Reed's medical editors saw that hospitals' largest legal liability was the result of nurses giving the wrong drugs to patients, so they created Virtual Clinical Excursions, an interactive CD dubbed "Nursetendo" in which nurses administer drugs virtually to a kidney patient who eventually goes into shock and dies.

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Similar devices could be implanted near a tumor to administer a multidrug cancer treatment, custom-tailored for the patient's particular disease.

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But the Prometheus patent is different, the appeals court said, because in the former case the doctor is passively calculating results while under the Prometheus process the doctor has to administer a drug then adjust the dose based on how the patient responds.

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Someday a new style of individualized medicine will let doctors analyze the DNA in a patient's tumor, then administer customized cocktails of drugs designed to attack that tumor's particular genetic defects.

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Prometheus has a patent on a method for administering the proper dose of a drug by first administering a little, then checking the amount in the patient, and then deciding whether to administer more.

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