Epinephrine autoinjector

The epinephrine autoinjector emerged from military technology adapted for civilian emergencies. Sheldon Kaplan's 1977 design at Survival Technology put a precise dose of life-saving medication into a device any panicking parent could use during a child's anaphylactic reaction—no training required.

The adjacent possible combined several technological threads. Epinephrine (adrenaline) had been used to treat allergic reactions since 1901, but administration required drawing medication from a vial with a syringe—slow, error-prone, and terrifying during an emergency when the patient couldn't breathe. Military medics faced similar challenges delivering nerve agent antidotes on battlefields.

Kaplan, a biomechanical engineer at Survival Technology in Bethesda, Maryland, had designed the first emergency medical kit for NASA's Apollo moon missions. In 1973, the Pentagon approached the company seeking a delivery method for atropine, a nerve agent antidote. Kaplan's solution would serve both military and civilian needs.

The engineering challenges were significant. Glass vials were fragile, but plastics leaked medication through vapor transmission. Several consulting firms told Survival Technology that glass was 'just not possible' given the casing requirements. Kaplan harnessed his analytical skills: tempered glass for the medication container, a calibrated spring for precise injection force, and a mechanism that could deliver larger dosages than previous attempts.

The inventors received US Patent 4,031,893 in 1977. The military version became the ComboPen; the civilian version, designed for anaphylaxis, eventually became the EpiPen. The FDA approved the EpiPen for commercial use in 1987.

The design's genius was its simplicity. A person suffering anaphylaxis—difficulty breathing, plummeting blood pressure, swelling throat—needs epinephrine immediately. Their companion might be a teacher, a restaurant server, a frightened parent. The autoinjector required no measurement, no vial, no syringe technique: press against thigh, medication delivered.

Kaplan continued refining the design throughout his career, adjusting dosage, deployment sensitivity, and function. He was inducted into the National Inventors Hall of Fame; the Lemelson-MIT Program recognized his life-saving innovation. When Kaplan died in 2009, his invention had been used millions of times to reverse anaphylaxis from bee stings, peanuts, shellfish, and countless other allergens.

Path dependence made EpiPen the default despite price controversies. By 2026, epinephrine autoinjectors remain the first-line treatment for anaphylaxis—Kaplan's military technology now standard equipment in schools, restaurants, and the pockets of millions of allergy sufferers worldwide.