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Our Tribute to one of ACCE’s most prominent founders
Alfred Grazutis Jakniunas
March 9, 1936 - October 1, 2003
Catalytic, Caring Clinical Engineer

Our enthusiastic friend and colleague,
Al was a world renowned clinical engineer
who was always willing to help others
and never forgot his Lithuanian roots
In joint expression of sorrow, ACCE, HTF, and PAHO joined the Lithuanian department of BaltMedTech and placed this plaque in the hallway of Vilnius University Hospital… the site of the ACEW that was organized by AL Jakniunas. Donations from all over the world continue to arrive at the Healthcare Technology Foundation with expression of sadden sympathy for all of AL’s lifetime work.



I first met Al in 1973 when he attended a seminar at George Washington University that James Wear and I were presenting. Al has been a friend and Associate for 30 years. His commitment to our profession and to improving the human condition were unquestionably of the highest magnitude. Al had undying faith in the greatness of the Human Spirit! He is loved and missed.

I've had a hard time picturing an ECRI Institute without Dr. Nobel. He was such a force of nature and had his strong hands on so much of our operations. It's sensible to ask how we can figure a way forward without him. But among Dr. Nobel's many gifts I think that the most important was how he was able to impart his knowledge and wisdom, entrepreneurial spirit, and sense of purpose to so many individuals. That definitely applies to ECRI Institute. Visitors to ECRI Institute are often amazed at how many staff have worked here for decades. We're also proud of our many colleagues who have come back to the fold after working elsewhere. We stayed or returned because we believe in the amazing mission he started nearly 50 years ago. And, although we are sad that Dr. Nobel has passed away, we are so confident in what he has taught us over the years that we feel well prepared to carry on.

As I am winding down my final days as ACCE President, I feel honored to have represented ECRI Institute and, in effect, Joel Nobel in this role. The Clinical Engineering profession owes Dr. Nobel a huge debt of gratitude. He literally got us off the ground and has been our guide for nearly 50 years through the services he ran and provided at ECRI Institute. Just like the legacy that he left with ECRI Institute, ACCE's membership is filled with those who were influenced by and learned from Joel.

I am also very confident that ACCE has a strong future. A big part of that comes from what many of us in ACCE were taught by Joel. It's that we should do it for the patients, do it well, and do it with honesty and integrity. If you would like to learn more about Joel Nobel and his legacy, click here for an ECRI Institute tribute. ECRI Institute will be organizing a formal memorial event in Dr. Nobel's honor sometime during the fall of 2014. I'll be sure to keep the ACCE community informed about this and any other memorial-related activities.

Thanks for all you have done Joel. And thank you for your support, mentorship, and trust. You were one of a kind and will always be Clinical Engineering's icon!

Dave Simmons


Binseng Wang, a close comrade of Al’s, was the first to relay the news about Al to his fellow ACCE colleagues. Al went to Lithuania in September for additional voluntary work and returned very ill. Eventually, he was diagnosed with the Legionnaire's disease. Unfortunately, his body did not react to several antibiotics that were tried. He is survived by his wife, Priscilla, mother, Birute, children, Kaaran Carbajal, Glenn Jakniunas and Heather Passofaro, and two grandsons. Following a Christian mass at Fort Myer Chapel, Arlington National Cemetery, Al's ashes were placed in the Arlington National Cemetery's Columbarium.

Dear Colleagues:

It is with great sadness that I am reporting the passing of Alfred Grazutis Jakniunas on October 1, 2003. 

Al was born in Lithuanian but grew up in the US.  He held jobs in the industry and hospitals, eventually rising to the position of Director of Biomedical Engineering at Howard University Hospital.  He is one of the pioneers of clinical engineering and helped to establish the American College of Clinical Engineering (ACCE).

In spite of managing one of the most prestigious and sophisticated teaching hospitals, Al never forgot those less fortunate than him.  He tirelessly helped clinical engineers from developed and, especially, developing countries.  He enthusiastically contributed to the creation of the first Advanced Clinical Engineering Workshop held in Washington in 1991.  He not only participated in several subsequent workshops but also lead, with Yadin David, the Moscow and Lithuania workshops. The workshop in Vilnius, Lithuania was a landmark in cooperation among the Baltic countries where Al, together with WHO, brought clinical engineers and administrators from the various Baltic countries. During the Moscow workshop, Al got sick and was admitted to a military hospital where they loved him so much they nick named him “General Al”. 

One of Al’s most enduring contributions is the vision to create the Infratech listserv, sponsored by WHO and PAHO, with the support of ACCE.  Since its inception, Al gracefully led the management of this listserv, benefiting many users worldwide.

Al went to Lithuania in September for additional voluntary work and returned very ill.  Eventually, he was diagnosed with the Legionnaire's disease.  Unfortunately, his body did not react to several antibiotics that were tried.  He is survived by his wife, Priscilla, mother, Birute, sons (Kaaran Carbajal, Glenn Jakniunas and Heather Passofaro), and two grandsons.  The memorial service will be held on Tuesday, November 4, at 2:45 PM at Fort Myer Chapel, Arlington National Cemetery.  The inurnment will follow in the Columbarium at the same cemetery.

Please join his family and me to pray for him.


Binseng Wang


Over the years, Al showed us that we all follow destiny and wherever this takes us we must think with our hearts and see to it that our deeds made this place better. He did it as a practicing clinical engineer and as a human being never forgetting where his roots were. He guided us through trips to Russia and to Lithuania to the Infratec concept and to the reasons we work in hospitals. He was a good and honest person. I already miss him… I feel sad to lose a good friend.

I have to laugh to myself for the trust Joel placed in each of us as such young ages. In only a few years, many of us found ourselves presenting keynote speeches on his behalf at national and international scientific and medical sessions, and most of us had little more than a Bachelor's Degree and Dr. Nobel's say-so to back us up. As he sagely told me while calming my jitters before one of my first national debuts, "Just stick to what you know, Elliot, and don't let anyone draw you onto their turf. You know more about that product than anyone else in the nation, so stick to your guns."

I have to admit that Dr. Nobel was never easy to keep up with. He seemed to sleep but a couple of hours a night, and regardless of your medical, engineering, scientific, or legal specialty his habit of endless reading and his sharp, critical mind ensured that everyone needed to bring his or her "A-game" when you talked to him. Holidays and vacations seemed of little interest to him unless tied to a working mission or project, and the concept of retirement seemed unfathomable. Dr. Nobel never, ever sat still, and tracking him down around the globe was a challenge until the end! Not sure most of us would trade our own lives for his, but that was a choice that afforded him the constant cultural and scientific renewal and impact that made him tick.

I still hearken too many of the rules and explanations in that Employee Handbook, even though I've not been an employee at ECRI Institute for 25 years. Pearls like "a non-profit organization is not like most other corporations" as he tried to make it clear to everyone that ECRI's public mission and integrity took precedent over profit or rewards. Firm guidelines about spending funds as frugally as if they were your own personal money regardless of the situation, and incredibly restrictive conflict-of-interest and disclosure rules for each and every employee are today embedded in IRS and FDA guidelines and their peers around the world. I, and the non-profit organizations that I lead strive to live up to those requirements each and every day!

When I talked to Dr. Nobel as recently as last year, he had lost none of his missionary bravado, focus, or acuity, and his global treks were only limited by the wear and tear of travel. No country was too small, and no slice of society was unworthy of his time and attention. Unfortunately, though blessed with a brilliant mind and visionary perspective, his solid, stocky body turned out to be less robust than his intellect. Though I probably had close to a foot of height advantage over him, he was never less than a giant in my mind. I am sure that I won't be the only one to remember him that way, either!

You will certainly read of Dr. Nobel's accomplishments in the future, but I can tell you first hand that most of the accounts will be humble re-telling of a legacy that did -- and will continue to -- improve healthcare around the planet in remarkable and important ways. In the early days, half or more of the medical devices his engineers tested were at best mediocre, and many were a threat to life and/or limb. Today, though, most such testing reveals good-to-excellent products in the US market that are differentiated on features, price, and preference. That is quite an achievement, and it was won one year at a time relying on Dr. Nobel's commitment to "The Discipline of Science." and "The Integrity of Independence." That is the current marketing byline that the ECRI Institute that Joel founded, and it speaks volumes about the organizations ongoing mission.

Personally, few will know of Joel's wry humor and bent towards practical jokes, and few will know just how far he would go to help a younger engineer or physician develop a successful career. I owe him a huge debt of gratitude for his training, discipline, and visionary leadership, and can honestly help say that Dr. Nobel helped shape my career and life.

There are probably several other hundreds of my peers around the world -- younger and older -- who will have similar recollections and feelings, and I hope they all eventually say their piece. To me, early in my career Joel was like a second father, and leaving him and ECRI to expand my own career was not an easy decision for me to make in 1990, but he knew, too, that it was time for me to move on, and his friendship and support for me and many others proved to be unending. Farewell my dear friend. We will all miss you, but many of us will continue to do our best to honor you courage, vision, and insight. Honor and respect are due. Rest in peace, good Samurai, and soar joyously into the winds and in our memories for eternity.

Yadin David


AlJakniunas-group.pngAl Jakniunas was a highly skilled professional and a warm and enthusiastic person. His care and attention to our special needs and the time he shared with us was enriching in every way. His contributions have left a major imprint in the history of clinical engineering in the Baltics and will be appreciated forever by the patients in the Baltic countries.




ECRI went on to validate ambulances and the equipment carried in the ambulance. Many of today's standards (called KKK) for EMS equipment and vehicles were developed by ECRI and Dr. Noble reaching out to assure appropriate technology and patient care everywhere a patient was treated. Electrical safety testing, defibrillator, laser and ESU output testing, receptacle testing, medical gas testing and many other functions we do today he helped develop and standardize for our profession. Equipment databases as well as standardized descriptions, testing protocols, etc. were all developed by ECRI during hospital biomedical early years. Projects many of us work on today to properly manage technology from pre-purchase through surplus - technology management of medical devices - was developed and proven domestically and internationally under his guidance at ECRI. Work we do today to assure compatibility between medical devices, systems and facilities was something ECRI started educating biomeds about in the 1980's. Laser safety, operating room fires, the list goes on and on of work he directed and mentored at ECRI that is now practiced daily to improve patient safety.

The biomedical profession has lost some of our foundation with Dr. Joel Nobel's passing.

Rimantas Baytaks, Director of Clinical Engineering at Vilnius University Hospital, Lithuania


It was not long ago I mentioned to a doctor at Dad’s hospital that whenever I see someone who knew Dad, I somehow see a little bit of him in their faces. He, undoubtedly, made a lasting impression on all and I am certain that he will continue to director our thoughts during difficult times.

Joel was probably the first real genius I met...though there were unquestionably others on his team (who remembers Guy Knickerbocker?). As it is with so many great geniuses, I soon learned Joel had idiosyncrasies that would forever make him an icon and a legend. Many of my past and current ECRI friends will remember some (or most) of the following:

  • always wearing OR "greens" and with his flak jacket serving as an overcoat...He didn't like to go out of the "lab" often and it was probably 2 years when he and I did a speaking engagement together and he was forced to wear a jacket and tie.
  • equipping the company Toyota Cressida wagons with survival gear and supplies...complete with machetes
  • conducting an interview from under his desk with a flummoxed job candidate (who didn't get the job)
  • having telephones installed in the bathroom stalls
  • driving around the office campus in his full sized farm tractor
  • dropping in on orientation for a new group of technicians to give classic career advice (which though humorous now, I can't repeat)
  • hiring a violinist during one holiday period to stroll up and down between our cubicles to play holiday music
  • on one holiday giving each member of the staff a smoke alarm and on another, a fire extinguisher (practical gifts which left no doubt as to his concerns for our safety)


I will miss Joel. I will miss the idiosyncrasies that endeared him to us and the genius that inspired us. I loved him for all of it and I will be always be grateful to him for giving us the extended ECRI family...a family whose talent was synergistic and that continues to grow to this day. left this world a much, much better place. Who can aspire to more? Thank you and God speed.

Glenn Jakniunas, son



Why Me? Ask Al
AlJakniunas-WhyAl.pngAl was well-acquainted with the hazards of international work. While travelling to Moscou 5 years ago, for an ACEW, he fell ill. In Moscow, his discomfort rapidly worsened. A workshop participant, Dr. Sergei Barsukov, Deputy Chief of the A. Vishnevsky Central Clinical Hospital, Ministry of Defense of the Russia Federation, did a physical diagnosis. Six hours of emergency abdominal surgery performed by Dr. Valery K. Zuyev, Deputy Chief Surgeon, MoD RF, and Chief Surgeon of the Hospital followed by a two-week stay in the Intensive Care Unit.
Upon return to work at Howard University Al remarked: “Let there be no doubt as to the high quality of the medical care available in Russia.”
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