Dr. John A. Clements dies at 101; pioneered life-saving neonatal treatment

Dr. John A. Clements, a preeminent figure in pulmonary science who deciphered critical lung function in the 1950s and later developed a revolutionary drug to treat lung failure in newborns, has died at his home in Tiburon, California. He was 101.

His disappearance was confirmed by his daughter, Carol Clements.

Dr. Clements’ pioneering work began shortly after his graduation from Cornell University Medical College (now Weill Cornell Medical College) while serving as an Army physiologist. He was fascinated by the mechanics of human respiration, particularly how the tiny air sacs in the lungs manage to stay open during exhalation.

Determined to solve this mystery, Dr. Clements discovered a crucial substance, which he identified as a surfactant, similar to detergents, that helps reduce surface tension in the alveoli, allowing them to remain inflated. This discovery was first documented in a 1956 publication in which he outlined the presence and function of surfactants in the lungs using a rudimentary device he built.

His seminal research made significant progress in 1959, when he advised two Harvard researchers. Their collaborative efforts revealed that this surfactant was absent in premature infants with respiratory distress syndrome (RDS), which was then a leading cause of neonatal death in the United States, claiming about 10,000 lives annually during the 1960s.

This epidemic of infant mortality includes notable cases, such as that of Patrick Bouvier Kennedy, son of President John F. Kennedy and Jacqueline Kennedy, who was born prematurely and died of RDS shortly after birth in 1963.

Driven by these discoveries, a global initiative to develop a treatment for RDS emerged. While some researchers explored animal-based surfactants, Dr. Clements focused his efforts on creating a synthetic alternative. His dedication led to the development of the first synthetic surfactant, which was later licensed to Burroughs Wellcome & Company and approved by the Food and Drug Administration in 1990 as Exosurf.

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Although subsequent research demonstrated that animal-derived surfactants were more effective, Dr. Clements’ pioneering synthetic surfactant marked a significant advance in neonatal care, dramatically reducing infant mortality rates from RDS to less than 500 deaths per year in the United States.

In recognition of his monumental contributions, in 1994 Dr. Clements received the prestigious Albert Lasker Clinical Medical Research Award, which he humbly donated to UNICEF.

Born on March 16, 1923, in Auburn, New York, Dr. Clements was the youngest of four children. His parents nurtured his early passion for science, which saw him construct various experiments from an early age, including a homemade Tesla coil. After completing an Army-funded accelerated program at Cornell, he devoted his career to medical research and education.

Dr. Clements continued his influential work into his 90s, maintaining an active presence at the University of California, San Francisco, where he mentored countless medical professionals and researchers.

His legacy is carried on by his two daughters, Carol and Christine Clements, and remembered by the many lives he saved through his medical innovations.

By Robert K. Foster

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