SPARK was contracted by UVA-based Rivanna Medical (RIVANNA) to help design a revolutionary ultrasound imaging device meant to improve the accuracy of epidural needle insertions. Beginning with a clean slate, SPARK assisted with early product architecture–developing an ideal configuration for intuitive and fluid use by doctors performing a common procedure.

RIVANNA was able to build upon SPARK’s initial design, ultimately securing multiple patents and refining their device into the Accuro®, which is now available on the market.

“SPARK was able to understand and deliver what we really needed – a proof of concept prototype – and they did it in a fraction of the time and with a fraction of the cost compared to other firms we considered.”

-Will Mauldin (Chief Executive Officer, Rivanna Medical LLC)


When performing spinal anesthesia procedures, doctors must precisely insert a needle into a small space between vertebrae deep under the skin. Inaccurate placement can render the procedure ineffective, requiring repeated insertions and potentially causing complications for the patient. With overweight patients these procedures can be increasingly difficult to perform properly, consuming valuable physician time and decreasing patient care quality.

RIVANNA had developed an ingenuous software solution that utilized ultrasound to create real-time images of the patient’s spine and overlay graphical cues to help locate internal targets, taking the guesswork out before breaking the skin. After receiving a flawed design concept from another development firm that functioned poorly and could not be manufactured, RIVANNA turned to SPARK to rethink and repackage their technology into a more compact and usable form.


SPARK began with the end user–the physician. It was important that the device would be both intuitive and comfortable to use with standard patient positioning so it could fit seamlessly into procedures. To test which grip style and screen orientation would best fit their needs, a series of rough foam mock-ups were constructed representing different arrangements of key internal components.

These mock-ups were put into the hands of experienced physicians for feedback that would ultimately drive the device’s form. A vertical, “pinch” grip proved to be unanimously preferred as the most effective and versatile option. Additionally, variation in physician height and use cases established the need for a prominent, rotating screen that would also help minimize device size for storage.

“Accuro is a game changer… I use it now in all my procedures and to train our residents. Not only are we improving our first attempt success rates with Accuro, but we are also noticing a reduction in back pain and wet taps.” – Antonio Gonzalez, MD (Assistant Professor of Anesthesiology, Yale School of Medicine)


With a component arrangement defined, the industrial design styling phase focused on developing a simple, streamlined form that would be easy to hold, clean, and slip into a sterile sleeve while minimizing the package size around the ultrasound probe and imaging system.

SPARK also brainstormed on methods for marking the located insertion point after the Accuro device is removed. The resulting drop-off “Accuro Locator,” which was successfully patented by RIVANNA, combines two of SPARK’s concepts and uses plastic points to create temporary, pain-free dimples on the patient’s skin in a crosshair pattern.


Building on SPARK’s foundational design and descriptive illustrations, Rivanna Medical took the Accuro back in-house, partnering with an ultrasound expert and contract manufacturers to refine the design into a market-ready solution. The final product is now available at