Former Chief Warrant Officer 5 Gary Linfoot lost his mobility following a severe spinal cord injury from a 2008 helicopter crash in Iraq. Linfoot has since benefited from the capabilities of the iBOT wheelchair, which has gone out of production because of bureaucratic policies and market realities. (Philip Grey / The Leaf-Chronicle)
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CLARKSVILLE, Tenn. The iBOT Mobility System hit the market with great fanfare in 2003, when it was hailed as a game changer for people with severe mobility problems.
Unlike other power wheelchairs, the iBOT was capable of raising up on two wheels, gyroscopically self-balanced, which caused many to liken it to a Segway.
That was no coincidence. The inventor of the Segway, Dean Kamen, is also the inventor of the iBOT.
Together with medical giant Johnson & Johnson's Independence Technologies, Kamen launched the iBOT with great expectations that unfortunately collided with bureaucratic and market realities, causing manufacture of the chair to shut down in 2009. The manufacturer is committed to provide maintenance support until 2013, when, as the chairs inevitably malfunction at some point, they will be gone.
The iBOT was and is far more than a power wheelchair. For many who are paralyzed below the waist, or for double leg amputees whose injuries are so high up that prosthetics are not a good option, the iBOT has the capacity to navigate uneven terrain and, amazingly, to climb stairs.
Gary Linfoot, a former chief warrant officer who is paralyzed from the waist down and uses the iBOT, said, "It all comes down to the dollars."
"For a company, they have to be profitable," Linfoot said. "When the iBOT first came out, the cost was $25,000. You hear that and think, oh my gosh, that's the price of a nice new car, but for an electric wheelchair, that was the going rate at the time."
However, the Centers for Medicare and Medicaid Services sets the standards for Medicare, which in turn sets the standards for all other insurers, and Medicare was only reimbursing the standard amount for a wheelchair about $5,000.
"They didn't see the stair-climbing ability or the upright capability as something that was medically necessary," Linfoot said, "so the only people getting these chairs were people that had the chairs donated to them, or those who had the money on their own."
Additionally, not all paraplegics or below-the-waist amputees were suited to the device.
In order to use the iBOT, the patient had to demonstrate sufficient upper-body mobility and, in the case of using the stair-climbing function, the use of at least one arm.
The relatively small number of people who could use the device was a market consideration, as was the lack of reimbursement, but the way that the device was classified and viewed by government agencies was perhaps a bigger impediment.
An Associated Press article from May 2009 cited Henry Claypool, himself a wheelchair user and director of the federal Office on Disability, as saying, "new technology requires scientific evidence that it changes users' lives in ways existing alternatives cannot."
Linfoot and other iBOT users are certain, beyond a doubt, that the device has changed their lives.
‘It makes sense'
To hear Linfoot and his wife, Mari, talk about the iBOT, particularly about its psychologically empowering benefits, you think you understand. But until you see the couple in a social setting, you don't.
At the opening of the new Fort Campbell, Ky., USO center just a few days ago, the Linfoots were in attendance because Gary helped enormously in a special project the restoration of an America's Huey 091 Foundation helicopter that was turned into a high-tech game station that is the facility's centerpiece.
Gary was in the iBOT, raised up to near his natural height of six feet, conversing at the doorway with his arm around his wife as passers-by marveled at the device.
In a short time, it was the iBOT that became unnoticeable, and you could easily forget that Linfoot was in a wheelchair at all.
Linfoot is gratified whenever he hears someone say that.
"When you talk to people (when in a regular wheelchair), it's an awkward situation," he said. "You have to look up and they have to look down. With the iBOT, I get to regain that bit of dignity I lost. It's hard to put a value on that. It's an intangible until you see it. When you see it, you get it. It makes sense."
Linfoot is forthright about contrary views on the iBOT, however. He explained that the Veterans Affairs frowns upon power chairs because bureaucrats worry that people will stay in the chair and gain weight for lack of the exercise they would get in a manual chair.
But Linfoot, who recently rode a handcycle for more than 500 miles in a Ride2Recovery event, rarely uses the chair in the house, finding the manual chair more convenient, including for going to work at his Fort Campbell job.
He likens switching between chairs to switching shoes for different occasions or tasks.
"Still, the iBOT fills that need that no other device can," he said, referring to being able to walk his dog, working in the garage, going to see a NASCAR race at the track, or attending events, parties and barbecues with friends.
Call to duty
Linfoot lost his mobility in the course of performing his duties as a soldier when his helicopter crashed in Iraq in 2008.
He has regained that mobility, crucial to the furtherance of anything approaching a normal life, as the result of a device that has been shown to be reliable, stable and highly effective in allowing people such as Linfoot to again do the things that most Americans take totally for granted.
"You don't really know what you've lost until you've lost it," Linfoot said, regarding his loss of mobility after his crash. "It's the little things. I'm not trying to be dramatic, but it's like the death by a thousand cuts."
Soldiers like Linfoot cope with the loss when they have to, accommodating reality because there is no arguing with it.
But as Kamen, the iBOT's inventor, has said, "Game-changing technological advances that significantly improve the lives of disabled people should not simply fade away because of correctable bureaucratic flaws. For those of us benefiting from this wonderful device, allowing the iBot to become extinct would be like over-regulating and under-supporting insulin pumps or prosthetic hips until they were simply no longer available. Would America let that happen? I don't think so."
Gary Sinise, the actor and veterans advocate, may have put it best: "We have our own call to duty (as a nation), a wonderful chance to show veterans like these our gratitude, by supporting the efforts of America's Huey 091 Foundation to build and distribute the iBOT.
"There is a lot that happens in this world that we may feel ... we can't do anything about. Well, this isn't one of those things."