COL James A. (Andy) Nuce

COL James A. (Andy) Nuce
Commander
U.S. Army Medical Materiel Development Activity
Fort Detrick, MD

DELIVERING MEDICAL MATERIEL IN SUPPORT OF WORLD-CLASS CARE

COL Andy Nuce currently commands the U.S. Army Medical Materiel Development Activity and serves as the Medical Acquisition Consultant to The Surgeon General and the Army Medical Department Acquisition Career Management Advocate. COL Nuce began his military career as Platoon Leader, Bravo
Company, 147th Medical Logistics Battalion (Rear), Fort Sam Houston, Texas. His other assignments include serving as Chief of Logistics, Medical Element, Joint Task Force Bravo, Soto Cano Air Force Base, Honduras; 147th Accountable Officer for Class VIII, Fort Hood, Texas; Chief of Materiel and PROFIS Company Commander, Evans Army Community Hospital and A Company, 172nd Medical Battalion (LOG), Operation Iraqi Freedom; Property Book Officer for HHC, 30th Medical Brigade, Heidelberg, Germany and Baghdad, Iraq (in support of Operation Iraqi Freedom); Support Operations Officer and Company Commander for A Company, 226th Medical Logistics Battalion, Germany and Iraq; Assistant Product Manager, Medical Communications for Combat Casualty Care, Fort Detrick, Maryland; Deputy Commander for Operations, U.S. Army Medical Materiel Center-Korea, Camp Carroll; Executive Officer, 168th Multifunctional Medical Battalion, Camp Walker, Korea; Medical Acquisitions Officer, U.S. Special Operations Command, MacDill AFB, Florida; Commander, Troop Battalion, Tripler Army
Medical Center, Hawaii; and Division Chief, Department of Leader Training, U.S. Army Medical Center of Excellence, Fort Sam Houston, Texas.

Combat & Casualty Care recently spoke with COL Andy Nuce, Commander of USAMMDA, about his organization’s role as the Department of Defense’s advanced developer for medical products to
protect Warfighter health and enhance readiness.

C&CC: Please describe USAMMDA’s role in the development of medical materiel to protect Warfighters.

COL Nuce: The U.S. Army Medical Materiel Development Activity (USAMMDA) develops, delivers, and fields critical drugs, vaccines, biologics, devices, and medical support equipment to enhance
readiness, ensure provision of the highest quality medical care to the Department of Defense (DoD), and maximize survival of casualties on the battlefield. We are the primary medical product development,
systems management, and acquisition organization within DoD.

Our project managers guide the development of medical products for the U.S. Army Medical Department, other U.S. Services, the Joint in contested regions in the Indo-Pacific and Arctic regions. Future onflicts are expected to include dispersed operations, with logistics and supply lines stretching across hundreds, or even thousands, of miles.

To meet these challenges, USAMMDA and our partner organizations under the U.S. Army Medical Research and Development Command (USAMRDC) and the Army Medical Command (MEDCOM) are
developing devices, treatments, and technologies for military health care providers at and near the front line.

Working with combat developers to define gaps and requirements, our Project Management Offices (PMOs) collaborate with partners in DoD laboratories, academia, industry partners (both nationally and
internationally), and other government agencies to develop products to support Warfighter health and performance across the continuum of care.

C&CC: Could you address materiel development targeting surgical medicine in particular?

COL Nuce: The latest innovation is the incorporation of portable CT scanners designed for field deployment. These scanners are engineered to function in harsh and resource-limited settings,
providing crucial diagnostic imaging closer to the point of injury. This technology allows for rapid and accurate assessment of internal injuries, which is vital for surgical planning and intervention. USAMMDA continues to field CT scanners to the force, while training biomedical equipment technicians and operators to ensure personnel are prepared for operational use, benefits, and maintenance protocols of the CT scanning systems.

USAMMDA’s Warfighter Expeditionary Medicine and Treatment PMO leads the development and fielding of FDA-cleared or approved medical devices, drugs, and biologics that fulfill unmet requirements
identified by military capability developers or end users. Several of our current focus areas support surgical medicine, including hemorrhage detection and control, extremity injury repair, multi-organ support, and oxygen supply and generation.

One example is the new Expeditionary Deployable Oxygen Con-centration System (EDOCS). Built for military use in austere environ-ments, EDOCS is a commercially produced oxygen-generation unit that takes in ambient air and produces approximately 93 percent medical grade oxygen. It can be used in the field to provide oxygen to medical treatment facilities. To prepare for the Army’s 2024 field-ing of EDOCS, USAMMDA coordinated operational and service train-ing in September 2023 to allow Army Medical Logistics Command team members to learn more about the system and its maintenance requirements.

C&CC: How will the products USAMMDA is developing today support the battlefield of the future?

COL Nuce: Blood and blood products are critical to multi-domain operations for humans and canines, and USAMMDA is developing several solutions to treat massive blood loss and improve patient
survival far forward on the battlefield. Our portfolio includes freezedried plasma, cold-stored platelets, and cryo-preserved platelets to extend the shelf life of these life-saving blood components. We are
also developing resuscitation fluids and hemoglobin-based oxygen carriers (HBOCs). Fluid resuscitation is a vital treatment in the care of hypotensive trauma patients to diminish the effects of shock at Staff, the Defense Health Agency (DHA), and the U.S. Special Forces community. The process takes promising potential military technolnogy from DoD, industry, and academia through the testing required for
U.S. Food and Drug Administration (FDA) approval or licensing, all the way to the feliding and sustainment of the finshed product

USAMMDA was initially established in 1985 to serve as the Army’s medical materiel developer. Over the years, however, that mission has expanded to protecting and serving all branches of the U.S. military,
as demonstrated by our ongoing organizational transition to DHA.

C&CC: What are your organization’s top priorities, and how do they align with Army and DoD priorities?
COL Nuce: Army medicine has shifted its focus during the past several years, from sustaining combat operations during the wars in Afghanistan and Iraq, to modernizing the medical technologies and treatments the U.S. Joint Force will require during operations the cellular and organ level, while HBOCs can potentially provide therapeutic oxygenation when whole blood or red blood cells are not
available.

USAMMDA partnered with Army deployed units and medical treat-ment facilities to assess a point of use blood test for mild traumatic brain injury (TBI), which was developed in partnership with industry
and cleared by the FDA in 2021. This first-ever TBI blood test on a hand-held, deployable device may help avoid unnecessary evacua-tions and computed tomography (CT) scans among Service members.
In addition, data from Level I trauma centers throughout the U.S. dem-onstrates that the test could serve as a triage tool to help clinicians manage more severe head trauma cases.

Our Force Health Protection Division develops and manages protocols for biological threats, whether they are naturally occurring or deliberately released. We rapidly provide investigational medical countermeasures for the Warfighter and can manage interim fielding of promising Investigational New Drug (IND) products until they have been licensed by the FDA. One recent example that will likely be famil-iar to your readers is Remdesivir, the drug used to treat COVID-19.