Two sisters leave their mark when it comes to X-rays Irish health innovators: Dr Aisling Snow and Fiona Snow  

Irish Times: Eimear Galvin

Designer Fiona Snow still remembers the day her sister Aisling came to her studio with an “idea for a side project”. OLCH  consultant paediatric radiologist Dr Aisling Snow wanted to explore developing disposable X-ray markers. 

 It is globally accepted best practice that all radiographic images must display a correct anatomical side marker to ensure right/left fidelity. These radiographic markers are the most frequently handled objects in the radiology department. The same markers are used with every patient, and are often kept in the radiographer’s pockets. 

 Aisling was aware that disposable markers already available are expensive, and can contain materials unsuited to use in healthcare settings, such as latex. 

Fiona developed a number of early samples, all of which worked but contained metal, plastic or both. When they did a ‘back of the envelope’ calculation of the size of the market they realised the product had to be sustainably disposable. 

All of the metal/plastic options were parked, and Fiona began to research and test low-impact waste options. It was through this lens that she developed a range of materials that require minimal resources to manufacture, are completely biodegradable, safe in any waste stream and, crucially, sufficiently radiopaque to be visible on X-ray. The sisters quickly realised they had developed a brand new innovative solution – SideSafe disposable X-ray markers were born. 

Patient care 

SideSafe plays three key roles in disrupting the market and improving patient care. 

 The first is cleanliness – current reusable markers have been found to be contaminated (80 per cent) and rarely if ever cleaned (92 per cent). One SideSafe marker for one patient eliminates any opportunity for the spread of infection via X-ray markers. 

The second is accessibility. Reusable markers are underused, with reliance often on digital X-ray marking, which is not recommended best practice. This can actually lead to errors in image reporting. SideSafe makers can be docked in portable X-rays, are clean and safe to take into ICU, and will always be present in the X-ray room ensuring markers are within reach of radiologists. 

Finally, CE marked Sidesafe meets all of the necessary EU Medical Device Regulations 2020, compared with the unregulated legacy product. 

Aisling’s experience in the field means she also recognises the cost benefit to Irish hospitals of SideSafe. “In a large Irish hospital more than 100,000 radiographs are taken each year – this is up to 100,000 opportunities for infection to spread via current reusable markers and 100,000 chances for a side safety error to be made if a marker isn’t used. “Infection control and the treatment of hospital-acquired infections bears a significant cost on hospitals and serious risks for patient health. SideSafe protects hospitals from the costs associated with managing infection spread by side markers, and the cost associated with decontamination of reusable markers and ensures that all X-ray images are correctly side-marked, eliminating the risk of a procedure being performed on the wrong side of a patient.” 

Opportunities 

Both Fiona and Aisling agree that there are increasing numbers of opportunities for healthcare innovators in Ireland with valuable supports available. The sisters founded the company Combimark, of which SideSafe is one product. 

Combimark is in the process of becoming a Trinity College Dublin (TCD) spin-out. Through TCD they were put in touch with the university’s Health Innovation Hub Ireland (HIHI) office to run usability tests in Irish healthcare settings. Last July they won Enterprise Ireland support as part of the Female Competitive Start Fund, receiving investment and extensive mentoring. 

Reflecting on being in business with her sister, Fiona says “overall it’s definitely easier – we know exactly what each other’s perspective is and what our goals are” . 

Aisling agrees: “Combimark is a true collaboration that wouldn’t have come into being without input from both of us. In the very early days it was helpful to have an unspoken understanding of each other.”  

Looking to the future, Combimark is focussed on delivering sustainability in healthcare disposables, and is working on more products that will sit in this space. 

Fiona explains: “If you start to count the number of plastic disposables used every day in clinical settings you quickly realise that the entire medical device and accessory market is very reliant on plastic, even when it is not being used for hygiene reasons. 

 SideSafe shows that where appropriate plastics and metals can be avoided, and certain healthcare products can still meet the rigours of medical device regulation and clinical needs.”