Joan Sullivan Garrett remembers early in her career as a flight nurse responding to a young boy who was thrown from a vehicle in a rollover crash on a remote dusty road.
She was on board a helicopter bound for the scene, which would be 20 minutes by air, but the aircraft was told to return to the base after an ambulance crew on the scene said they could safely transport the boy to the hospital for treatment.
By the time the boy got to the hospital, however, he had died because no one on the scene had the medical expertise to recognize the seriousness of his injuries.
“There are different levels of trained individuals and you had a basic life support team on the scene,” Sullivan Garrett said. “Depending on what level of education they had or ongoing, recurrent training, they did the best they could, but clearly it wasn’t enough. By sending us back, they took a level of expertise away from that decision making.”
She agonized over the boy’s death and found herself repeatedly questioning whether it could have somehow been prevented.
She finally came to the realization that emergency room-level medical expertise should be made available on the scene of medical emergencies regardless of location.
Sullivan Garrett decided to become an entrepreneur and started her own company with this goal in mind. In 1986, she founded Tempe-based MedAire, which has been providing medical and health services to remote travelers all over the world.
“Through medical kits, training and technology, we’re able to bring emergency room-level medical expertise to the scene of remote medical incidents — on board airplanes in flight, ships far at sea and in hotel rooms and clinics in distant countries,” Sullivan Garrett said.
MedAire is now a global corporation and employs about 100 people in the Valley, and more than 90 in China, Thailand and Indonesia.
Its MedLink Global Response Center is located at Good Samaritan Medical Center in Phoenix. Doctors and other medical experts there relay critical information by high-tech communications equipment to airplanes, ships and other modes of transportation worldwide.
MedAire took a financial beating in the aftermath of the Sept. 11, 2001, terrorist attacks, when air travel virtually ground to a halt, and then during the sudden acute respiratory syndrome, or SARS, threat, but has now rebounded and is poised for strong growth next year, Sullivan Garrett said.
The company is private in the United States, but is traded publicly on the Australian Stock Exchange.
According to the latest report from Australia-based Tolhurst Noall Share Brokers & Financial Planners, MedAire’s revenue performance has been in line with analysts’ expectations and it reported a net profit for the first half of this year.
“Overall, the result represented a strong positive turnaround in the operational performance of the company,” analyst George Semerdjian said in the report.
Getting MedAire off the ground was like scaling Mount Kilimanjaro, Sullivan Garrett said. At that time, the Federal Aviation Administration required little of airlines in terms of on-board medical equipment and information, she said.
“Even in 1988, the FAA didn’t require CPR for training,” she said. “Basically my attempts to educate the market in the early days fell on deaf ears. The airline industry didn’t really keep track of medical emergencies. It was really my vision that this was going to be something that needed to be reckoned with.”
Sullivan Garrett remembers nervously addressing airlines’ boards of directors, and nearly being laughed out of the room because they failed to see the significance of what she was proposing.
“It wasn’t just how to provide better service to the airline passenger by having better training to deal with medical events, but also how do you protect yourself from diseases that you may not even be aware that people have,” she said. “The other point was having the right equipment on board the aircraft, with kits and medical equipment. I felt they had an extremely limited, inadequate medical kit.”
Over time, the airlines began to listen and MedAire began gaining clients. American Trans-Air was the first airline to sign with MedAire, followed by America West Airlines.
America West signed with MedAire in August 1989.
“If there is a medical situation on board one of our flights, we can get advice and input from medical experts,” said America West spokeswoman Janice Monahan. “Their input certainly helps determine what we need to do with the flight, can we continue on or do we need to land as quickly as possible, and what do we need to do to make sure that customer gets the best care.”
As the company gained more clients, it continued compiling data that served as even stronger evidence that airlines needed the service being offered by MedAire, Sullivan Garrett said.
The transition from small, Valley-based company to global corporation was a daunting task for MedAire, Sullivan Garrett said.
“When you’re tied to transportation, transportation is a very global business,” she said. “Here we are a U.S. company and fairly small, and then trying to take on the Queen’s English in how to respond to an international carrier. So we worked very hard to think like a global company.”
That involved understanding the many different cultures of passengers throughout the world and incorporating that into its service, Sullivan Garrett said.
“We may have a Middle Eastern lady who is ill and complaining of abdominal pain,” she said. “Well, how we conduct our advice for treating her is important because there are certain religious factors here that are very, very important; religious beliefs and cultural beliefs that go into how we manage this whole event.”
About 500 million travelers worldwide fly aboard planes with MedAire’s service, including more than 85 percent of the people who fly out of Phoenix Sky Harbor International Airport. It also has expanded its service to support maritime operators, government agencies, the military, and business travelers and expatriates all over the world.
“We have been supporting the business aviation market, carrying the top five to 100 business executives on board corporate jets throughout the world,” Sullivan Garrett said. “Also, we happen to end up taking care of luxury yachts, and now we acquired a company called Maritime Advisory Systems, and that business is about 2,500 vessels out there on the sea carrying shipping containers and fuel, and all kinds of goods. Transportation is the shaking and moving of our economic society.”
There’s still room for growth in the United States and Europe, but the real growth for MedAire is taking place and will continue to take place in Asia, she said.
“They’re hungry for what we bring to the table in terms of Western health care philosophies, technologies and innovative ways to deliver health care,” Sullivan Garrett said.
In January 2003, MedAire acquired Australia-based Global Doctor Ltd., which was publicly traded on the Australian Stock Exchange.
“We did kind of a reverse merger and as a result of that acquisition we delisted Global Doctor and listed MedAire,” Sullivan Garrett said.
The Australian stock provides access to capital for growth and MedAire would at some point like to go public in the United States, she said. But, the Sarbanes-Oxley Act of 2002, a far-reaching set of laws aimed at corporate reform, would make doing so too costly, she said.
“For a company our size, we figured out it would cost us about $1 million in fees alone, possibly per year, just to be able to say that we are in compliance with Sarbanes Oxley,” she said.
Joe Blankenship, vice president of research at Scottsdale-based Source Capital Group, isn’t surprised at MedAire’s reluctance to go public in the United States. He researches Arizona-based companies and stocks.
“Their comment relative to going public and Sarbanes Oxley is something that a lot of companies are looking at and considering whether they should even remain public because of the cost of complying with it,” he said. “I would suspect that over the next year . . . you might see as many as five companies withdraw their listings in Arizona.” MedAire does have investors in the United States, and some of its biggest investors are employees based here, Sullivan Garrett said.
“But it is difficult for people to invest,” she said. “They have to go through a few extra steps to invest here.”