The iBOT: A mission to revolutionize the wheelchair
Dean Kamen is the first to admit it. “From the day it came out, and from that day forward, I’ve been known as the Segway guy,” the serial inventor tells Yahoo News, referring to the two-wheeled, self-balancing personal transporter that he first brought to market in 2001.
But “the Segway,” Kamen is quick to add, “came from the iBOT.”
Before the Segway made him famous, the Long Island, N.Y., native had already spent decades revolutionizing medical devices: infusion pumps, insulin pumps, stents, dialysis machines. Kamen’s boldest idea, though, was the one he was really working on when he decided to repurpose a few of its core engineering advances to create the stripped-down, recreational Segway: a far more advanced — and potentially life-altering — all-terrain electric wheelchair known as the iBOT.
Kamen’s ambitions for the iBOT couldn’t have been loftier. “How can it be … we can put people on the moon, we can fly across the continent, and yet a disabled person is given a wheelchair — a pathetic, inadequate substitute for what you and I take for granted?” he says. “And so I said, ‘I’ve got to restore not just mobility. I’ve got to restore … independence, dignity, access. We have to give them something that closely resembles that human ability to stand up and balance and walk.’”
The fact that Kamen and his team succeeded in doing just that should come as no surprise to anyone who’s followed his multi-decade career. The iBOT, introduced in 1999, can, in fact, “walk” up and down stairs by rotating its two sets of powered wheels around each other like gears. It can be controlled remotely for loading or parking. It can keep its balance while scaling obstacles such as curbs or traveling through sand, gravel and shallow water. It can even raise its user from sitting to standing level by lifting one pair of wheels above the other.
But the story of the iBOT doesn’t end there. Instead, Kamen’s creativity and persistence are still being tested today, decades later, as he continues to search for innovative ways to overcome cost barriers and bring the next-generation iBOT, introduced in 2019, to as many people with disabilities as possible.
“It’s not incremental; it is transformative,” Kamen says. “There is nothing even trying to compete with the iBOT. We’ve now seen hundreds of people have their lives changed by it. It would almost be immoral to give up now.”
The iBOT’s genesis goes as far back as 1990. “In the early to mid-’90s, Dean certainly had a reputation as an innovator and inventor in the medical device field,” says Lucas Merrow, the product manager from 1994 to 2000 at Kamen’s company, DEKA Research. “[But] before I got involved, a lot of the actual solutions they were working on were so complex and unwieldy, they really wouldn’t help in the real world.”
Merrow was brought in, as Kamen puts it, to “make this thing a product.”
At first, what Merrow saw didn’t look like much: “a device with a lot of … wires hanging off of it, some gyroscopes from [Kamen’s] airplane, I think some small electric motors from a sewing machine, the guts of a desktop computer literally shoved underneath a metal platform that you can sit on.”
But as soon as Kamen powered it up, “this machine basically stood upright.” It was, Merrow says now, “such a stunning thing to see. And then when you actually sit in it and drive in it, it just feels so natural.”
In 1994, Kamen and Merrow persuaded Johnson & Johnson to invest in their project, which carried the code name “Fred Upstairs” because it was, Kamen jokes, as “light on its feet” as Fred Astaire. The development process was shrouded in “extreme secrecy,” according to Merrow.
“The first I’d ever heard of the iBOT was just sort of inklings,” says Bob Vogel, a senior correspondent at New Mobility magazine.
The big unveiling came during a 1999 episode of NBC’s “Dateline” that hailed Kamen as a medical “Thomas Edison” and promised the iBOT would hit the market “within 18 to 24 months.”
“This is amazing,” Vogel recalls thinking. “It is a complete game changer.”
From a technological standpoint, Vogel was right. But there was a problem. Though the U.S. Food and Drug Administration held the iBOT to a much higher regulatory standard than any other mobility device, the Centers for Medicare & Medicaid Services ultimately decided it would reimburse only $5,000 of its $25,000 cost, the same as any ordinary motorized wheelchair.
“We said, ‘The amount of stuff we have in this thing, just our material costs for gyroscopes, accelerometers, servos, high-performance batteries — it costs more just to acquire some of those critical components than you reimburse for an entire wheelchair,’” Kamen explains. “We were shocked and disappointed.”
Realizing the iBOT would now be out of reach for all but the wealthiest customers, Johnson & Johnson — which ultimately spent $100 million on Kamen’s dream — backed out and stopped selling the devices in 2009.
“The introduction of the first iBOT — as far as a business and getting it out to all the people — was a spectacular failure,” says Vogel.
But Kamen didn’t let go. “Beautiful theories can be beautiful theories, but no matter how beautiful the theory is, the ugly fact wins,” he recalls. So “all I could say to them was, ‘You’ve done a remarkable amount. We thank you. But could you do one more thing for me? Since you’re not going to go forward with it, essentially, for $1 would you give it back to me so I can find a way to keep going?’ And they did.”
Now hope may finally be on the horizon.
About a decade ago, DEKA started working on the next-generation iBOT. Soon afterward, Kamen called Merrow, who had just sold the company he’d left DEKA to start.
“Come back,” Kamen said. “And this time, instead of partnering with anybody big, let’s go and figure out how to efficiently, directly get this technology to the people who need it.”
The result was a new and improved iBOT with configurable rehab seating to make it more accessible to more people, now sold and distributed directly through Merrow’s startup, Mobius Mobility.
To be sure, price remains a barrier. “What we need from policymakers is a framework which recognizes the value in activities that are beyond the basics of getting from your bed to the bathroom,” Merrow says. “And there are all these costs to the current reimbursement model which aren’t tracked. You know, they don’t [consider] the fact that, oh, you had to modify your house, modify your car, maybe you’re taking medicines because you’re depressed, because you can’t get out more. Recognizing in a common framework those different outcomes and those different health care costs for innovations like the iBOT that help people with disabilities — I think isn’t something that has to happen. It’s just the right thing to do.”
Yet Kamen and company are optimistic about making progress on cost. This time around, the FDA has reclassified the iBOT as a Class II medical device, enabling Kamen to update it without having to restart the expensive and time-consuming approval process. Meanwhile, he’s donating 50 iBOTs to the U.S. Department of Veterans Affairs — two for each VA hospital that treats spinal cord injuries — in hopes of triggering a shift in awareness.
Either way, says Merrow, “the product is done. I mean, we’ll always improve it. But the technology is proven. It was proven the first time around.”
At the 2019 relaunch, first-generation iBOT user and retired Army Col. Greg Gadson gushed, “If the first iBOT was a Model T, then this current new generation is a Ferrari.”
Vogel agrees. “After years and years of buzz, I was afraid it wouldn’t live up to [the hype],” he says. “It exceeded it.”
Kamen, for his part, says he won’t rest until everybody who needs an iBOT can finally get one. “I spent a lot of time and a lot of money failing,” he says. “But the first time we actually took a disabled person and put them in the first iBOT, that person went zipping around. He went up a curb and even went up some stairs. He lit up. Then when he came back down, all we did was have him stand up. His wife was there. And there’s this big, burly guy just standing up in that iBOT, and he was back to being a little taller than his wife. He’s crying. His wife is crying.
“An iBOT,” Kamen adds, “gives people something that a wheelchair can’t even dream about.”