Award Number: W81XWH-

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AD Award Number: W81XWH- TITLE: PRINCIPAL INVESTIGATOR: CONTRACTING ORGANIZATION: REPORT DATE: TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for public release; distribution unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation.

Form Approved REPORT DOCUMENTATION PAGE OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. ReporT DATE (DD-MM-YYYY) 2. REPORT TYPE 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR S REPORT NUMBER(S) 12. DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT a. REPORT U b. ABSTRACT U c. THIS PAGE U UU 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18

14. ABSTRACT Perseus Medical, Inc. proposes to build and test a cost effective self-contained video laryngoscope (SVL} providing visualization of trache~ and vocal chords during emergent situations at the point of care. The SVL will fulfill currently unmet needs by providing a completely self-contained portable endoscopic system that can be used at bedside without the need for external power sources and/or instrumentation. The annual report fully details that strides that have been made to the SVL sub-systems: optical, mechanical, electronics, and software. 15. SUBJECT TERMS Self-contained video larynogoscope

Concept Description Henry M. Jackson Foundation processed a sub award to UCLA for Perseus Medical, Inc. to work on designing a self-contained video laryngoscope (SVL). Perseus Medical, Inc. proposes to build and test a cost effective SVL providing visualization of trachea and vocal chords during emergent situations at the point of care. Our SVL will fulfill currently unmet needs by providing a completely self-contained portable endoscopic system that can be used at bedside without the need for external power sources and/or instrumentation. Perseus is a company founded and run by a dedicated team of UCLA MBA, Medical and Engineering Ph.D. students and alumni. This team was awarded highly prestigious first place in the 2009 Knapp Venture Competition at the UCLA Anderson School of Management, judged by dozens of entrepreneurs, venture capitalists and angel investors, faculty, and advisors. The Perseus SVL novelty is in its unique integration of various state of the art components. The combination of these new optical, electronic, and mechanical elements now permits construction of an entirely self-contained video laryngoscope. The Perseus laryngoscope features a 4.0mm (preliminary data) outer diameter probe without fiber-optic bundles. The elimination of fiber optics reduces costs, weight and potential damage while improving robustness, portability, mechanical bending, and steering capabilities. Mechanical controls in Perseus SVL permit 2-way deflection with bending radii lesser and angles greater than current endoscopes. The use of removable, rechargeable high-capacity lithium ion batteries permits at least 1.5 hours of continuous operation before a rapid battery exchange or recharge. Video capture achieves at least a QVGA resolution often seen in handheld devices. It has a minimum video frame rate of 24fps achieving a balance between image clarity and battery life while exceeding both the 23.976fps NTSC and 24fps PAL/SECAM standard. The endoscope will use a solid state image sensor with an objective lens which provides an 80 field of view. A bright white LED light source provides both general and stroboscopic illumination, which is synchronized with the video capture system. The Perseus SVL system will deliver efficient information management, significant cost-savings, and video-laryngostroboscopy capability in an ultra-portable and user friendly package. Technical Accomplishments Achievements/Results: The funds for this project became available through UCLA on July 1, 2011. Since then, we parallel. The systems: optical, Optical Mechanical have started working on main sections following describes updates for each mechanical, electronics, and software. 1. Determined the size and optical parameters for distal end lens. of the system in of the SVL sub- 2. Placed the order for the initial set of lenses from the John Tesar and Associates (JT&A). 3. We have determined the bset testing methods and end points for optimization of the optical system. Once we receive the optical cells form JT&A, we will conduct tests with the image sensor and electronics image acquisition circuitry to verify the optical properties of the lens assembly. Potential Issues: If the image quality and optical characteristics of the optical cell assembly and image sensor are not satisfactory, we will reorder new set of lenses. This may delay completion of the system. Insertion Tubing

The mechanical, optical, and electronic components need to be incased in an outer shell composed of the handle and tubing. The tubing component plays the critical role in determining the flexibility of endoscope. It needs to be stiff enough to not buckle under a specified bend radius, while being flexible enough to travel through the nasal passage as required. 1. Determined required 2. Communication with specifications. specifications for insertion tubing. tubing manufacturers to attain quotes and available Once the specifications are approved by the necessary parties, the insertion tubing will be ordered with a 4-6 week lead time. Once the distal subassembly is finished, we will begin to decide on the best method for attachment to the insertion tubing. These methods include the use of heat-shrink wrap tubing, glues, and mechanical devices to lock components in place. Potential Issues: If we decide that the insertion tubing does not meet specifications, we may need to re-order and have to wait another 4-6 weeks. Potential Issues: None. Distal Subassembly The main function of the distal subassembly is to contain the distal components (LED, image sensor, and their respective optical components) in the correct orientation and distance in respects to one another. A secondary function of the subassembly is to properly isolate light and heat from the LED to the image sensor. 1. Initial CAD model for the distal subassembly in respect to current knowledge of the optical components. 2. Determined material used for initial prototyping to be aluminum for machinability, thermal properties, and strength. 3. Communicated with UCLA machine shop to ensure the machinability of the initial design. Current Pigun 1.: OW rend~ring of disll:zl md assembly design Figw-e 2: Engineel'ilVJ l"endering of i Sft prpxijjjrl ~ltd de#nn ' Update distal subassembly with updated specifications of distal components. There will be changes in regards to component dimensions which we will need to take into consideration. At this point, we expect to have a distal subassembly built by a machine shop to be tested. Next, we will test the imaging capabilities of the distal subassembly with the LED and image sensor combined. The testing will also

Electronics include a study of the thermal and light isolation capabilities of the distal subassembly. Potential Issues: If the thermal isolation between the LED and the image sensor is inadequate, the design may need to be restructured or a different material may have to be used. The electronic subsystem consists of the image sensor, LED, the LCD screen, connecting wires, and information storage. The subsystem provides drivers to enable software interfacing with the control board, LEOs, and electronics. Wiring assembly in the distal end needs to fit in the available space with the endoscopes. The electronic subsystem uses OMAP based processor board with a Linux operating system. The processor has native support for camera, screen, and storage, which we have tested to work. We have tested this system and it operates as designed. In addition, we have also completed the design for the LED board with strobe capability. Figure 3: Gumstix"" board (under LCD screen) with LCD screen and OEM camera displaying real-time imagejvideo Incorporate a functional video driver adjusted from an confirm its functionality using a live video stream. board and its drivers and test their functionality. existing generic driver and Complete the design for LED Potential Issues: LED board might need adjustment if desired results are not achieved. Software / Graphical User Interface (GUI) The Graphical User Interface (GUI) subsystem channels camera to the screen, and allow user to control the perform function selections. the video brightness, feed from contrast, the and The GUI software platform has been defined using Java and tested standard video feed. The interface currently contains brightness control. The function selection development will be deferred until is developed. to work with and contrast the LED board

Perform feasibility test for GUI software platform and select the most stable version. Develop the GUI which will display video feed from the camera to the screen and implement the user control for image brightness and contrast. Design user controls for various stroboscopic functions. Potential Issues: LED board might need adjustment if the desired result cannot be achieved. Programmatic Perseus Team During the last period of performance, our team met several times to discuss project responsibilities, details, issues, and other considerations. The following is a list of our team members, their background, and project responsibilities: Jules Huang, M.D, M.B.A., Founder, President, and Chairman of Board. Dr. Huang is currently an Anesthesiology and Critical Care Medicine Resident Physician at Johns Hopkins. She will support the group with testing of prototypes and business development efforts. Boris Vulovic, Ph.D., Engineer. Responsibilities will include electronic parts acquisition, PCB assembly, CCD camera acquisition and testing, basic electronic development for testing of LEOs and CCD options, driver development for the image sensor, optimization of the electronics system, and battery charger PCB assembly. Andreas Ali, Ph.D., Engineer. electronics, LED, and FPGA, development, electronic system battery lifetime testing. Responsibilities will focus on components for FPGA board design, distal tip subassembly assembly, battery testing PCB assembly, and Ali Ayazi, Ph.D., Engineer. Responsibilities will focus on optical system parts acquisition, optical system jig development, ceo and lens component testing, ceo Lens development and assisting on the distal tip subassembly development. Kirby Chiang, M.S., Engineer. Responsibilities will include mechanical development, distal tip packaging development, insertion tube material selection and testing, machining, handle subassembly construction and testing, and final device assembly. Marko Kostic, Ph.D. student, Engineer. With over eight years of experience in medical device research, development, testing, and product development, Mr. Kostic will focus on electrical and optical system integration as well as regulatory testing compliance and prototype testing. Pushkar Gejji, M.S. student, Engineer. Responsibilities will focus on electrical circuit design for analog and digital sections of the system, power supply design. Mr. Gej j i will be assisting Dr. Ali with any other electrical system integration tasks. Prof. Warren S. Grundfest, MD, FACS - overall project supervisor, sub-contract PI. Schedule The project has initially been delayed due to UCLA funding issues earlier this year. However, since then, we have started work on multiple sections in parallel and anticipate on-time project completion by the end of no-cost extension period.