ML20235S713
| ML20235S713 | |
| Person / Time | |
|---|---|
| Site: | 07002205 |
| Issue date: | 02/04/1976 |
| From: | Howe G, Manley J ST LUKE'S MEDICAL CENTER, MILWAUKEE, WI (FORMERLY |
| To: | US ATOMIC ENERGY COMMISSION (AEC) |
| Shared Package | |
| ML20235S679 | List: |
| References | |
| NUDOCS 8903070230 | |
| Download: ML20235S713 (24) | |
Text
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Chief, Materials Branch.
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Div*sio of Mate la a Fuel Cycle Facility Licensing Washington, D.C. 20555 l
l Re: Application for license to participate in the research study involving the implantation of Nuclear Omni-Stanicor #184A nuclear powered pacemakers Gentlemen:
The following information is wbmitted in application for a license to participate in the investigational program utilizing Nuclear Omni-Stanicor # 84A nuclear powered pacemakers:
1 Applicant:
St. Luke's Hospital 2900 West Oklahoma Avenue Milwaukee, Wisconsin 53215 -
Physician Responsible for study:
John C. Manley, M.D.
Office Address:
7635 W. Oklahoma Avenue Milwaukee, Wisconsin 53215 Telephone:
414-321-8130 State Licensed to Practice in:
Wisconsin and California Specialty Board Certification:
Internal Medicine and Cardiolo'gy Position with Applicant:
Active Staff, Internal Medicine, 3
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5 Cardiology Previous experience in the clinical g
use of implantable pacemakers by j
physician -
1 ms SS$
Total number of implants physician has done:
193 Ogg7 Sd Total number physician has done at applicant's facilities: 189
$$E Transvenous Leads:
193 cotu z 03Q to The caJacens represents the medhd proleuion. The sphere represents sbo world uide nope of the meJhd practice, and the u inged cdl u ith the hdo is the autpted ecclesiastical symbol of she sacri-
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ficid natore of St. Lake, the Apostle Physician. Thus, the mobile personifi-s St. Luke's llospisd, b;t*t l EA y
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.P R O F 4 T O R G A N 3 2 A T I O N i
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u Chief of Materials ~ Branch-February 4,1976 Page Two
- Information regarding other physicians who will be participating in this study is attached.
The master protocol for clinical evaluation of the Programmable Cordis Nuclear Omni-Stanicor Pacemaker, dated October 1974, will be followed.
The number of Nuclear Omni-Stanicor # 84A pacemakers requested to be implanted annually 1
during the study will be approximately ten per year..
1 St. Luke's Hospital has a 690 bed complement which includes 63 intensive care beds; 20 '
will be used for cardiovascular surgery and neurosurgery,11 for general surgery,10 for pulmonary medicine,12 for coronary care and 10 for medical care. in addition, three' patient' floors contain back-up beds for the intensive care areas with the equipment and personnel.
requisite for an intermediate level of care. Each of the three intermediate units have'44 beds
. and each unit has the capability of telemetry monitoring for 16 patients which will be :
expanded to 24 patients in the near future.
The primary transvenous electrode with power pack insertions are usually performed in-the Cardiac Catheterization Laboratories. Generator pack replacements are performed in surgery unless the cardiologist believes the electrode needs adjustment.
i i
Our Cardiac Catheterization Laboratory will expand from two to four procedure rooms early -
]
in 1976, all of which will be available for primary implantation; each room has fluroscopy
'J and the back-up surgical equipment required to perform this procedure.
The statistics for the Cardiac Catheterization Laboratory include:
p 1974 - 2051 patients studied.
i 66 primary pacemaker implantation 1975 - 2229 patients studied 68 primary pacemaker implantation Our cardiovascular surgery program is also quite extensive. These statistics include:
1974 - 854 open heart procedures 1975 - 869 open heart procedures 101 generator pack replacements Our emergency room operates 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> a day with'M.D. coverage.. Therefore, if the patient would experience problems with his pacemaker, emergency treatment'would always be available, l
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' Chief of Materials B nch February 4,1976 Page Three Following the procedure, these patients may be' monitored in our 12-bed coronary care 1
unit with hard wire monitoring or on any.one of the three intermediate units by. telemetry. '.
.l All personnel in these areas receive specialized training on pacemaker function, patient j
- )
assessment and teaching. -
Our records of pacemaker insertions date back to 1965, with 'a total of.731 implantation at our facility. We' handle the entire warranty program through the Cardiac Catheterization y
Lab, which includes completion of the registration forms and out-of-service pacer reports both for credit or adjustments. The Cardiac Catheterization Lab would be responsible fors q
1 monitoring the entire nuclear pacemaker program.
Because of the size of our institution and the extent of our cardiac program, we currently have eleven cardiologists and fifteen cardiovascular-thoracic surgeons on our staff. The cardiologists rotate call for the coronary care unit and, as a result, may' receive pacemaker.-
referrals. Therefore, all our cardiologists are requesting to be included in the study, in order.
1 to cover our emergency program.
4 Each patient receiving a Nuclear Omni-Stanicor #184A Pacemaker, and each of the control group patients, will be started on the CDI Pacemaker Following' System before leaving the hospital. Our own personnel will be responsible for teaching the patient the use of this equip-1 ment. The patient will have a time schedule for calls, which is determined by the age.of his pacemaker. Each time he calls, a' report will be sent to his physician (s) and"a' copy will be -
j sent to our Cardiac Catheterization Lab, which will then become part of his implantation record.
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4 We agree to establish appropriate control procedures to ensure the physical security of the pace-a maker while in our possession. These procedums will include keeping track, by serial number,.
of the location of each pacemaker and requiring that each be kept under lock and key, when
-l" not being used, to guard against loss or theft. All activities will be conducted in accordance' with the regulations under Title 10, Code of Federal Regulations,' Port'70, to the best of our knowledge.
1 i
We confirm the physicians responsible for and participating in the study will be informed of the' Master Protocol for Clinical Evaluation of the Programmable Cordis Nuclear' Omni-Stanicor 1
Pacemaker, dated October 1974, and the Institutions for Use of the #184A Model. We further agree that they must represent that they are familiar with the Master Protocol through discussion
. with the Medical Director responsible for the program, and understand that the issuance of a license is conditioned upon the following of this protocol.-
We confirm that packaging, labeling, and shipping instructions, to be furnished by Cordis Corporation, will be followed upon the return of the pacemaker for approved disposal.
1
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~ Chief of Materials Branch February ~4,.1976 1
Page Four St. Luke's Hospital hereby requests a license to receive, possess, store, and implant the Nuclear Omni-Stanicor #184A nuclear-powered pacemaker, in accordance with this application.
Signed:
1 I
Applicant:
St. Luke's Hospital i
2900 W. Oklahoma Ave..
Milwaukee, Wisconsin 53215 i
By:
/
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'G. Edwin Howe President Medical Director: CMdu C. M o John C. Manley, M.D.
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APPLICANT:
St. Luke's Hospital 2900 West Oklahoma Avenue Milwaukee, Wisconsin 53215 PHYSICIAN RESPONSIBLE IDR STUDY:
John C. Manley, M.D.
STUDY TEAM PHYSICIAN:
Samuel L. Kalush, M.D.
017 ICE ADDRESS:
2300 North Mayfair Road Wauwatosa, WI $3226 l
1 TELEPHONE:
2$7-2200 I
STATE LICENSED TO PRACTICE IN:
Wisconsin, Oregon MEDICAL SCHOOL AFFILIATION:
none SPECIALTY BOARD CERTIFICATION:
American Board of Surgery POSITION WITH APPLICANT:
Division Courtcey Department -Surgery Section -
Thoracic Surgery s
PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEW.KERS BY PHYSICIAN:
l TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE:
19 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES: 10 MYOCARDIAL LEADS:
TRANSVENOUS LEADS: 19
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1 APPLICANT:
St. Luke's Hospital-2900 West Oklahoma Avenue Milwaukee, Wisconsin.53215
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PHYSICIAN RESPONSIBLE FOR STUDY:.
John C. Manley, M.D.
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STUDY TEAM PHYSICIAN:
Donald Mu11ons, M.D.
OFFICE ADDRESS:
9800' West Bluemound Road.
Milwaukee; VI 53226
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TELEPHONE:
475-1585 STATE LICENSED TO PRACTICE IN: Wisconsin, North Carolina MEDICAL SCHOOL AFFILIATION:
Wisconsin, North Carolina SPECIALTY BOARD CERTIFICATION: American Board of Cardiology-American Board of Thoracic-Surgery 1
American Board of General Surgery
]
POSITION WITH APPLICANT:
Division -
. Courtesy-d Department Surgery.
j Section -
Thoracio'. Surgery-PREVIOUS EDCPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAKERS
'l BY PHYSICIAN:
'l
-J TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS I)ONE: 300
'IOTAL NUMBER HE HAD I)0NE AT APPLICANTS FACILITIES: 12 MYOCARDIAL LEADS:
TRANSVENOUS LFADS:
1 1
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V APPLICANT:
St. Luke's Hospital 2900 West Oklahoma Avenue Milwaukee, Wisconsin $3215 PHYSICIAN RESPONSIBLE IUR STUDY:
John C. Manley, M.D.
STlfDY TEAM PHYSICIAN:
Lowell Davis, M.D.
OFFICE ADDRESS: 3112 West Highland Blvd.
Milwaukee, WI $3208 TELEPHONE:
931-0020 s
STATE LICENSED TO PRACTICE IN:
Wisconsin, California MEDICAL SCHOOL AFFILIATION: none SPECIALTY BOARD CERTIFICATION:
American Board of Surgery American Board of Thoracic Surgery POSITION WITH APPLICANT:
Division -
Temporary Privileges Department - Surgery Section -
Thoracic Surgery PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAKERS BY HIYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS I)0NE: O TOTAL NUMBER HE HAD I)0NE AT APPLICANTS FACILITIES: 0 MYOCARDIAL IPADS:
TRANSVENOUS LEADS:
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o APPLICANT:
St. Lukn*z Hospital 2900 Wec Cklahoma Avenue Milwat'a., 31sconsin 53215 l
l PHYSICIAN RESPONSIBLE FOR STUDY:
Johu C. Manley, M.D.
1 I
STlTDY TEAM PHYSICIAN:
Mohammad Cheama, M.D..
0FFICE ADDRESS:
2300 North Mayfai7 Road Vauwatoca, WI $3226 TELEPHONE:
257-2200 l
v 1
STATE LICENSED TO PRACTICE IN:
MEDICAL SCHOOL AFFILIATION:
none 1
l SPECIALTY BOARD CERTIFICATE 0Nr.
American Board of Surgery
{
American Board of Thoracic Surgery l
l l
POSITION WITH APPLICANT:
Division -
Courtesy l
i Department - Surgery Section -
Thoracic Surgery 6
PREVIOUS EXPERIENCE IN TEE CLINICAL USE OF IMPLANTABLE PACEMAKERS j
BY PHYSICIAN:
l l
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE:
90 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES: 33 MYOCARDIAL LEADS:
3 1
TRANSVENOUS LFADS:
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APPLICANT:
St. Luke's Hospital I
.2900 West Oklahoma Avenue
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Milwaukee, Wisconsin 53215 I
IIIYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
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q STUDY TEAM PHYSICIAN:
Thomas M. O'Connor, M.D.
OFFICE ADDRESS:
2266 North Prospect Avenue Milwaukee, WI 53202 TELEPHONE:
273-7553 j
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STATE LICENSED'TO PRACTICE IN: Wisconsin NEDICAL SCHOOL AFFILIATION:
Medical College of Wisconsin SPECIALTY BOARD CERTIFICATION:
American Board of General Surgery l
American Board of Thoracic Surgery.
l POSITION WITH APPLICANT:
Division - Active Department - Surgery Section - Thoracic Surgery
)
FREVIOUS EXPERIENCE IN TEIE CLINICAL USE OF 1MPLANTABLE PACEMAKERS BY PHYSICIAN:
l TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE:
7 TOTAL UUMBEEt IB HAD DONE AT APPLICANTS FACILITIES: 7 MYOCARDIAL LEADS:
TRANSVENOUS LEADS:
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APPLICANT:
St. Luke's Hospital l
2900 West Oklahoma Avenue Milwaukee, Wisconsin $3215 PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
STUDY TEAM PHYSICIAN:
James F. King, M.D.
OFFICE ADDRESS:
7635 West Oklahoma Avenue Milwaukee, WI 53215 l
TELEPHONE:
321-3130 STATE LICENSED TO PRACTICE IN:
Wisconsin, Kansas, California l
MEICAL SCHOOL AFFILIATION:
Clinical Instructor Medical College of Wisconsin SPECIALTY BOARD OFRTIFICATION:
POSITION WITH APPLICANI:
Division - Courtesy Department - Internal Medicine Section -
Cardiology PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAKERS BY PHYSICIAN:
l l
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE:
29 TOTAL NUMBER HE HAD DOND AT APPLICANTS FACILITIES:
29 MYOCARDIAL LFJ\\DS:
TRANSVENOUS LEADS: 29 1
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1 APPLICANT:
St. Luke's Hospital 2900 West Oklahoma Avenue l
Milwaukee, Wisconsin $3215 l
PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
STULY TEAM PHYSICIAN:
Howard J. Zeft, M.D.
OFFICE AI) DRESS:
7635 West Oklahoma Avenue Milwaukee, WI $3219 TELEFHONE:
321-8130 l
STATE LICDISED TO PRACTICE IN:
Wisconsin, New York, California, MEDICAL SCHOOL AFFILIATION: Assistant Clinical Professor of Medicine Medical College of Wisconsin SPECIALTY BOARD CERTIFICATION: Internal Medicine and Cardiology Diseases j
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POSITION WITH APPLICART:
Division -
Active Department - Internal Medicine Section -
Cardiology.
PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACD4AITRS I
BY HIYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE:
61 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIFS: 61 MYOCARDIAL IEADS:
TRANSVENOUS LEADS: 61 l
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l APPLICANT:
St. Luke's Hospital 2900 West Oklahoma Avenue Milwaukee, Wicconsin $321$
l MIYSICIAU RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
1 l
STUDY TFAM HIYSICIAU:
James F. Hoffman, M.D.
O NICE ADDRESS:
3112 West Highland Blvd.
Milwaukee, WI 53208 l
l l
TELERIONE:
931-0020 o
l STATE LICENSED TO PRACTICE IN:
MEDICAL SCHOOL AFFILIATION:
no SPECIALTY BOARD CERTIFICATION: American Board of Thoracic Surgery American Board of General Surgery.
POSITION WITH APPLICANT:
Division - Courtesy i
Department Surgery j
Section -
Thoracic Surgery 1
PRINIOUS EXPERIENCE IN TflE CLINICAL USE OF IMPLANTABLE PACE!MKERS i
i DY HIYSICIAN:
)
l TOTAL NUMBER OF IFIPLANTS HIYSICIAN HAS DONE:
h TOTAL NUMBER HE HAD IONE AT APPLICANTS FACILITIES:
h MYOCARDIAL LEADS:
TftANSVENOUS LEKDS:
l 2
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APPLICANT:
St. Lukei B Hospital 2900 Went Oklahoma Avenue Milwaukee, Wisconsin $321$
PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
l 1
l STtJDY TEAM PHYSICIAN:
David G., Kamper, M.D'.
OFFICE ADDRESS:
3214 East Wiucons.in Avenue Milwaukee, WI 53202 TELEPHONE:
272-6310 9
I I
STATE LICENSED TO PRACTICE IN:
Wisconsin, Florida, Ohio MEDICAL SCHOOL AFFILIATION:
Medical College of Wisconsin i
SPECIALTY DOARD CERTIFICATION:
leericou Board of Internal Medicine I
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POSITION WITH APPLICANT:
Division -
Associate Department - Internal Medicine Section -
Cardiology l
PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAIGRS BY PETYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAH HAS DONE:
22 COTAL NUMRER HE HAD DONE AT APPLICANTS FACILITIES: 2 PYOCARDIAL LFADS:
'idANSVENOUS LEADS:
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t APPLICANT:
St. Luke's Hospital 2900 Weat Oklahona Avenuo Milttaukee, Wiccorsin $321$
PHYSICIAM RESPONSIBIL IUR STUDY:
John C. Manley, M.D.
STUDY TEAM PHYSTCIAN:
Massoud M. Maleki, M.D.
OFMCE ADDRESS:
3201 South 16th Street Milwaukee, WI 53215 TELE 1 HONE:
6h3-0370 o
STNfE LICENSED TO FRACTICE IN: Wisconsin MEDICAL SCHOOL AFFILIATION:
Medical College of WJoconsin SPECIALTY BOARD CERTIFICATION: American Board of Internal Medicine Canadian Board of Internal Medicine POSITION WITH APPLICANT:
Division -
Active Department Internal Medicine Section - Cardiology PREVIOUS EXPERIIGICE IN THE CLINICAL USE OF IMPLANTABLE PACEMAKERS BY PHYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAU HAS DONE:
32 TOTAL UUMBER HE HAD DONE AT APPLICANTS FACILITIES: 26 MYOCARDIAL LEADS:
TRANEVENCUS LFADS:
32
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APPLICANT:
St. Luke's Hospital 2900 West, Oklahoma' Avenue Milwaukee, Wisconsin 53215 PHYSICIRf RESPONSIBLE IDR STUDY:
John C. Hanley, M.D.
STUDY TdAM PHYSICIAU:
Richard E. Silberman, M.D.
OFICE /J) DRESS:
1425 East Wisconsin Avenue Milwaukee, WI 53202 TELEPHONE:
278-7212
+
STATE LICENSED TO PRACTICE IH:
Wisconsin, California MEDICAL SCHOOL AFFILIATION:
Medical College of Wisconsin SPECIALTY BOARD CERTIFICATION:
POSITION WITH APPLICANT:
Division -
Courtesy Department -
Internal Medicine Section -
Cardiology PHSVIOUS IIPERIENCE IN TrIE CLINICAL USE OF IMPLAUTADLE PACEMAKERS DY H1YSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONB:
91 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES: 16 MYOCARDIAL LFADS:
TRANSVENOUS LEADS:
91 l
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o APPLICAt"P:
St. Luke's Hospital i-2900 West Oklahoma Avenue Milwaukee, Wisconsin-$3215 PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
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STLTDY MEAM PHYSICIAN:
Bernard J. Staller, M.D..
l OFFICE /JTDRESS:
2722 West Oklahoma Avenue Milwaukee, WI $3215 4ELEPHONE:
38h-2710 o
STATE LICENSHD TO PRACTICE IN:
Wisconsin, Virginia, Illinois MEDICAL SCHOOL A FILIATION:
Medical College of Wisconsin l
SPECIALTY BOARD CERTIFICATION:
American Board of Cardiology American Board of Internal Medicine POSITION WITH APPLICANT:
Division -
Courtesy Department - Internal Medicine-Section -
Cardiology PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAIGRS BY PHYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAN llAS DONE:
25 l
TOTAL NUMBER HR HAD DONE AT APPLICANTS FACILITIES: 2h 1
MYOCARDIAL LEADS:
TRANSVENOUS LEADS:
25 l
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6,g AITLICANT:
.St. Luko'c Hospital 2900 Vent Oklahoma Avenue Milwaukee, Wisconsin $3215 s
PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
STtTDY TEAM MIYSICIAN:
H.D. Friedberg, M.D.
OFFICE ADDRESS:
1:25 East Wisconsin Avenue Milwaukee, WI $3202 TELEPHONE:
27tk7212 l
o STATE LICENSFID TO PRACTICE IN:
Wisconsin, Maryland IGIDICAL SCHOOL AFFILIATION:
Associate Profossor of Medicine Medical College of Wisconsin Royal Academy of Medicine, London SPECIALTY BOARD CERTIFICATION:
Cardiology POSITION WITH APPLICANT:
Division - Active Dapartment - Internal Medicine Section - Cardiology l
PREVIOUS EXPERIENCE IN THE CLINICAL USE OF II@LANTADLE PACEMAKERS BY MfYSICIAN:
TOTAL NUMBER OF II@LANTS PHYSICIAN HAS DONE:
216 l
TOTAL UUMBER HE HAD DONE AT APPLICANTS FACILITIES:
66 l
MYOCARDIAL LEADS:
TRANSVEN0US LEADS:
216 1
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APPLICANT:
St. Luke's Hospital 2900 West Oklahorca Avenue Milwaukee, Wisconsin $3215 l
PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
STUDY TEAM PHYSICIAU: Alfred J. Tector, Jr., M.D.
OFFICE ADDRESS:
3201 South 16th Street Milwe.ukee, WI 53215 TELEPHONE:
647-1120 STATE LICENSED TO PRACTICE IN: Wisconsin, Iowa, Missouri, New York, Ohio MEDICAL SCHOOL AFFILIATION:
SPECIALTY BOARD CERTIFICATION:
Board of Thoracic Surgery American Board.of Surgery j
i POSITION WITH APPLICANT:
Division -
Active l
Department - Surgery a
Section -
Thoracic Surgery 1
3 PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEtGKERS l
BY PHYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICI AN HAS DONE: 86 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES:
83 MYOCARDIAL LFlDS:
TRANSVEN0US LEADS:
I s
9
'T, O-1 APPLICANT:
St. Luke's Hospital 2900 West Oklahoma Avenue Milwaukee, Winconsin $3215 HIYSICIAN RESPONSIBLE FOR S'IUDY:
John C. Manley, M.D.
STUDY TEAM PHYSICIAU:
John A. Walker, M.D.
)
OFFICE ADDRESS:
2722 West Oklahoma Avenue Milwaukee, WI 53215 TELEPHONE:
38h-2710 STATE LICENSED TO PRACTICE IN:
Wisconsin MEDICAL SCHOOL AFFILIATION:
Medical College of Wisconsin SPECIALTY BOARD CERTIFICATION:
Cardiology POSITION WITf1 APPLICANT:
Division -
Active Department - Internal Medicine Section -
Cardiology - Chairman PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAKERS DY MfYSICIAN:
l 1
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE:
246 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES: 21h MYOCARDIAL LFADS:
TRANSVENOUS LEADS: 197 l
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APPLICANT:
St. Luke's IIospital 2900 West Oklahoma Aventto Miluaukee, Wicconsin $321$
1 IMYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
l STUDY TFJ\\M PIIYSICIAN:
Henry II. Cale, M.D.
OFFICE ADDRESS:
2722 Wcat Oklahoma Avenue Milwaukee, WI 53215
)
'381-2710
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TELEMIONE:
4
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STATE LICENSED TO PRACTICE IN:
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MEDICAL SCHOOL AFFILIATION: Medical College of Wisconain SPECIALTY BOARD CERTIFICATION: Cardiology - Internal Medicine
~
POSITION WITIf APPLICANT:
Division -
Active Department - Internal Medicine Section -
Cardiology MtEVIOUS EXPERIENCE IN TIIE CLINICAL USE OF IMPLANTABLE PACEMAKERS DY HIYSICIAN:
TOTAL NUMBER OF IMPLANTS HIYSICIAN HAS I)0NE:
189 TOTAL NUMBER HE HAD I)0NE AT APPLICANTS FACILITIES: 106 MYOCARDIAL LFADS:
1 TRANSVENOUS LEADS:
189 i
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.s APPLICANT:
St. Luke'o Hospital 2900 West Oklahoma Avenue Milwaukee, Wisconsin 53215 1
PHISICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
STUDY TFEI PHYSICIAN:
W.D. Johnson, M.D.
OFFICE ADDRESS:
3112 West Highland Blvd.
Milwaukee, WI $3208 TELEPHONE:
931-0020 STNfE LICENSED TO PRACTICE IN:
Wisconsin MEDICAL SCHOOL AFFILIATION: Associate Clinical Professor of Surgery Medical College of Wisconsin SPECIALTY BOARD CERTIFICATION: American Board of General Surger /
American Board of Thoracic Surgerf POSITION WITH APPLICANT:
Division -
Active Department -
Surgery Section -
Thoracic Surgery PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABIE PACEMAIGRS DY PHYSICIAN:
TOTAL NUMBER ;F IMPLANTS PHYSICIAN HAS DONE:
h1 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES:
37 MYOCARDIAL LEADS:
h TRA15 VENOUS LEADS:
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l APPLICANT:
St. Luko's Hospital l
2900 West Oklahoma Avenue Milwaukee, Wisconsin $3215 i
PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
l STUDY TEAM PHYSICIAN:
James E. Auer, M.D.
1 0FFICE ADDRESS:
2300 North Mayfiar Road Wsnwatosa, WI $3226 TELEPHONE:
257-2200
)
STATE LICENSED TO PRACTICE IN:
MEDICE SCHOOL AFFILIATION:
none q
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1 SPECIALTY BOARD CERTIFICATION:
American Board of Surgery 969 American Board of Thoracio Surgery i
POSITION WITH APPLICidT:
Division -
-Active Department - Surg:ary Section -
Thora.cio Surgery l
l l
PREVIOUS EXPERIENCE IN THE CLINICE USE OF IMPLANTABLE PACEMAKCRS I
BY PHYSICIAN:
TOTE NUMBER OF IMPIANTS PHYSICIAN HAS I)0NE:
68 TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES:
62 i
l MYOCARDIE LFADS:
TRANSVENOUS LE.GS:
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i
.5 APPLICANT:
St. Luke's Hospital 2900 West Oklahoma Avenue Milwaukee, Wicconsin $3215 PIIYSICIAU RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
S WDY TEAM PHYSICIAN:
Robert J. Flemma OFFICE ADDRESS:
9800 West Bluemound Road Milwaukee, WI 53226 TELUPHONE:
475-1585 o
STATE LICENSED TO PRACTICE IN: Wisconsin, New York, North Carolina MEDICAL SCHOOL A WILIATION:
Associate Clinical Professor Medical College of Wisconsin SPECIALTY BOAKO CERTIFICATION:
American Board of Surgery 15437 American Board of Thoracic Surgery 1925 POSITu ' WITH APPLICANT:
Division -
Active t
Department Surgery Section -.
Thoracic Surgery PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEHAKERS BY PHYSICIAN:
q TOTAL NUMBER OF IMPLAIES PHYSICIAU HAS DONE: 266 TOTAL 1RTMDER HE HAD DONE AT APPLICANTS FACILITIES: 115 MYOCARDIAL LFADS: 5 l
TRANSVENOUS IFADS:
,I e
i l
)
1 OQ Y^.]
o.
APPLICANT:
St. Luke's Hospital 2900 Woot Oklahoma Avenuo Milwaukee, Wisconsin $3215 PHYSICIAN RESPONSIBLE FOR STUDY:
John C. Manley, M.D.
STUDY TEAM PHYSICIAN:
Richard T. Shore, M.D.
017 ICE ADDRESS:
3112 West Highland Blvd. Milwaukee, WI $3208 TELEPHONE:- 931-0020 STATE LICENSHD TO PRACTICE IN: Wicconcin, New hexico IEDICAL SCHOOL AFFILIATION:
none SPECIALTY BOARD CERTIFICATION:
American Board of_ Surgery POSITION WITH APPLICANT:
Division -
Courtesy Department -
Surgery Section -
Thoracic Surgery PREVIOUS EXPERIENCE IN THE CLINICAL USE OF IMPLANTABLE PACEMAKERS BY PHYSICIAN:
TOTAL NUMBER OF IMPLANTS PHYSICIAN HAS DONE: h7 j
' TOTAL NUMBER HE HAD DONE AT APPLICANTS FACILITIES: h0 MYOCARDIAL LEADS:
TRANSVENOUS LEADS: 1 J