation. At the time, Dr. William R. Brody, a radiologist who had trained with him, and who later became president of Johns Hopkins University, hailed Fogarty, saying he had “single-handedly changed the face of cardiovascular surgery.”
Fogarty received more than 190 medical patents and founded more than 45 medical technology companies, according to Fogarty Innovation, which he founded in 2007 in Silicon Valley to foster medical device advances.
He was inducted into the National Inventors Hall of Fame in 2001. In 2014, President Barack Obama awarded him the National Medal of Technology and Innovation, the nation’s highest honor for engineers and inventors, for his creation of minimally invasive medical devices.
Thomas James Fogarty was born Feb. 25, 1934, in Cincinnati, the youngest of three siblings. His father, William, a laborer, died in 1944 at 52. His mother, Anna (Ruthemeyer) Fogarty, was an office assistant.
As a teenager, Thomas aspired to become a boxer. He had approximately 40 bouts in a semipro career, he told the journal Vascular News. At 17, while fighting a 23-year-old opponent to a bloody draw over seven rounds, his nose was broken, and one eye was swollen shut, while his opponent was left with a broken hand. “If that’s a draw,” he recalled thinking to himself, “I never want to lose.” He began seeking another profession.
With a recommendation from a family priest and the financial assistance of Cranley, Fogarty entered Xavier University in Cincinnati, graduating in 1956 with a bachelor’s degree in biology.
After earning his medical degree in 1960, he completed his residency at the University of Oregon in 1965. In the late 1960s, he began a decades-long affiliation with Stanford University Medical Center as a researcher and professor of cardiovascular surgery. He also maintained a private practice. He served as director of cardiovascular surgery at Sequoia Hospital in Redwood City, California, from 1980 to 1993.
In the 1970s, Fogarty continued to develop medical devices. Collaborating with others, he invented the AneuRX stent graft, another minimally invasive technique that used a fabric implant to protect weakened blood vessels in patients who had abdominal aortic aneurysms.
Working with Warren Hancock, an engineer, Fogarty created the Hancock aortic tissue heart valve. Made of pig tissue, it was the first commercially available prosthetic heart valve made from a living organism.
In addition to his medical work, Fogarty was a venture capitalist and a winemaker; in 1981, he opened a winery on his 320-acre estate on Skyline Boulevard in Portola Valley. He suggested to Endovascular Today in 2004 that wine ought to be classified as a health food.
“So what do you prescribe?” the publication asked.
“Two or three glasses of Fogarty Pinot Noir,” he replied.
Fogarty is survived by his sons Thomas Jr. and Jonathon, who confirmed his death; his wife, Rosalee (Brennan) Fogarty, whom he married in 1965; two other children, Patrick and Heather Fogarty; and 10 grandchildren.
In a video tribute on his 90th birthday in 2024, colleagues at Fogarty Innovation described him as unconventional, stubborn and “about as touchy-feely as a steel screw.” Colleagues also paraphrased the mantra that drove Fogarty’s career: “How can I make this better? How can I reduce pain? How can I get the patient out of the hospital more quickly?”
At the same time, Andrew Cleeland, the organization’s CEO, said in an interview that Fogarty had been a prankster who didn’t always take himself so seriously. Thomas Fogarty Jr. added that his father “wouldn’t tolerate foolishness except foolishness of the highest quality; well into his 80s, nothing was funnier to him than a whoopee cushion.”
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