Trademark Trial and Appeal Board Electronic Filing System. http://estta.uspto.gov

ESTTA Tracking number: ESTTA1050048

Filing date: 04/20/2020

IN THE UNITED STATES PATENT AND TRADEMARK OFFICE

BEFORE THE TRADEMARK TRIAL AND APPEAL BOARD

Proceeding 79243532

Applicant TRACOE medical GmbH

Applied for Mark TRACOE APEX

CorrespondenceAddress

LINDSAY M R JONESMERCHANT & GOULD PCP O BOX 2910MINNEAPOLIS, MN 55402-0910UNITED STATESdockmpls@merchantgould.com, aehard@merchantgould.com, cmanth-ie@merchantgould.com, ljones@merchantgould.com,jschmidt@merchantgould.com612-336-5300

Submission Appeal Brief

Attachments 2020 04 20 Amended Appeal Brief TRACOE APEX.PDF(185151 bytes )Exhibit A.PDF(297090 bytes )Exhibit B.PDF(283952 bytes )Exhibit C.PDF(223590 bytes )Exhibit D.PDF(450485 bytes )

Filer's Name ANDREW S. EHARD

Filer's email dockmpls@merchantgould.com, aehard@merchantgould.com, cmanth-ie@merchantgould.com, ljones@merchantgould.com,jschmidt@merchantgould.com

Signature /Andrew S. Ehard/

Date 04/20/2020

IN THE UNITED STATES PATENT AND TRADEMARK OFFICE

BEFORE THE TRADEMARK TRIAL AND APPEAL BOARD

APPLICATION SERIAL NO: 79/243,532 FILING DATE: AUGUST 28, 2018

APPLICANT: TRACOE MEDICAL GMBH EX. ATTORNEY: A. BIACHE

MARK: TRACOE APEX DOCKET NO: 16333.0020USIB

_______________________________________________________________________

CERTIFICATE UNDER 37 CFR 1.8: The undersigned hereby certifies that this correspondence is being

electronically filed with the Trademark Trial and Appeal Board via ESTTA, on April 20, 2020.

By: s/Lindsay M.R. Jones

Lindsay M.R. Jones

APPLICANT’S APPEAL BRIEF

Tracoe Medical GmbH ("Applicant") appeals the trademark examining attorney's

refusal to register the trademark TRACOE APEX on the ground that the mark so

resembles the mark APEX in U.S. Registration No. 1,922,866 as to be likely to cause

confusion, to cause mistake, or to deceive, under Section 2(d) of the Trademark Act.

I. FACTS

On August 28, 2018, Applicant filed a federal trademark application under the

provisions of Section 66(a) of the Trademark Act to use the mark TRACOE APEX in

connection with the following Class 10 goods:

“Medical apparatus and instruments; surgical apparatus and instruments for

medical use; cannulas; tracheal cannulas; tracheostomy cannulas; anesthesia

cannulas; speaking cannulas; tracheastomy tubes; tubes and attachments for use

with cannulas; stoma seals; medical aids for use in stoma care; straps for

cannulas; tweezers for medical use; accessories and attachments for medical-

technical instruments and apparatus, in particular for tracheostomy tubes; surgical

and wound treating equipment; medical instruments for dilation tracheometry;

pressure monitoring apparatus for medical purposes; medical instruments for

diagnostics, examinations and monitoring; medical clothing; shower protection

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for medical purposes.”

Upon initial examination of the Application, the U.S. Patent and Trademark Office (the

“Trademark Office") refused registration of the proposed mark under §2(d) of the

Trademark Act as likely to cause confusion with the following registrations: U.S.

Registration Nos. 1,922,866 (APEX), 1,934,197 (APEX), 2,065,134 (APEX), 2,399,854

(APEX), 2,505,277 (APEX), 2,792,216 (APEX), 4,394,657 (APEX), and 4,523,338

(APEX). The Office also issued a requirement for an amendment of the identification of

goods.

On July 1, 2019, Applicant submitted an Amendment and Response to the Office

Action wherein arguments were presented against the finding of likelihood of confusion.

Specifically, Applicant argued that longstanding use of its house mark TRACOE in

association with tracheotomy devices and apparatus sufficiently delineates the applied-for

mark from the Cited Registrations. Additionally, Applicant noted the dilution and weak

nature of marks comprised of the term APEX in Class 10 and the discerning nature of the

customers that purchase Applicant’s goods. Applicant also amended the identification of

goods as follows:

“Medical apparatus and instruments for use in tracheotomies; surgical apparatus

and instruments for medical use; cannulas; tracheal cannulas; tracheostomy

cannulas; anesthesia cannulas; speaking cannulas; tracheostomy tubes; tubes and

attachments for use with cannulas; stoma seals for use with tracheostomy tubes;

medical aids for use in stoma care, namely, sensors for stoma bags and stoma

caps; straps for cannulas; accessories and attachments for medical-technical

instruments and apparatus, in particular for tracheotomy tubes; surgical and

wound treating equipment, namely, absorbent compresses and pads, elastic

positioning ribbons, distance holder clips, mucous collecting devices, cannula,

tracheostoma protective pads, suture materials, wound suction apparatus, wound

drainage apparatus, medical devices for closing wounds; medical instruments for

dilation tracheotomy; blood pressure monitoring apparatus for medical purposes;

medical instruments for diagnostics, examinations and monitoring, namely,

medical instruments for percutaneous tracheotomy.”

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In response, however, the Trademark Office issued a final refusal of registration based on

likelihood of confusion with U.S. Registration No. 1,922,866 for the mark APEX and

recommended further amendment of the identification of goods.

On December 3, 2019, Applicant filed a Request for Reconsideration with the

Trademark Office, wherein Applicant presented additional arguments and evidence

against the finding of likelihood of confusion. In particular, Applicant presented

arguments that the applied-for mark is dissimilar in overall appearance, sound, meaning,

and commercial impression from the Cited Registration shown in U.S. Registration No.

1,922,866. Applicant also amended its identification of goods as follows:

“Medical apparatus and instruments for use in tracheotomies and not for

arthroscopic devices and parts and accessories therefor; surgical apparatus and

instruments for medical use; cannulas; tracheal cannulas; tracheostomy cannulas;

anesthesia cannulas; speaking cannulas; tracheostomy tubes; tubes and

attachments for use with cannulas; stoma seals for use with tracheostomy tubes;

medical aids for use in stoma care, namely, sensors for stoma bags and stoma

caps; straps for cannulas; accessories and attachments for medical-technical

instruments and apparatus, in particular for tracheotomy tubes; surgical and

wound treating equipment, namely, cannula, tracheostoma protective pads, suture

materials, wound suction apparatus, wound drainage apparatus, medical devices

for closing wounds; medical instruments for dilation tracheotomy; blood pressure

monitoring apparatus for medical purposes; medical instruments for diagnostics,

examinations and monitoring, namely, medical instruments for percutaneous

tracheotomy.”

On January 8, 2020, the Trademark Office denied Applicant’s Request for

Reconsideration based on the likelihood of confusion refusal. Shortly thereafter, the

Board issued a Notice indicating that Applicant’s Appeal Brief was due on March 27,

2020.

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Applicant now appeals the final refusal of registration of its TRACOE APEX

mark, and asserts that its mark is not likely to cause confusion, to cause mistake, or to

deceive under Section 2(d) of the Trademark Act.

II. ISSUE

Whether the term TRACOE APEX is likely to cause confusion, to cause mistake,

or to deceive under Section 2(d) of the Trademark Act in view of U.S. Registration No.

1,922,866.

III. APPLICANT REQUESTS FURTHER REVISION OF ITS

IDENTIFICATION OF GOODS TO FURTHER OUTLINE THE

DIFFERENCES BETWEEN THE APPLIED-FOR MARK AND THE

MARK SHOWN IN U.S. REGISTRATION NO. 1,922,866.

Applicant requests amendment of the following Class 10 goods in U.S. Application Serial

No. 79/243,532 as follows:

“Medical apparatus and instruments for use in tracheotomies and not for

arthroscopic devices and parts and accessories therefor; surgical apparatus and

instruments for medical use but not for arthroscopic devices and parts and

accessories therefor; cannulas but not for arthroscopic devices and parts and

accessories therefor; tracheal cannulas; tracheostomy cannulas; anesthesia

cannulas but not for arthroscopic devices and parts and accessories therefor;

speaking cannulas; tracheostomy tubes; tubes and attachments for use with

cannulas but not for arthroscopic devices and parts and accessories therefor;

stoma seals for use with tracheostomy tubes; medical aids for use in stoma care,

namely, sensors for stoma bags and stoma caps; straps for cannulas but not for

arthroscopic devices and parts and accessories therefor; accessories and

attachments for medical-technical instruments and apparatus, in particular for

tracheotomy tubes; surgical and wound treating equipment but not for

arthroscopic devices and parts and accessories therefor, namely, cannula,

tracheostoma protective pads, suture materials, wound suction apparatus, wound

drainage apparatus, medical devices for closing wounds; medical instruments for

dilation tracheotomy; blood pressure monitoring apparatus for medical purposes;

medical instruments for diagnostics, examinations and monitoring, namely,

medical instruments for percutaneous tracheotomy.”

IV. APPLICANT’S MARK IS NOT LIKELY TO CAUSE CONFUSION WITH

THE CITED REGISTRIATON IN U.S. REGISTRATION NO. 1,922,866.

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Applicant’s mark is entitled to registration because no likelihood of confusion

exists between the applied-for TRACOE APEX mark and U.S. Registration No.

1,922,866 for the mark APEX. See 15 U.S.C. §1052(d). The burden of proof as to

likelihood of confusion lies with the Trademark Office. In this case, the Trademark

Office has failed to meet its burden because the evidence of record establishes that no

confusion has occurred or is likely to occur between the applied-for mark and the mark

shown in U.S. Registration No. 1,922,866.

The Application here at issue should be allowed to register because the mark

TRACOE APEX is not similar to the mark APEX in U.S. Registration No. 1,922,866.

Upon first glance, it is readily apparent that the goods used in connection with

Applicant’s TRACOE APEX mark, as amended, are not similar to the goods used in

connection with U.S. Registration No. 1,922,866 and that the mark TRACOE APEX is

not similar to the mark APEX in sight, sound, meaning, or commercial impression.

Moreover, in view of relevant and competitive unchecked third party use, the TRACOE

APEX mark cannot be an indication of source that leads to confusion with APEX mark

shown in U.S. Registration No. 1,922,866. Further to this end, Applicant submits that its

customers, as well as the customers of the Cited Registrant are highly sophisticated

customers seeking medical equipment and supplies. Consequently, the discerning nature

of the relevant purchasing public only further delineates the likelihood of confusion

among the relevant parties. Lastly, Conmed Corporation, owner of the Cited Registration,

has agreed to provide its consent to allow Applicant to register the applied-for TRACOE

APEX mark, an agreement which will be produced in the coming days. In consideration

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of all of the above, it would be a miscarriage of justice to deny registration of Applicant’s

TRACOE APEX mark in light of Registrant’s U.S. Registration No. 1,922,866.

Denying registration of Applicant’s mark is improper because consumers are not

likely to be confused that Applicant’s products originate from the Cited Registrant or

vice-versa. The Trademark Act precludes registration of a mark if the mark resembles

another registered or used mark such that use of the mark is likely “when used on or in

connection with the goods of the Registrant, to cause confusion, or to cause mistake, or to

deceive.” 15 U.S.C. § 1052(d). The Trademark Office determines the likelihood of

confusion on a case-by-case basis applying the factors set out in In re E.I. DuPont

DeNemours & Co., 476 F.2d 1357, 1361, 77 U.S.P.Q. (BNA) 563, 567 (C.C.P.A. 1973).

The relevant factors in this case include:

1. The relatedness of the goods used in connection with the marks here at issue;

2. The similarity or dissimilarity of the marks in their entireties as to appearance,

sound, connotation, and commercial impression;

3. The strength of the Cited Registration;

4. The number and nature of similar marks in use on similar goods; and

5. The sophistication of the relevant consuming public.

In re E.I. DuPont de Nemours & Co., 476 F.2d 1357, 177 USPQ 563 (CCPA 1973). Not

every DuPont factor must be considered. Han Beauty, Inc. v. Albert-Culver Co., 236 F.3d

1333, 1336, 57 U.S.P.Q.2d (BNA) 1577, 1559 (Fed. Cir. 2001) (“While it must consider

each factor for which it has evidence, the Board may focus its analysis on dispositive

factors, such as similarity of the marks and relatedness of goods.”). Yet, some factors

may be dispositive by themselves, such as the differences as between the marks and the

number and nature of similar marks in use on similar goods. As demonstrated below,

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applying these factors to the facts at hand compels the conclusion that registration is

appropriate because no confusion is likely.

A. APPLICANT HAS AMENDED ITS IDENTIFICATION OF GOODS

SUCH THAT THERE IS NO OPPORTUNITY FOR CONFUSION AS

BETWEEN APPLICANT AND THE CITED REGISTRANT.

As noted in the first section of Applicant’s Appeal Brief, Applicant has amended

its identification of goods as to the goods included in Class 10. In particular, Applicant

has expressly limited its Class 10 goods to make clear that it neither offers nor sells

medical or surgical instruments, including, specifically, arthroscopic devices and parts

and accessories therefor in connection with its mark. The Cited Registrant’s Class 10

goods, which have been cited as against the Application, are solely comprised of

“medical and surgical instruments, namely, arthroscopic devices and parts and

accessories therefor.” Thus, in amending its identification of Class 10 goods to make

clear that Applicant in no way uses its mark in connection with the very goods used in

connection with Registrant’s mark, Applicant has dispelled any opportunity by which

consumers could mistake Applicant’s goods as emanating from the same source as the

goods sold by the Cited Registrant under its APEX mark shown in U.S. Registration No.

1,922,866. As such, Applicant has ensured that consumers will not believe that the

arthroscopic devices and parts and accessories therefor deriving from Registrant are

related to the Class 10 goods sold by Applicant.

B. APPLICANT’S TRACOE APEX MARK IS NOT SIMILAR IN SIGHT,

SOUND, MEANING, OR COMMECIAL IMPRESSION TO

REGISTRANT’S APEX MARK.

Similarity of marks is determined by comparing the marks in sight, sound,

meaning, and commercial impression. Specialty Brands, Inc. v. Coffee Bean Distribs.,

8

Inc., 223 U.S.P.Q. 1281, 1283 (Fed. Cir. 1984). The Board has on several occasions

found the dissimilarity of two marks to be a single dispositive DuPont factor in

evaluating a likelihood of confusion. See Shen Mfg. Co., Inc. v. The Ritz Hotel Ltd., 393

F.3d 1238, 1242, 73 U.S.P.Q.2d (BNA) 1350, 1353 (Fed. Cir. 2004) (the dissimilarity of

the marks RITZ for bathroom towels and PUTTING ON THE RITZ for shower curtains

required that the opposition proceedings be dismissed); Champagne Louis Roederer v.

Delicato Vineyards, 148 F.3d 1373, 1375, 47 U.S.P.Q.2d (BNA) 1459, 1460 (Fed. Cir.

1998) (affirming Board’s sole reliance on the dissimilarity of CRISTAL and CRYSTAL

CREEK to hold that no likelihood of confusion existed). Considering Applicant’s

deployment of the house mark TRACOE in connection with its TRACOE APEX mark,

and in examining the differences between the mark TRACEO APEX and TRACOE, the

Trademark Office should similarly conclude that Applicant’s TRACOE APEX mark is

unlikely to cause confusion with Registrant’s APEX mark.

1. USE OF THE HOUSE MARK TRACOE DEMONSTRATES A

MARKED DIFFERECE BETWEEN APPLICANT’S TRACOE

APEX MARK AND REGISTRANT’S TRACOE MARK.

Applicant’s TRACOE APEX mark most obviously differs from the Cited

Registration in its deployment of the wording TRACOE. Use of the term TRACOE is not

only the first term in Applicant’s TRACOE APEX mark, but it is the dominant element.

Since at least as early as 1987, Applicant has used its TRACOE house mark in

connection with the sale and manufacture of tracheotomy devices and apparatus. In

conjunction with this longstanding use, Applicant has registered a family of TRACOE

and TRACOE variant marks, denoting its ownership of the brand TRACOE and all brand

9

extensions incorporating the term TRACOE. For example, Applicant owns the following

U.S. registrations and published marks containing the term TRACOE:

Mark/Name/AN

/RN

Status/Status

Date

Full Goods/Services Owner Information

TRACOE

RN: 2117376

SN: 75072311

Renewed

December 2,

2017

(Int'l Class: 10)

medical equipment for

diagnostic and

therapeutic purposes,

namely, tracheostomy

tubes, and accessories

therefor, namely, elastic

positioning ribbons,

distance holder clips,

mucous collecting

devices, cannula,

absorbent compresses

and pads, and

tracheostoma protective

pads

Tracoe Medical GmbH

(Germany Limited

Liability Company)

Reichelsheimer Str. 1/3

Nieder-Olm 55268

Germany

TRACOE H2O

CUFF (Stylized)

SN: 87493412

Allowed - Intent

to Use

Statement of

Use - Non-Final

Refusal Mailed

April 17, 2019

(Int'l Class: 10)

Medical apparatus and

instruments, namely,

cannulas in combination

with tracheotomy tubes

for tracheotomy and

medical equipment for

diagnostic or

therapeutic purposes

which allow setting and

control of pressure;

surgical apparatus and

instruments for medical

use; cannulas;

endotracheal tubes;

tracheotomy tubes;

tubing and attachments

for use with cannulas;

stoma seals; medical

aids for use in stoma

care, namely, sensors

for stoma bags, stoma

Tracoe Medical GmbH

(Germany Gesellschaft

Mit Beschränkter

Haftung (Gmbh))

Reichelsheimer Str. 1/3

55268 Nieder-Olm

Germany

10

Mark/Name/AN

/RN

Status/Status

Date

Full Goods/Services Owner Information

caps; medical

instruments for

percutaneous

tracheostomy; pressure

monitors for medical

use; medical

instruments for

diagnostics,

examinations and

monitoring, namely,

medical diagnostic

instruments for the

analysis of body fluids,

medical instruments for

cardiovascular

diagnostics

TRACOE

HUMIDASSIST

RN: 2905441

SN: 76179730

Renewed

November 30,

2014

(Int'l Class: 05)

Cancelled - Sec. 8

[substances for the

disinfection and

sterilization of medical-

technical devices]

(Int'l Class: 10)

medical-technical

devices, namely, heat

and moisture

exchangers for

tracheotomy; canules,

tubes and adhesive

carriers; tracheal

canules; canules for

anesthetics with

receptacles; tracheal

prostheses; [surgical

instruments used for

tracheotomies, namely,

for emergency

tracheotomies; medical

life-saving devices,

namely, scalpels and

dilators in combination

with tracheotomy tubes

Tracoe Medical GmbH

(Germany Limited

Liability Company)

Reichelsheimer Str. 1/3

Nieder-Olm 55268

Germany

11

Mark/Name/AN

/RN

Status/Status

Date

Full Goods/Services Owner Information

for tracheotomy;

devices, namely,

sterilization and

disinfection units for the

chemical disinfection

and sterilization of

medical-technical

devices;] speaking

canules [; stomabuttons]

TRACOE

PHONASSIST

RN: 2863972

SN: 76179729

Renewed July

20, 2014

(Int'l Class: 05)

Cancelled - Sec. 8

[substances for the

disinfection and

sterilization of medical-

technical devices]

(Int'l Class: 10)

medical-technical

devices, namely, voice

valves; tracheal canules;

canules for anesthetics

with receptacles;

tracheal prostheses;

[surgical instruments

used for tracheotomies,

namely, for emergency

tracheotomies; medical

life-saving devices,

namely, scalpels and

dilators in combination

with tracheotomy tubes

for tracheotomy;

devices, namely,

sterilization and

disinfection units for the

chemical disinfection

and sterilization of

medical-technical

devices; ]speaking

canules[ ; stomabuttons]

Tracoe Medical GmbH

(Germany Limited

Liability Company)

Reichsforstrasse 32

Frankfort Am Main

Germany

TRACOE Registered (Int'l Class: 10) Tracoe Medical GmbH

12

Mark/Name/AN

/RN

Status/Status

Date

Full Goods/Services Owner Information

SILCOSOFT

RN: 5337590

SN: 79200939

November 21,

2017

medical apparatus and

instruments, namely,

dialators in combination

with tracheotomy tubes

for tracheotomy and

medical equipment for

diagnostic or

therapeutic purposes

which allow setting and

control of pressure;

surgical apparatus and

instruments for medical

use; cannulas;

endotracheal tubes;

tracheotomy tubes;

tubing and attachments

for use with cannulas;

stoma seals; medical

aids for use in stoma

care, namely, sensors

for stoma bags, stoma

caps; surgical and

wound treating

equipment, namely,

suture materials, wound

suction apparatus,

wound drainage

apparatus, medical

devices for closing

wounds; medical

instruments for

percutaneous

tracheostomy; pressure

monitors for medical

use; medical

instruments for

diagnostics,

examinations and

monitoring, namely,

medical diagnostic

instruments for the

analysis of body fluids,

medical instruments for

(Germany Limited

Liability Company)

Reichelsheimer Str. 1

Nieder-Olm 55268

Germany

13

Mark/Name/AN

/RN

Status/Status

Date

Full Goods/Services Owner Information

cardiovascular

diagnostics

TRACOE

SMART

RN: 4911702

SN: 85571556

Registered

March 8, 2016

(Int'l Class: 10)

technical medical

equipment for

diagnostic or

therapeutic purposes,

namely, tracheostomy

tubes and endotracheal

tubes with high

precision and medical

devices, which allow

setting and control of

pressure in low pressure

cuffs of tracheostomy;

cannulae, in particular

tracheotomy tubes,

cannulae for anesthetics

and collection cups;

speech cannulae

Tracoe Medical GmbH

(Germany Corp.)

Reichelsheimer Str. 1/3

Nieder-Olm 55268

Germany

See Exhibit A, TESS printouts.

Customers of Applicant are familiar with Applicant and its goods, and they

recognize the house mark TRACOE as that of Applicant. Indeed, upon seeing the mark

TRACOE APEX, customers and potential customers are most likely to associate the

mark with Applicant, Tracoe Medical GmbH, as opposed to the Cited Registrant, who is

an unrelated third party using the dissimilar mark APEX.

2. THE TRADEMARK OFFICE HAS IMPROPERLY COMPARED

APPLICANT’S TRACOE APEX MARK AND REGISTRANT’S

TRACOE MARK ONLY AS TO THE TERM TRACOE.

The Trademark Office concludes that Applicant’s mark, TRACOE APEX, and

Registrant’s APEX mark are similar in overall appearance, sound, and meaning because

the marks contain alike terms – APEX. Applicant, however, disagrees with this

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conclusion, as Applicant’s mark and Registrant’s mark differ in appearance, sound, and

meaning. The mark TRACOE APEX creates a distinct commercial impression from

Registrant’s mark, and therefore, does not result in the marks being confusingly similar.

The applied-for mark’s inclusion of the term TRACOE in the mark TRACOE

APEX creates a significantly different impression than the term APEX alone. Marks must

be considered in their entireties when determining whether there is a likelihood of

confusion. Estate of P.D. Beckwith, Inc., v. Commissioner of Patents, 252 U.S. 538, 545-46,

40 S. Ct. 414, 64 L. Ed. 705 (1920) (“The commercial impression of a trade-mark is derived

from it as a whole, not from its elements separated and considered in detail. For this reason

it should be considered in its entirety ….”). A mark should not be dissected or split up into

its component parts and each part then compared with corresponding parts of the conflicting

mark to determine the likelihood of confusion. McCarthy on Trademarks and Unfair

Competition § 23:41 (4th ed.). It is the impression that the mark as a whole creates on the

average reasonably prudent buyer and not the parts thereof, that is important. Id. As the

Supreme Court observed: “The commercial impression of a trademark is derived from it as a

whole, not from its elements separated and considered in detail. For this reason it should be

considered in its entirety.” Estate of P. D. Beckwith, Inc., 252 U.S. at 545–46. Thus, as

Judge Newman has observed: “It is incorrect to compare marks by eliminating portions

thereof and then simply comparing the residue.” China Healthways Institute, Inc. v. Wang,

491 F.3d 1337, 83 U.S.P.Q.2d 1123 (Fed. Cir. 2007), cert. denied, 128 S. Ct. 661 (2007)

(reversing the Board's finding of no likely confusion between CHI and design and CHI

PLUS for competing electric massagers because the Board downplayed the importance of

the Chinese word “chi”). The applied-for mark’s inclusion of the term TRACOE in the mark

15

TRACOE APEX creates a significantly different impression than the term APEX alone. In

comparing the marks only as to the terms APEX, the Trademark Office has drawn improper

conclusions regarding the likelihood of confusion as between them.

The Trademark Office has also overlooked the fact that the employment of the term

TRACOE in Applicant’s TRACOE APEX mark suggests something completely different to

consumers than that suggested by the Registrant’s APEX-only mark. If two conflicting

marks each have an aura of suggestion, but each suggests something different to the buyer,

this tends to indicate a lack of a likelihood of confusion. McCarthy on Trademarks and

Unfair Competition § 23:28 (4th ed.). Applicant’s inclusion of the phrase TRACOE conveys

the impression of something entirely separable from Registrant’s mark. Namely, use of the

term TRACOE indicates that the associated goods in Class 10 involve goods that relate to

the “trachea organ, colloquially called the windpipe.” This cartilaginous tube “connects the

pharynx and larynx to the lungs, and allows the passage of air in almost all breathing

animals with lungs.” See Exhibit B. This makes sense, as Applicant’s goods include various

medical products that may be used in applications where tracheal structures have been

damaged or in connection with individuals who are being treated for breathing illness. Use

of the term TRACOE is therefore suggestive of the trachea organ and underscores the

unique applications for which Applicant’s goods may be use and thereby acts as a primary

way in which consumers can separate Applicant’s mark from Registrant’s mark. Upon

establishing this fact, then, it should be foreseeable that the term TRACOE is a key feature

of Applicant’s mark and will have a lasting impression on the minds of consumers looking

to purchase Applicant’s goods. Nowhere in Registrant’s mark is this term present, rather, the

mark uses only the term APEX, which alone has no clear meaning but may be used in

16

reference to a number of things ranging from “a narrowed or pointed end” to a “sharp

curvature in a path.” See Exhibit C. In any case, the mark TRACOE APEX is significantly

different in appearance, sound, meaning, and commercial impression than the term APEX

alone. Given this fact, and the fact that Applicant’s mark and Registrant’s mark are further

separated given the divergent goods in which their marks are used in connection with, it is

clear that a likelihood of confusion between the marks is unlikely.

Further to all of the above, it should also be noted that Applicant’s mark is displayed

in a unique manner, and therefore, likely to be processed with greater care by the relevant

consuming public, as it is presented in a far more fanciful way than if otherwise presented

with no such detailing. Conversely, the mark APEX in U.S. Registration No. 1,922,866 is

presented with no such variation. Registrant and Applicant’s respective marks are

presented to consumers as follows:

APPLICANT’S MARK REGISTRANT’S

MARK

APPEARANCE

TRACOE apex APEX

SOUND

Tray-co-ayy-pex Ayy-pex

MEANING/COMMERCIAL

IMPRESSION

Goods emanating from

Tracoe Medica GmbH; goods

related to the tracheal organ

No clear meaning;

narrow or pointed end;

sharp curvature in a

path; one of a sea of

APEX and APEX

variant marks

As is clear, Applicant’s mark is distinguishable based on its large capital lettering used for

the term TRACOE, with spacing between, and then immediate placement of the term APEX

in all lowercase lettering – e.g., “TRACOE apex.” Consumers of Applicant’s medical

17

equipment and associated goods are sophisticated consumers seeking specialized medical

products, and therefore, are likely to notice these far from subtle differences in the

presentation of the marks here at issue. This is only further buttressed by the fact that the

marks are not identical and that the emphasis on Applicant’s mark is clearly on the larger,

more noticeable term TRACOE. As such, the presentation of Applicant’s mark should be

granted credence as a demarcation between the applied-for mark and the mark shown in

U.S. Registration No. 1,922,866.

The Trademark Office’s attempt to conclude the marks at issue are similar

because the marks use the same term - APEX - fails to demonstrate a likelihood of

confusion. Because the marks are distinct and easily distinguishable, no likelihood of

confusion should be found. Not only does the Trademark Office rely on a single word in

Applicant’s mark, it compares dissimilar wording sequences, ignores that Applicant’s

house mark – TRACOE – is both the first and dominant element of Applicant’s mark,

and overlooks the visual and typographical differences between the marks at issue. Such

dissection and wishful comparison is not consistent with how consumers perceive marks

and is not persuasive. Indisputably, the mark “TRACOE apex” is visually and audibly

distinct from the mark TRACOE. No amount of alleged similarity of underlying goods

can erase the lack of visual and audible similarity between these marks.

C. SIGNIFICANT THIRD PARTY USE OF TRADEMARKS INCLUDING

THE TERM APEX FOR USE IN CONNECTION WITH MEDICAL

INSTRUMENTS AND DEVICES EXEMPLIFIES A CROWDED

MARKET.

The medical instrument and device industry is extremely crowded with a myriad

of trademarks incorporating the term APEX. This demonstrates that medical and device

industry brands commonly coexist with very similar names, and consumers are

18

conditioned to distinguish between them even when minor differences differentiate each

brand. Here, the regular coexistence of marks with identical components for these goods

underscores the differences in the commercial impressions conveyed by each mark.

Third-party registrations may be relevant to show the sense in which a mark is

used in ordinary parlance; that is, an element common to both parties' marks may have a

normally understood and well-recognized descriptive or suggestive meaning, leading to

the conclusion that that segment is inherently relatively weak. Jack Wolfskin Ausrustung

Fur Draussen GmbH & Co. KGAA v. New Millennium Sports, S.L.U., 797 F.3d 1363,

116 USPQ2d 1129, 1136 (Fed. Cir. 2015); see also In re Morinaga Nyugyo Kabushiki

Kaisha, 120 USPQ2d 1738, 1745 (TTAB 2016) ("[T]hird party registrations are relevant

evidence of the inherent or conceptual strength of a mark or term because they are

probative of how terms are used in connection with the goods or services identified in the

registrations."). In addition, evidence of third-party use of similar marks on similar goods

can show that customers have been educated to distinguish between different marks on

the basis of minute distinctions. Jack Wolfskin, 116 USPQ2d at 1136 (quoting Juice

Generation, Inc. v. GS Enters. LLC, 794 F.3d 1334, 115 USPQ2d 1671, 1674 (Fed. Cir.

2015)).

There are numerous precedents in which the Board and the courts have found

confusion to be unlikely where the only element in common was one single term –

whether a descriptive or suggestive word. See, for example, Keebler Co. v. Murray

Bakery Prods., Inc., 866 F.2d 1386, 9 U.S.P.Q.2d (BNA) 1736 (Fed. Cir. 1989) (PECAN

SHORTEES vs. PECAN SANDIES); Kellogg Co. v. Pack 'Em Enterprises, Inc., 951

F.2d 330, 21 U.S.P.Q.2d (BNA) 1142 (Fed. Cir. 1991) (FROOTEE ICE vs. FROOT

19

LOOPS); General Mills, Inc. v. Health Valley Foods, 24 U.S.P.Q.2d (BNA) 1270 (TTAB

1992) (FIBER ONE vs. FIBER 7 FLAKES; Nutri/Sys., Inc. v. Con-Stan Indus., Inc., 809

F.2d 601, 1 U.S.P.Q.2d (BNA) 1809 (9th Cir. 1987) (NUTRI/SYSTEM vs. NUTRI-

TRIM); Sears Mortgage Corp. v. Northeast Savings F.A., 24 U.S.P.Q.2d (BNA) 1227

(TTAB 1992) (APPROVAL PLUS vs. APPROVAL FIRST); Burns Philp Food, Inc. v.

Modern Prods., Inc., 24 U.S.P.Q.2d (BNA) 1157 (TTAB 1992) (SPICE ISLAND vs.

SPICE GARDEN and design); and Stouffer Corp. v. Health Valley Natural Foods Inc., 1

U.S.P.Q.2d (BNA) 1900 (TTAB 1986) (LEAN CUISINE vs. LEAN LIVING).

Moreover, use by numerous third parties in a market reduces the individual

distinctiveness of similar marks and makes confusion unlikely. See General Mills, Inc.,

24 U.S.P.Q.2d at 1277 (the field of “FIBER” composite marks for foods is crowded, such

that there is no likely confusion between FIBER ONE and FIBER 7 FLAKES for both

breakfast cereals high in fiber). Third party use in commerce conditions consumers to

expect different sources for different goods or services under a commonly used mark.

Nat’l Cable Television Ass’n v. Am. Cinema Editors, Inc., 937 F.2d 1572, 1579, 19

U.S.P.Q.2d (BNA) 1424, 1430 (Fed. Cir. 1991) (noting that terms such as PREMIUM,

SUN, BLUE RIBBON, NATIONAL, GIANT, or AMERICAN are commonly used on

numerous types of related goods and services, and are thus “weak” terms.) Consumers

will distinguish between the weak marks on similar goods “on the basis of minute

distinctions.” Standard Brands, Inc. v. RJR Foods, Inc., 192 U.S.P.Q. (BNA) 383, 385-

386 (TTAB 1976). However, actual use by third parties must be shown. Palm Bay

20

Imports, Inc. v. Veuve Clicquot Ponsardin Maison Fondee En 1772, 396 F.3d 1369,

1373, 73 U.S.P.Q.2d (BNA) 1689, 1693 (Fed. Cir. 2005) (“The probative value of third-

party trademarks depends entirely upon their usage.”).

In this case, initially, the Trademark Office cited to a total of seven (7)

registrations for the mark APEX used in connection with medical instruments and

devices, namely, U.S. Registration Nos. 1,922,866, 1,934,197, 2,065,134, 2,399,854,

2,505,277, 2,792,216, 4,394,657, and 4,523,338. Applicant has further identified the

existence of countless other registrations comprised of the term APEX, in whole or in

part, likewise for use in connection with medical instruments and devices. See Exhibit D.

Consequently, it appears to be the position of the USPTO to allow such medical

instrument and device related marks using the term APEX to peacefully coexist in the

marketplace and on the Federal Register with only slight differences in the marks or the

associated goods. Therefore, each mark is entitled to a relatively narrow scope of

protection, and that small differences between the marks, the goods, or the channels of

trade through which they travel are sufficient to avoid creating a likelihood of confusion.

Obviously, if the Trademark Office allows the peaceful coexistence of these marks, logic

must dictate that Applicant’s TRACOE APEX mark can likewise coexist without

confusion with U.S. Registration No. 1,922,866, based on the differences between the

marks and the goods offered in connection therewith.

D. APPLICANT AND REGISTRANT’S CUSTOMERS ARE HIGHLY

SOPHISTICATED AND UNLIKELY TO CONFUSE APPLICANT AND

REGISTRANT OR THE GOODS OF THE RESPECTIVE PARTIES.

Applicant’s mark is associated with apparatus and devices used during

tracheotomy procedures. Applicant’s customers are surgeons and medical purchasing

21

groups. These customers are very sophisticated, very discerning, and are aware of

differences between medical devices used for different specific procedures. Purchases of

medical devices and apparatus are typically made for a specific product used for a

specific purpose. It is highly unlikely, for example, that a surgeon or medical purchasing

group would confuse the mark APEX as associated with arthroscopic medical

instruments and devices with the mark TRACOE APEX, as used in association with

tracheotomy instruments and devices. A physician looking to purchase medical devices

for arthroscopic medical goods would be doing so under vastly different conditions than a

physician looking to purchase tracheotomy goods. Furthermore, the discerning nature of

the medical community is highlighted by the ability of all of the third party APEX marks

to co-exist with one another, given minimal differences between the respective goods. As

noted above, not one of the third party APEX registrations is associated with tracheotomy

goods or apparatus. In view of the sophisticated nature of the consumers, Applicant

respectfully submits that its TRACOE APEX mark is simply not likely to cause

confusion with the Cited Registration.

E. REGISTRANT HAS AGREED TO PROVIDE ITS CONSENT TO

APPLICANT TO REGISTER THE APPLIED-FOR TRACOE APEX

MARK.

As of today’s date, March 27, 2020, Conmed Corporation, owner of U.S.

Registration No. 1,922,866, has agreed to consent to Applicant’s registration of the

applied-for TRACOE APEX mark. In the coming days, Applicant will produce an

agreement memorializing the terms of said consent in support Applicant’s Appeal Brief.

22

IV. CONCLUSION

Rejection of the application is inappropriate where confusion is unlikely. In this

case, confusion between Applicant’s TRACOE APEX mark and Registrant’s APEX

mark is unlikely. The marks are not similar. Registrant does not have rights in the term

APEX that are significant enough to preclude Applicant from using it in its TRACOE

APEX mark. The parties’ marks are too dissimilar from each other in appearance, sound,

meaning, and commercial impression to create a likelihood of confusion, the goods used

in connection with the marks are not similar, and third party use has diluted what the

Trademark Office contends is the distinctive portion of Registrant’s mark. Further to this

end, and in support of registration of the Application, the Cited Registrant has agreed to

consent to registration of the Application. Therefore, under the Du Pont analysis,

confusion is clearly unlikely, and Application should be allowed to register.

By this Appeal Brief, Applicant has addressed the outstanding refusal raised by

the Office. Applicant respectfully requests that the Trademark Office accept an

agreement setting forth the Cited Registrant’s agreement to permit registration of the

Application in the coming days and that the Examining Attorney’s refusal be reversed

and the Application be approved for publication at an early date.

Respectfully Submitted,

TRACOE MEDICAL GMBH

By its Attorneys,

Date: April 20, 2020 s/Lindsay M.R. Jones

Andrew S. Ehard

Lindsay M.R. Jones

23

MERCHANT & GOULD P.C.

P.O. Box 2910

Minneapolis, MN 55402-0910

612-332-5300

612-332-9081

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Word Mark TRACOEGoods andServices

IC 010. US 026 039 044. G & S: medical equipment for diagnostic and therapeutic purposes, namely, tracheostomytubes, and accessories therefor, namely, elastic positioning ribbons, distance holder clips, mucous collectingdevices, cannula, absorbent compresses and pads, and tracheostoma protective pads. FIRST USE: 19870000.FIRST USE IN COMMERCE: 19870000

MarkDrawingCode

(1) TYPED DRAWING

SerialNumber 75072311

Filing Date March 12, 1996CurrentBasis 1A

OriginalFiling Basis 1A

PublishedforOpposition

September 9, 1997

RegistrationNumber 2117376

RegistrationDate December 2, 1997

Owner (REGISTRANT) TRACOE Gesellschaft fur medizinische Bedarfsgegenstande mbH LIMITED LIABILITY COMPANYGERMAN DEM REP Reichsforstsrasse 32 60528 Frankfurt am Main GERMAN DEM REP

(LAST LISTED OWNER) TRACOE MEDICAL GMBH LIMITED LIABILITY COMPANY BY CHANGE OF NAME FEDREP GERMANY Reichelsheimer Str. 1/3 Nieder-Olm FED REP GERMANY 55268

AssignmentRecorded ASSIGNMENT RECORDED

Attorney ofRecord Andrew S. Ehard

Type ofMark TRADEMARK

Register PRINCIPALAffidavitText SECT 15. SECT 8 (6-YR). SECTION 8(10-YR) 20171222.

Renewal 2ND RENEWAL 20171222

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Word Mark TRACOE H2O CUFFGoods andServices

IC 010. US 026 039 044. G & S: Medical apparatus and instruments, namely, cannulas in combination withtracheotomy tubes for tracheotomy and medical equipment for diagnostic or therapeutic purposes which allowsetting and control of pressure; surgical apparatus and instruments for medical use; cannulas; endotracheal tubes;tracheotomy tubes; tubing and attachments for use with cannulas; stoma seals; medical aids for use in stoma care,namely, sensors for stoma bags, stoma caps; medical instruments for percutaneous tracheostomy; pressuremonitors for medical use; medical instruments for diagnostics, examinations and monitoring, namely, medicaldiagnostic instruments for the analysis of body fluids, medical instruments for cardiovascular diagnostics. FIRSTUSE: 20180100. FIRST USE IN COMMERCE: 20180100

MarkDrawingCode

(5) WORDS, LETTERS, AND/OR NUMBERS IN STYLIZED FORM

SerialNumber 87493412

Filing Date June 16, 2017CurrentBasis 1B

OriginalFilingBasis

1B

PublishedforOpposition

December 19, 2017

Owner (APPLICANT) TRACOE medical GmbH gesellschaft mit beschränkter haftung (gmbh) FED REP GERMANYReichelsheimer Str. 1/3 55268 Nieder-Olm FED REP GERMANY

Attorney ofRecord Andrew S. Ehard

Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "H20 CUFF" APART FROM THE MARK AS SHOWNDescriptionof Mark

Color is not claimed as a feature of the mark. The mark consists of "TRACOE H2O Cuff" -- the "2" is slightly belowthe rest of the text.

Type ofMark TRADEMARK

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Word Mark TRACOE HUMIDASSISTGoods andServices

(CANCELLED) IC 005. US 006 018 044 046 051 052. G & S: [Substances for the disinfection and sterilization ofmedical-technical devices]

IC 010. US 026 039 044. G & S: Medical-technical devices, namely, heat and moisture exchangers fortracheotomy; canules, tubes and adhesive carriers; tracheal canules; canules for anesthetics with receptacles;tracheal prostheses; [surgical instruments used for tracheotomies, namely, for emergency tracheotomies; medicallife-saving devices, namely, scalpels and dilators in combination with tracheotomy tubes for tracheotomy; devices,namely, sterilization and disinfection units for the chemical disinfection and sterilization of medical-technicaldevices;] speaking canules [; stomabuttons]

MarkDrawingCode

(1) TYPED DRAWING

SerialNumber 76179730

Filing Date December 12, 2000CurrentBasis 44E

OriginalFiling Basis 1B;44D

Published forOpposition September 7, 2004

Change InRegistration CHANGE IN REGISTRATION HAS OCCURRED

RegistrationNumber 2905441

RegistrationDate November 30, 2004

Owner (REGISTRANT) TRACOE MEDICAL GMBH LIMITED LIABILITY COMPANY FED REP GERMANYReichelsheimer Str. 1/3 Nieder-Olm FED REP GERMANY 55268

AssignmentRecorded ASSIGNMENT RECORDED

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Attorney ofRecord Andrew S. Ehard

Priority Date August 15, 2000PriorRegistrations 2117376

Type of Mark TRADEMARKRegister PRINCIPALAffidavit Text SECT 15. PARTIAL SECT 8 (6-YR). SECTION 8(10-YR) 20140610.Renewal 1ST RENEWAL 20140610Live/DeadIndicator LIVE

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Word Mark TRACOE PHONASSISTGoods andServices

(CANCELLED) IC 005. US 006 018 044 046 051 052. G & S: [SUBSTANCES FOR THE DISINFECTION ANDSTERILIZATION OF MEDICAL-TECHNICAL DEVICES]

IC 010. US 026 039 044. G & S: Medical-technical devices, namely, voice valves; tracheal canules; canules foranesthetics with receptacles; tracheal prostheses; [surgical instruments used for tracheotomies, namely, foremergency tracheotomies; medical life-saving devices, namely, scalpels and dilators in combination withtracheotomy tubes for tracheotomy; devices, namely, sterilization and disinfection units for the chemicaldisinfection and sterilization of medical-technical devices; ]speaking canules[ ; stomabuttons]

MarkDrawingCode

(1) TYPED DRAWING

SerialNumber 76179729

Filing Date December 12, 2000CurrentBasis 44E

OriginalFiling Basis 1B;44D

Published forOpposition April 27, 2004

Change InRegistration CHANGE IN REGISTRATION HAS OCCURRED

RegistrationNumber 2863972

RegistrationDate July 20, 2004

Owner (REGISTRANT) TRACOE MEDICAL GMBH LIMITED LIABILITY COMPANY FED REP GERMANYReichelsheimer Str. 1/3 Nieder-Olm FED REP GERMANY 55268

AssignmentRecorded ASSIGNMENT RECORDED

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Attorney ofRecord

Andrew S. Ehard

Priority Date August 15, 2000PriorRegistrations 2117376

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Word Mark TRACOE SILCOSOFTGoods andServices

IC 010. US 026 039 044. G & S: Medical apparatus and instruments, namely, dialators in combination withtracheotomy tubes for tracheotomy and medical equipment for diagnostic or therapeutic purposes which allow settingand control of pressure; surgical apparatus and instruments for medical use; cannulas; endotracheal tubes;tracheotomy tubes; tubing and attachments for use with cannulas; stoma seals; medical aids for use in stoma care,namely, sensors for stoma bags, stoma caps; surgical and wound treating equipment, namely, suture materials,wound suction apparatus, wound drainage apparatus, medical devices for closing wounds; medical instruments forpercutaneous tracheostomy; pressure monitors for medical use; medical instruments for diagnostics, examinationsand monitoring, namely, medical diagnostic instruments for the analysis of body fluids, medical instruments forcardiovascular diagnostics

StandardCharactersClaimedMarkDrawingCode

(4) STANDARD CHARACTER MARK

SerialNumber 79200939

Filing Date November 15, 2016CurrentBasis 66A

OriginalFiling Basis 66A

PublishedforOpposition

September 5, 2017

RegistrationNumber 5337590

InternationalRegistrationNumber

1329668

RegistrationDate November 21, 2017

Owner (REGISTRANT) TRACOE medical GmbH LIMITED LIABILITY COMPANY FED REP GERMANY Reichelsheimer Str.

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Priority Date May 20, 2016Type ofMark TRADEMARK

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Word Mark TRACOE SMARTGoods andServices

IC 010. US 026 039 044. G & S: Technical medical equipment for diagnostic or therapeutic purposes, namely,tracheostomy tubes and endotracheal tubes with high precision and medical devices, which allow setting andcontrol of pressure in low pressure cuffs of tracheostomy; Cannulae, in particular tracheotomy tubes, cannulae foranesthetics and collection cups; Speech cannulae

StandardCharactersClaimedMarkDrawingCode

(4) STANDARD CHARACTER MARK

SerialNumber 85571556

Filing Date March 16, 2012CurrentBasis 44E

OriginalFiling Basis 1B;44D

Published forOpposition December 11, 2012

RegistrationNumber 4911702

RegistrationDate March 8, 2016

Owner (REGISTRANT) TRACOE medical GmbH CORPORATION FED REP GERMANY Reichelsheimer Str. 1/3 Nieder-Olm FED REP GERMANY 55268

Attorney ofRecord Andrew S. Ehard

Priority Date March 16, 2012PriorRegistrations 2117376;2863972;2905441

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Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

Trachea

Trachea

Conducting passages.

Details

Pronunciation /trəˈkiːə, ˈtreɪkɪə/[1]

Artery tracheal branches of inferior

thyroid artery

Vein brachiocephalic vein , azygos vein

accessory hemiazygos vein

Identifiers

Latin Trachea

MeSH D014132

TA A06.3.01.001

FMA 7394

Anatomical terminology

[edit on Wikidata]

From Wikipedia, the free encyclopedia

For the genus of moth, see Trachea (moth). For the cup-shaped Byzantine coins, see

Trachy (currency).

The trachea, colloquially called the windpipe, is a

cartilaginous tube that connects the pharynx and

larynx to the lungs, allowing the passage of air,

and so is present in almost all air-breathing

animals with lungs. The trachea extends from the

larynx and branches into the two primary bronchi.

At the top of the trachea the cricoid cartilage

attaches it to the larynx. This is the only complete

tracheal ring, the others being incomplete rings of

reinforcing cartilage. The trachealis muscle joins

the ends of the rings and these are joined

vertically by bands of fibrous connective tissue –

the annular ligaments of trachea. The epiglottis

closes the opening to the larynx during

swallowing.

The trachea develops in the second month of

development. It is lined with an epithelium that has

goblet cells which produce protective mucins (see

Respiratory epithelium). An inflammatory

condition, also involving the larynx and bronchi,

called croup can result in a barking cough. A

tracheotomy is often performed for ventilation in

surgical operations where needed. Intubation is

also carried out for the same reason by the

inserting of a tube into the trachea. From 2008,

operations have experimentally transplanted a

windpipe grown by stem cells, and synthetic

windpipes; however, a successful method for this

method of transplant does not currently exist and

development of such a method remains

theoretically daunting.[2][3]

The word "trachea" is used to define a very different organ in invertebrates than in vertebrates.

Insects have an open respiratory system made up of spiracles, tracheae, and tracheoles to

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Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

transport metabolic gases to and from tissues.

Contents [hide]

1 Structure

1.1 Position

1.2 Development

1.3 Microanatomy

2 Clinical significance

2.1 Inflammation

2.2 Intubation

2.3 Congenital disorders

2.4 Other

3 Other animals

3.1 Vertebrates

3.2 Invertebrates

4 Bioengineering and prosthesis

5 Additional images

6 References

7 External links

Structure [edit]

An adult's trachea has an inner diameter of about

1.5 to 2 centimetres (0.59 to 0.79 in) and a length of

about 10 to 11 centimetres (3.9 to 4.3 in); wider in

males than females.[4] It begins at the bottom of the

larynx, and ends at the carina, the point where the

trachea branches into left and right main

bronchi.[4]The trachea is surrounded by 16-20 rings

of hyaline cartilage; these 'rings' are incomplete and

C-shaped.[4]

Position [edit]

It begins at the bottom of the larynx, and ends at the

carina, the point where the trachea branches into left

and right main bronchi.[4] The trachea begins level

with the sixth cervical vertebra (C6) and the carina is found at the level of the sixth thoracic

vertebra (T6),[4]opposite the sternal angle and can be positioned up to two vertebrae lower or

higher, depending on breathing.

The trachea passes by many structures of the neck and thorax along its course. In front of the

upper trachea lies connective tissue and skin.[4]Several other structures pass or sit over it; the

jugular arch, which joins the two anterior jugular veins, sits in front of the upper part of the

trachea. The sternohyoid and sternothyroid muscles stretch along its length, and the thyroid

gland sits below this; with the isthmus of the gland overlying the second to fourth rings, with the

lobes of the thyroid stretching to the level of the fifth or sixth cartilage.[4]The vessels of the

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Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

thyroid sit adjacent to the thyroid isthmus on the tracheal; the superior thyroid arteries join just

above it, and the inferior thyroid veins below it.[4]In front of the lower trachea lies the manubrium

of the sternum, the remnants of the thymus in adults; to the front left the large blood vessels the

aortic arch and its branches the left common carotid artery and the brachiocephalic trunk; and

the left brachiocephalic vein. The deep cardiac plexus and lymph nodes are also positioned in

front of the lower trachea.[4]

Behind the trachea, along its length, sits the oesophagus, followed by connective tissue and the

vertebral column.[4]To its sides run the carotid arteries and inferior thyroid arteries; and to its

sides on its back surface run the recurrent laryngeal nerves in the upper trachea, and the vagus

nerves in the lower trachea.[4]

The trachealis muscle connects the ends of the incomplete rings and contracts during coughing,

reducing the size of the lumen of the trachea to increase the rate of air flow.[5] The esophagus

lies posteriorly to the trachea, adjoining along the tracheoesophageal stripe. Circular horizontal

bands of fibrous tissue called the annular ligaments of trachea join the tracheal rings together.

The cartilaginous rings are incomplete to allow the trachea to collapse slightly so that food can

pass down the esophagus. A flap-like epiglottis closes the opening to the larynx during

swallowing to prevent swallowed matter from entering the trachea.

The sternohyoid and

sternothyroid muscles lie

on top of the upper part

of the trachea

The thyroid gland also

lies on top of the trachea,

and lies below the cricoid

cartilage. The isthmus of

the thyroid, which

connects both wings, lies

directly in front, whereas

the wings lie on the front

and stretch to the side.

Development [edit]

In the fourth week of development of the human embryo as the respiratory bud grows, the

trachea separates from the foregut through the formation of tracheoesophageal ridges which

fuse to form the tracheoesophageal septum and this separates the future trachea from the

oesophagus and divides the foregut tube into the laryngotracheal tube.[6] By the start of the fifth

week, the left and right main bronchi have begin to form, initially as buds at the terminal end of

the treachea.[6]

The trachea is no more than 4mm diameter during the first year of life, expanding to its adult

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diameter by late childhood. The trachea is of more variable length and site in relation to its

surrounding structures in children.[7]

Microanatomy [edit]

The trachea is lined with a layer of pseudostratified ciliated columnar epithelium. The epithelium

contains goblet cells, which are glandular, modified simple columnar epithelial cells that produce

mucins, the main component of mucus. Mucus helps to moisten and protect the airways.[8]

Mucus lines the ciliated cells of the trachea to trap inhaled foreign particles that the cilia then

waft upward toward the larynx and then the pharynx where it can be either swallowed into the

stomach or expelled as phlegm. This self-clearing mechanism is termed mucociliary

clearance.[9]

The trachea is surrounded by 16-20 rings of hyaline cartilage; these 'rings' are incomplete and

C-shaped.[4]Two or more of the cartilages often unite, partially or completely, and they are

sometimes bifurcated at their extremities. The rings are generally highly elastic but they may

calcify with age.

Cross-section

Cross-section of the

trachea, with

pseudostratified ciliated

columnar epithelium and

goblet cells labelled

Magnified cross-section

of the cartilage of the

trachea.

Clinical significance [edit]

Inflammation [edit]

Inflammation of the trachea is known as tracheitis. When the trachea is inflamed as well as the

larynx and bronchi, this is known as croup, which often causes a distinct, barking cough.

Intubation [edit]

Main articles: Tracheal intubation and Airway management

Tracheal intubation refers to the insertion of a catheter down the trachea. This procedure is

commonly performed during surgery, in order to ensure a person receives enough oxygen when

sedated. The catheter is connected to a machine that monitors the airflow, oxygenation and

several other metrics. This is often one of the responsibilities of an anesthetist during surgery.

The epiglottic vallecula is an important anatomical landmark for carrying out this procedure.

In an emergency, or when tracheal intubation is deemed impossible, a tracheotomy is often

Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

Tracheal diverticulum as seen on

axial CT imaging

performed to insert a tube for ventilation, usually when needed for particular types of surgery to

be carried out so that the airway can be kept open. The provision of the opening via a

tracheotomy is called a tracheostomy.[10] Another less invasive method is used when a

procedure can be carried out more quickly, or in an emergency situation, and this is a

cricothyrotomy.

Congenital disorders [edit]

Tracheal agenesis[11] is a rare birth defect in which the

trachea fails to develop. The defect is usually fatal

though sometimes surgical intervention has been

successful.

A tracheoesophageal fistula is a congenital defect in

which the trachea and esophagus are abnormally

connected (a fistula). This is because of abnormalities

in the separation between the trachea and oesophagus

during development.[12] This occurs in approximately 1

in 3000 births, and the most common abnormalities is a

separation of the upper and lower ends of the oesophagus, with the upper end finishing in a

closed pouch.[12] Other abnormalities may associated with this, including cardiac abnormalities,

or VACTERL syndrome.[12] Such fistulas may be detected before a baby is born because of

excess amniotic fluid; after birth, they are often associated with pneumonitis and pneumonia

because of aspiration of food contents.[12]

Sometimes as an anatomical variation one or more of the tracheal rings are completely formed.

These O rings are smaller than the normal C-shaped rings and can cause narrowing of the

trachea, resulting in breathing difficulties. An operation called a slide tracheoplasty can open up

the rings and rejoin them as wider rings, shortening the length of the trachea.[13] Slide

tracheoplasty is said to be the best option in treating tracheal stenosis.[14]

Mounier-Kuhn syndrome is a very rare congenital disorder of an abnormally enlarged trachea.

Other [edit]

A tracheo-oesophageal puncture is a surgically created hole between the trachea and the

esophagus in a person who has had a total laryngectomy, (removal of larynx). The purpose

of the puncture is to restore a person's ability to speak after the vocal cords have been

removed.

Tracheomalacia (weakening of the tracheal cartilage)

Tracheal collapse (in dogs)

Tracheobronchial injury (perforation of the trachea or bronchi)

A chondrolaryngoplasty commonly called a tracheal shave is the shaving of the cricoid

cartilage in order to reduce it to lessen the prominence of the Adam's apple. It is often

carried out in transgender surgery.

Other animals [edit]

Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

Tracheal system of dissected cockroach.

The largest tracheae run across the width of

the body of the cockroach and are

horizontal in this image. Scale bar, 2 mm.

The tracheal system branches into

progressively smaller tubes, here

supplying the crop of the cockroach.

Scale bar, 2 mm.

Allowing for variations in the length of the neck, the trachea in other mammals is, in general,

similar to that in humans. Generally, it is also similar to the reptilian trachea.[15]

Vertebrates [edit]

In birds, the trachea runs from the pharynx to the syrinx, from which the primary bronchi

diverge. Swans have an unusually elongated trachea, part of which is coiled beneath the

sternum; this may act as a resonator to amplify sound. In some birds, the tracheal rings are

complete, and may even be ossified.[15]

In amphibians, the trachea is normally extremely short, and leads directly into the lungs, without

clear primary bronchi. A longer trachea is, however, found in some long-necked salamanders,

and in caecilians. While there are irregular cartilagenous nodules on the amphibian trachea,

these do not form the rings found in amniotes.[15]

The only vertebrates to have lungs, but no trachea, are the lungfish and the Polypterus, in which

the lungs arise directly from the pharynx.[15]

Invertebrates [edit]

The word

"trachea" is

used to

define a

very

different

organ in

invertebrates than in vertebrates. Insects have an

open respiratory system made up of spiracles, tracheae, and tracheoles to transport metabolic

gases to and from tissues.[16] The distribution of spiracles can vary greatly among the many

orders of insects, but in general each segment of the body can have only one pair of spiracles,

each of which connects to an atrium and has a relatively large tracheal tube behind it. The

tracheae are invaginations of the cuticular exoskeleton that branch (anastomose) throughout the

body with diameters from only a few micrometres up to 0.8 mm. Diffusion of oxygen and carbon

dioxide takes place across the walls of the smallest tubes, called tracheoles, which penetrate

tissues and even indent individual cells.[17] Gas may be conducted through the respiratory

system by means of active ventilation or passive diffusion. Unlike vertebrates, insects do not

generally carry oxygen in their haemolymph.[18] This is one of the factors that may limit their

size.

A tracheal tube may contain ridge-like circumferential rings of taenidia in various geometries

such as loops or helices. Taenidia provide strength and flexibility to the trachea. In the head,

Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

thorax, or abdomen, tracheae may also be connected to air sacs. Many insects, such as

grasshoppers and bees, which actively pump the air sacs in their abdomen, are able to control

the flow of air through their body. In some aquatic insects, the tracheae exchange gas through

the body wall directly, in the form of a gill, or function essentially as normal, via a plastron. Note

that despite being internal, the tracheae of arthropods are lined with cuticular tissue and are

shed during moulting (ecdysis).[17]

Bioengineering and prosthesis [edit]

In 2008, a Colombian woman, Claudia Castillo (30), received a trachea transplant using her own

stem cells.[19]

Between 2011 and 2014 Paolo Macchiarini of the Karolinska University Hospital performed

eight operations in which he generated an artificial trachea from a person's stem cells; four of

them at Karolinska, three in Russia, and one in Illinois.[2] In January 2016 the Swedish television

station Sveriges Television broadcast a three part documentary about Macchiarini that

suggested that Macchiarini did not obtain informed consent from these people, six of whom

died.[2] Macchiraini had been a "media darling" and had been seen as a pioneer in the field.[2] In

February 2016 Karolinska announced it would not renew his contract when it expired in

November 2016 and that it would open an investigation of Macchiarini's work and

publications.[2]

Several bioengineering approaches have been tested to repair and replace the trachea,

indicating extraordinary difficulties in a successful graft due. A 2016 article cited the tremendous

difficulties of tracheal revascularization as a major challenge to any form of tracheal

replacement. The study also notes that on top of the revascularization issue, there is no

evidence that using bone-marrow stem-cells on a de-cellularized native trachea or synthetic

scaffold will induce airway tissue regeneration, and such a method remains hypothetical.[3]

Additional images [edit]

Trachea.

The tracheobronchial

lymph glands.

Coronal section of larynx

and upper part of

trachea.

References [edit]

1. ^ "Trachea | Definition of Trachea by Lexico" . Lexico Dictionaries | English. Retrieved

27 October 2019.

a b c d e

Trachea - Wikipedia

https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

2. ^ "Karolinska Institute has 'lost confidence' in Paolo Macchiarini, says it won't renew his

contract" . KI. 4 February 2016. Retrieved 7 February 2016.

3. ^ a b Delaere, P; Van Raemdonck, D (March 2016). "Tracheal replacement" . Journal of

Thoracic Disease. 8 (Suppl 2): S186–96. doi:10.3978/j.issn.2072-1439.2016.01.85 .

PMC 4775267 . PMID 26981270 .

4. ^ a b c d e f g h i j k l Standring, Susan, ed. (2016). "Trachea and bronchi". Gray's anatomy : the

anatomical basis of clinical practice (41st ed.). Philadelphia. pp. 965–969.

ISBN 9780702052309. OCLC 920806541 .

5. ^ Ross, Michael. Histology a text and atlas (5th ed.). Wojciech Pawlina. p. 617.

6. ^ a b Langman's Embryology 2019, pp. 223-9.

7. ^ Gray's Anatomy 2016, pp. 965-9.

8. ^ Mescher AL, "Chapter 17. The Respiratory System" (Chapter). Mescher AL: Junqueira's Basic

Histology: Text & Atlas, 12e: "Archived copy" . Archived from the original on 3 June 2013.

Retrieved 24 February 2015..

9. ^ Antunes, MB; Cohen, NA (February 2007). "Mucociliary clearance—a critical upper airway

host defense mechanism and methods of assessment". Current Opinion in Allergy and Clinical

Immunology. 7 (1): 5–10. doi:10.1097/aci.0b013e3280114eef . PMID 17218804 .

10. ^ Molnar, Heather. "Types of Tracheostomy Tubes" .

11. ^ Chiu, T.; Cuevas, D.; Cuevas, L.; Monteiro, C. (1990). "Tracheal agenesis". Southern Medical

Journal. 83 (8): 925–930. doi:10.1097/00007611-199008000-00018 . PMID 2200137 .

12. ^ a b c d Langman's Embryology 2019, pp. 224.

13. ^ "Slide tracheoplasty" . Retrieved 2 October 2015.

14. ^ Xue, B; Liang, B; Wang, S; Zhu, L; Lu, Z; Xu, Z (January 2015). "One-stage surgical correction

of congenital tracheal stenosis complicated with congenital heart disease in infants and young

children". Journal of Cardiac Surgery. 30 (1): 97–103. doi:10.1111/jocs.12418 .

PMID 25109422 .

15. ^ a b c d Romer, Alfred Sherwood; Parsons, Thomas S. (1977). The Vertebrate Body.

Philadelphia, PA: Holt-Saunders International. pp. 336–337. ISBN 978-0-03-910284-5.

16. ^ Wasserthal, Lutz T. (1998). Chapter 25: The Open Hemolymph System of Holometabola and

Its Relation to the Tracheal Space. In "Microscopic Anatomy of Invertebrates". Wiley-Liss, Inc.

ISBN 0-471-15955-7.

17. ^ a b Triplehorn, Charles (2005). Borror and DeLong's introduction to the study of insects.

Johnson, Norman F., Borror, Donald J. (7th ed.). Belmont, CA: Thompson Brooks/Cole. pp. 28–

29. ISBN 978-0030968358. OCLC 55793895 .

18. ^ Westneat, Mark W.; Betz, Oliver; Blob, Richard W.; Fezzaa, Kamel; Cooper, James W.; Lee,

Wah-Keat (January 2003). "Tracheal Respiration in Insects Visualized with Synchrotron X-ray

Imaging". Science. 299 (5606): 558–560. doi:10.1126/science.1078008 . PMID 12543973 .

19. ^ "The top health stories of 2008 - CNN.com" . CNN. 26 December 2008. Retrieved 27 May

2010.

Books

Britton, the editors Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston; illustrated by

Robert (2010). Davidson's principles and practice of medicine (21st ed.). Edinburgh:

Churchill Livingstone/Elsevier. ISBN 978-0-7020-3085-7.

Sadley, TW (2019). Langman's medical embryology (14th ed.). Philadelphia: Wolters

Kluwer. ISBN 9781496383907.

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https://en.wikipedia.org/wiki/Trachea[11/22/2019 11:37:18 AM]

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Human systems and organs

Anatomy of the lower respiratory tract

Authority control GND: 4134946-5 · NDL: 00565765 · TA98: A06.3.01.001

Categories: Arthropod anatomy Invertebrate respiratory system Trachea

Human head and neck Thorax (human anatomy) Respiratory system

Apex | Definition of Apex by Merriam-Webster

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Synonyms & Antonyms

Choose the Right Synonym

apex noun

\ ˈā-ˌpeks \

plural apexes or apices \ ˈā- pə- ˌsēz , ˈa- \

Definition of apex

: the uppermost point : VERTEX

// the apex of a mountain

: the narrowed or pointed end : TIP

// the apex of the tongue

1 a

b

: the highest or culminating point

// the apex of his career

2

: the point of sharpest curvature in a path (such as that followed by a turning

vehicle)

// a driver hitting the apex as he races around a corner

// At the apex of the turn his rear wheels apparently came unstuck from the oil-

drenched groove.

— Robert F. Jones

3

SINCE 1828

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Did You Know?

More Example Sentences

Learn More about apex

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Synonyms & Antonyms for apex

Synonyms

acme, apogee, capstone, climax, crescendo, crest, crown, culmination, head, height,

high noon, high-water mark, meridian, ne plus ultra, noon, noontime, peak, pinnacle,

sum, summit, tip-top, top, zenith

Antonyms

bottom, nadir, rock bottom

Visit the Thesaurus for More

Choose the Right Synonym for apex

SUMMIT, PEAK, PINNACLE, CLIMAX, APEX, ACME, CULMINATION mean the

highest point attained or attainable. SUMMIT implies the topmost level attainable. // at

the summit of the Victorian social scene // PEAK suggests the highest among other

high points. // an artist working at the peak of her powers // PINNACLE suggests a

dizzying and often insecure height. // the pinnacle of worldly success // CLIMAX

implies the highest point in an ascending series. // the war was the climax to a series

of hostile actions // APEX implies the point where all ascending lines converge. // the

apex of Dutch culture // ACME implies a level of quality representing the perfection of

a thing. // a statue that was once deemed the acme of beauty // CULMINATION

suggests the outcome of a growth or development representing an attained objective.

// the culmination of years of effort //

Apex | Definition of Apex by Merriam-Webster

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Did You Know?

Apex entered English from Latin, where it originally meant "a small rod at the top of a

flamen's cap." What's a flamen's cap? Flamens were priests who devoted themselves

to serving just one of the many ancient Roman gods (for instance, just Jupiter or

Mars). Those priests wore distinctive conical caps that English speakers dubbed

"flamen's caps." Sixteenth- and seventeenth-century dramatist Ben Jonson was one of

the few English writers known to have used "apex" in its flamen's-cap sense: "Upon

his head a hat of delicate wool, whose top ended in a cone, and was thence called

apex."

Examples of apex in a Sentence

// she reached the apex of fame, only to find it wasn't what she expected

// the apex of the spear

Recent Examples on the Web

// And then, pow pow, Biles is in the air, a möbius loop of motion 10 feet off the ground

at the apex, more than a second in the air, twisting around her head-to-toe axis three

times and flipping over her side-to-side axis twice before, bang!

— Adam Rogers, WIRED, "The Biomechanical Perfection of Simone Biles in Flight," 13 Aug.

2019

// Hong Kong’s nine-week-long protest movement reached a new apex today, as the

city came to a near standstill, with protesters paralyzing public transportation on top of

a general strike.

— Isabella Steger, Quartz, "1,000 canisters of tear gas and 160 rubber bullets: Hong Kong’s

summer of dissent, by the numbers," 5 Aug. 2019

These example sentences are selected automatically from various online news sources to reflect current usage of the

word 'apex.' Views expressed in the examples do not represent the opinion of Merriam-Webster or its editors. Send us

feedback.

See More

First Known Use of apex

Apex | Definition of Apex by Merriam-Webster

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1590, in the meaning defined at sense 1a

History and Etymology for apex

Latin

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Share apex Time Traveler for apex

The first known use of apex was in

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apex beat

apexed

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See the full definition for apex in the English Language Learners Dictionary

apex noun

English Language Learners Definition of apex: the top or highest point of something

apex noun

\ ˈā-ˌpeks \

plural apexes or apices \ ˈā- pə- ˌsēz \

Kids Definition of apex

: the highest point : PEAK

// “She's on top of the roof, walking with a foot either side of the apex …”

— Brian Jacques, Redwall

1

: the most successful time

// He was at the apex of his career.

2

apex noun

\ ˈā-ˌpeks \

plural apexes or apices \ ˈā- pə- ˌsēz \

Medical Definition of apex

: a narrowed or pointed end of an anatomical structure: as

: the narrow somewhat conical upper part of a lung extending into the roota

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More from Merriam-Webster on apex

Thesaurus: All synonyms and antonyms for apex

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Britannica English: Translation of apex for Arabic Speakers

Comments on apex

What made you want to look up apex? Please tell us where you read or heard it

(including the quote, if possible).

: the lower pointed end of the heart situated in humans opposite the space

between the cartilages of the fifth and sixth ribs on the left side

: the extremity of the root of a tooth

b

c

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Apex | Definition of Apex by Merriam-Webster

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Words from the week of 11/22/2019

When there's 'positively' none of

something

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Two spellings, an ocean apart

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Word Mark APEXGoods andServices

IC 010. US 026 039 044. G & S: Hearing aids. FIRST USE: 20161222. FIRST USE IN COMMERCE: 20161222

IC 035. US 100 101 102. G & S: Retail store services featuring hearing aids, hearing aid batteries, and relatedhearing aid accessories. FIRST USE: 20161222. FIRST USE IN COMMERCE: 20161222

IC 044. US 100 101. G & S: Medical services, namely, providing audiometric hearing tests and evaluations.FIRST USE: 20161222. FIRST USE IN COMMERCE: 20161222

Mark DrawingCode (5) WORDS, LETTERS, AND/OR NUMBERS IN STYLIZED FORM

SerialNumber 87213403

Filing Date October 24, 2016Current Basis 1AOriginalFiling Basis 1B

Published forOpposition April 4, 2017

RegistrationNumber 5342314

RegistrationDate November 21, 2017

Owner (REGISTRANT) Apex Hearing Services LLC LIMITED LIABILITY COMPANY OHIO 13475 Strathmore DriveValley View OHIO 44125

Attorney ofRecord Howard G. Shimola

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Type of Mark TRADEMARK. SERVICE MARKRegister PRINCIPALLive/Dead LIVE

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Word Mark APEXGoods andServices

IC 010. US 044. G & S: foot bandages, orthopedic shoes and sandals, arch supports, heel supports, tongue pads,foot cushions. FIRST USE: 19460000. FIRST USE IN COMMERCE: 19460000

IC 017. US 001. G & S: rubber and crepe rubber in sheet form for soling and resoling shoes and sandals andphenolic foam materials in sheet form for use in the manufacture of both footwear and corrective articles and heatformable sheet cork material for making arch supports. FIRST USE: 19460000. FIRST USE IN COMMERCE:19460000

IC 025. US 039. G & S: insoles for shoes. FIRST USE: 19460000. FIRST USE IN COMMERCE: 19460000MarkDrawingCode

(1) TYPED DRAWING

SerialNumber 74120957

Filing Date December 6, 1990CurrentBasis 1A

OriginalFiling Basis 1B

Published forOpposition October 1, 1991

RegistrationNumber 1669288

RegistrationDate December 24, 1991

Owner (REGISTRANT) APEX FOOT HEALTH INDUSTRIES CORPORATION NEW JERSEY 414 ALFRED AVETEANECK NEW JERSEY 07666

(LAST LISTED OWNER) APEX FOOT HEALTH INDUSTRIES, LLC LIMITED LIABILITY COMPANY DELAWARE2905 VETERANS MEMORIAL HIGHWAY RONKONKOMA NEW YORK 11779

AssignmentRecorded ASSIGNMENT RECORDED

Attorney ofRecord Laura Goldbard George

PriorRegistrations 1449481

Type of Mark TRADEMARK

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Register PRINCIPALAffidavit Text SECT 15. SECT 8 (6-YR). SECTION 8(10-YR) 20111220.Renewal 2ND RENEWAL 20111220Live/DeadIndicator LIVE

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Word Mark APEXGoods andServices

IC 010. US 026 039 044. G & S: medication spoons, medicine droppers, pill splitters and pill pulverizers for use inadministering medication. FIRST USE: 19950300. FIRST USE IN COMMERCE: 19950300

IC 020. US 002 013 022 025 032 050. G & S: plastic pill boxes. FIRST USE: 19950300. FIRST USE INCOMMERCE: 19950300

Mark DrawingCode (3) DESIGN PLUS WORDS, LETTERS, AND/OR NUMBERS

DesignSearch Code

05.09.05 - Apples26.17.10 - Lines, zig-zag; Zig-zag line(s)

SerialNumber 75261423

Filing Date March 21, 1997Current Basis 1AOriginalFiling Basis 1A

Published forOpposition December 23, 1997

RegistrationNumber 2144591

RegistrationDate March 17, 1998

Owner (REGISTRANT) Apex Medical Corporation CORPORATION SOUTH DAKOTA 800 South Van Eps Avenue SiouxFalls SOUTH DAKOTA 57101

(LAST LISTED OWNER) COMPASS HEALTH BRANDS CORP. CORPORATION DELAWARE 6753 ENGLEROAD MIDDLEBURG HEIGHTS OHIO 44130

AssignmentRecorded ASSIGNMENT RECORDED

Attorney ofRecord Lorri W Cooper

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Type of Mark TRADEMARKRegister PRINCIPALAffidavit Text SECT 15. SECT 8 (6-YR). SECTION 8(10-YR) 20180331.Renewal 2ND RENEWAL 20180331Live/DeadIndicator LIVE

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Word Mark APEX BIOTECHNOLOGY CORPGoods andServices

IC 005. US 006 018 044 046 051 052. G & S: Reagent strips for medical diagnostic use; glucose control solution formedical diagnostic use; uric acid control solution for medical diagnostic use. FIRST USE: 19990813. FIRST USE INCOMMERCE: 20000600

IC 010. US 026 039 044. G & S: blood uric acid monitoring apparatus for medical diagnostic use; blood glucosemonitoring apparatus for medical diagnostic use; puncturers for medical use, lancets. FIRST USE: 19990813.FIRST USE IN COMMERCE: 20000600

MarkDrawingCode

(3) DESIGN PLUS WORDS, LETTERS, AND/OR NUMBERS

DesignSearchCode

26.01.26 - Coils; Spirals; Swirls

SerialNumber 76157260

Filing Date November 1, 2000CurrentBasis 1A

OriginalFiling Basis 1A

PublishedforOpposition

March 11, 2003

RegistrationNumber 2720410

RegistrationDate June 3, 2003

Owner (REGISTRANT) Apex Biotechnology Corp. CORPORATION TAIWAN 2F No. 1, Innovation Road II Science-BasedIndustrial Park Hsinchu TAIWAN

Attorney ofRecord Janet F. Satterthwaite

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Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "BIOTECHNOLOGY CORP" APART FROM THEMARK AS SHOWN

Descriptionof Mark The mark is not lined for color. The stippling in the mark is a feature of the mark and does not indicate color.

Type ofMark TRADEMARK

Register PRINCIPALAffidavitText SECT 15. SECT 8 (6-YR). SECTION 8(10-YR) 20130430.

Renewal 1ST RENEWAL 20130430Live/DeadIndicator LIVE

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Word Mark APEX DENTAL SENSORSGoods and Services IC 010. US 026 039 044. G & S: Digital sensor used for taking digital dental radiographs. FIRST USE:

20150401. FIRST USE IN COMMERCE: 20150401StandardCharacters ClaimedMark Drawing Code (4) STANDARD CHARACTER MARKSerial Number 86413934Filing Date October 3, 2014Current Basis 1AOriginal Filing Basis 1BPublished forOpposition June 9, 2015

RegistrationNumber 4984112

Registration Date June 21, 2016Owner (REGISTRANT) Masterlink, LLC LIMITED LIABILITY COMPANY ARIZONA Suite 103-501 24654 N. Lake

Pleasant Pkwy Peoria ARIZONA 85383Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "DENTAL SENSORS" APART FROM THE

MARK AS SHOWNType of Mark TRADEMARKRegister PRINCIPALLive/Dead Indicator LIVE

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Word Mark APEX IP FUSION DEVICEGoods andServices

IC 010. US 026 039 044. G & S: Medical devices, namely, intramedullary fusion devices for fusion of theinterphalangeal joints of the hand. FIRST USE: 20130701. FIRST USE IN COMMERCE: 20130701

StandardCharactersClaimedMark DrawingCode (4) STANDARD CHARACTER MARK

Serial Number 85922856Filing Date May 3, 2013Current Basis 1AOriginal FilingBasis 1B

Published forOpposition May 20, 2014

RegistrationNumber 4660373

RegistrationDate December 23, 2014

Owner (REGISTRANT) Extremity Medical LLC LIMITED LIABILITY COMPANY NEW JERSEY 300 Interpace ParkwayParsippany NEW JERSEY 07054

Attorney ofRecord Michael J. Zinna

PriorRegistrations 3652074;3684368;4057095;AND OTHERS

Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "IP FUSION DEVICE" APART FROM THE MARKAS SHOWN

Type of Mark TRADEMARKRegister PRINCIPALLive/Dead LIVE

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Word Mark APEX IP FUSION DEVICEGoods andServices

IC 010. US 026 039 044. G & S: Medical devices, namely, intramedullary fusion devices for fusion of theinterphalangeal joints of the hand. FIRST USE: 20130701. FIRST USE IN COMMERCE: 20130701

MarkDrawingCode

(3) DESIGN PLUS WORDS, LETTERS, AND/OR NUMBERS

DesignSearch Code

02.01.33 - Grotesque men formed by letters, numbers, punctuation or geometric shapes; Stick figures04.07.03 - Geometric figures or combinations of geometric figures representing a person; Geometric figuresrepresenting a person; Geometric shapes forming a person; Person formed by geometric shapes26.01.06 - Circles, semi; Semi-circles26.01.21 - Circles that are totally or partially shaded.26.17.09 - Bands, curved; Bars, curved; Curved line(s), band(s) or bar(s); Lines, curved27.03.01 - Geometric figures forming letters, numerals or punctuation

SerialNumber 85922839

Filing Date May 3, 2013CurrentBasis 1A

OriginalFiling Basis 1B

Published forOpposition May 20, 2014

RegistrationNumber 4660372

RegistrationDate December 23, 2014

Owner (REGISTRANT) Extremity Medical LLC LIMITED LIABILITY COMPANY NEW JERSEY 300 Interpace ParkwayParsippany NEW JERSEY 07054

Attorney ofRecord Michael J. Zinna

Prior 3652074;3684368;4057095;AND OTHERS

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RegistrationsDisclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "IP FUSION DEVICE" APART FROM THE MARK AS

SHOWNDescriptionof Mark

Color is not claimed as a feature of the mark. The mark consists of "APEX" where the "X" is represented as astylized person with a semi-circle above the stylized person and the words "IP FUSION DEVICE" underneath.

Type of Mark TRADEMARKRegister PRINCIPALLive/DeadIndicator LIVE

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Word Mark APEX MASSAGE CHAIRSGoods andServices

IC 010. US 026 039 044. G & S: Massage chairs; handheld massaging apparatus for personal use. FIRSTUSE: 20170101. FIRST USE IN COMMERCE: 20170101

StandardCharactersClaimedMark DrawingCode (4) STANDARD CHARACTER MARK

Serial Number 88229857Filing Date December 14, 2018Current Basis 1AOriginal FilingBasis 1A

Published forOpposition June 4, 2019

Owner (APPLICANT) TITAN CHAIR LLC LIMITED LIABILITY COMPANY TEXAS 1428 Van winkle Dr CarrolltonTEXAS 75007

Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "MASSAGE CHAIRS" APART FROM THEMARK AS SHOWN

Type of Mark TRADEMARKRegister PRINCIPALLive/DeadIndicator LIVE

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Word Mark APEXBIOGoods andServices

IC 005. US 006 018 044 046 051 052. G & S: reagent strips for medical diagnostic use; glucose control solutionfor medical diagnostic use; uric acid control solution for medical diagnostic use; hemoglobin testing agents formedical diagnostic use; cholesterol testing agents for medical diagnostic use; lactic acid testing agents for medicaldiagnostic use. FIRST USE: 20030821. FIRST USE IN COMMERCE: 20040910

IC 010. US 026 039 044. G & S: testing and analytical apparatus for medical diagnostic use; blood uric monitoringapparatus for medical diagnostic use; blood glucose monitoring apparatus for medical use; lancets; hemoglobintesting apparatus for medical diagnostic use; cholesterol testing apparatus for medical diagnostic use; lactic acidtesting apparatus for medical diagnostic use. FIRST USE: 20030821. FIRST USE IN COMMERCE: 20040910

MarkDrawingCode

(5) WORDS, LETTERS, AND/OR NUMBERS IN STYLIZED FORM

SerialNumber 86102910

Filing Date October 28, 2013CurrentBasis 1A

OriginalFiling Basis 1A

Published forOpposition April 15, 2014

RegistrationNumber 4559434

RegistrationDate July 1, 2014

Owner (REGISTRANT) APEX BIOTECHNOLOGY CORPORATION CORPORATION TAIWAN No. 7 Li-Hsin Rd. V,Hsinchu Science Park Hsinchu City TAIWAN

Attorney ofRecord Carlynn Davis

PriorRegistrations 2720410

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Descriptionof Mark Color is not claimed as a feature of the mark. The mark consists of the word "APEXBIO" in stylized bold font.

Type of Mark TRADEMARKRegister PRINCIPALLive/DeadIndicator LIVE

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Word Mark APEXCAREGoods andServices

IC 010. US 026 039 044. G & S: Operating tables; Beds, specially made for medical purposes; Invalids' hoists; Bedcushions for medical purposes; Bed pans; Crutches; Sphygmomanometers; Stethoscopes; Wheeled stretchers;Massage apparatus; Commode chairs for medical purposes; Medical examination tables; Stand for infusionapparatus. FIRST USE: 20110110. FIRST USE IN COMMERCE: 20110110

MarkDrawingCode

(5) WORDS, LETTERS, AND/OR NUMBERS IN STYLIZED FORM

SerialNumber 85302162

Filing Date April 22, 2011CurrentBasis 1A

OriginalFiling Basis 1A

PublishedforOpposition

January 24, 2012

RegistrationNumber 4173874

RegistrationDate July 17, 2012

Owner (REGISTRANT) APEX HEALTH CARE MFG. INC. CORPORATION TAIWAN 1-1, Hu Wei Liao Jhen Bei Village,Min Syong Township Chia Yi County TAIWAN

Attorney ofRecord John Alumit

Descriptionof Mark

Color is not claimed as a feature of the mark. The mark consists of the word "Apexcare" with the letters ''A'' and ''x''in a stylized font.

Type ofMark TRADEMARK

Register PRINCIPAL

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AffidavitText

SECT 8 (6-YR).

Live/DeadIndicator LIVE

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Word Mark APEXLIFTGoods andServices

IC 010. US 026 039 044. G & S: INVALID HOISTS *AND* INVALID LIFTS [ AND INVALID WALKERS ]. FIRSTUSE: 20011225. FIRST USE IN COMMERCE: 20011225

(CANCELLED) IC 011. US 013 021 023 031 034. G & S: [ BIDETS; TOILETS AND PORTABLE TOILETS ].FIRST USE: 20011225. FIRST USE IN COMMERCE: 20011225

Mark DrawingCode (3) DESIGN PLUS WORDS, LETTERS, AND/OR NUMBERS

Design SearchCode

02.01.33 - Grotesque men formed by letters, numbers, punctuation or geometric shapes; Stick figures14.03.25 - Brackets, fixture; Hooks, Utility (hardware); Magnets; Nozzles, hose21.03.07 - Barbell sets; Dumbbells; Exercise bicycles; Exercise machines; Exercise weights; Handgrips,exercise; Rowing machines; Weight lifting machines; Weights, exercise26.01.05 - Circles made of broken or dotted lines

Serial Number 76440071Filing Date August 12, 2002Current Basis 1AOriginal FilingBasis 1A

Published forOpposition February 4, 2003

Change InRegistration CHANGE IN REGISTRATION HAS OCCURRED

RegistrationNumber 2711317

RegistrationDate April 29, 2003

Owner (REGISTRANT) DYNAMIC HEALTHTECH INC. CORPORATION TAIWAN 1F, No. 6, Pao Kao Rd. Hsin TienCity, Taipei TAIWAN 231

(LAST LISTED OWNER) JAEGER INDUSTRIAL CO. LTD. CORPORATION TAIWAN NO. 6, PAO KAO RD.HSIN TIEN CITY, TAIPEI TAIWAN 23144

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AssignmentRecorded

ASSIGNMENT RECORDED

Attorney ofRecord Alan D. Kamrath

Type of Mark TRADEMARKRegister PRINCIPALAffidavit Text PARTIAL SECT 8 (6-YR). SECTION 8(10-YR) 20130624.Renewal 1ST RENEWAL 20130624Live/DeadIndicator LIVE

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Word Mark APEXMVGoods andServices

IC 010. US 026 039 044. G & S: Medical devices for the treatment of incontinence, namely, electrotherapyand biofeedback devices for strengthening pelvic floor muscles

StandardCharactersClaimedMark DrawingCode (4) STANDARD CHARACTER MARK

Serial Number 87952994Filing Date June 7, 2018Current Basis 1BOriginal FilingBasis 1B

Published forOpposition November 6, 2018

Owner (APPLICANT) InControl Medical, LLC LIMITED LIABILITY COMPANY WISCONSIN Suite 250 3225Gateway Road Brookfield WISCONSIN 53045

Attorney ofRecord Richard J. McKenna

PriorRegistrations 4523338

Type of Mark TRADEMARKRegister PRINCIPALLive/DeadIndicator LIVE

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Word Mark REVOLUTION APEXGoods and Services IC 010. US 026 039 044. G & S: medical equipment, namely, computed tomography (CT) apparatusStandard CharactersClaimedMark Drawing Code (4) STANDARD CHARACTER MARKSerial Number 87586210Filing Date August 28, 2017Current Basis 1BOriginal Filing Basis 1BPublished for Opposition December 5, 2017Owner (APPLICANT) General Electric Company CORPORATION NEW YORK 1 River Road Schenectady

NEW YORK 12345Attorney of Record Catherine MennengaType of Mark TRADEMARKRegister PRINCIPALLive/Dead Indicator LIVE

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Word Mark SPINECRAFT APEX SPINE SYSTEMGoods and Services IC 010. US 026 039 044. G & S: Surgical and medical apparatus and instruments for use in spinal surgery.

FIRST USE: 20050805. FIRST USE IN COMMERCE: 20060413Standard CharactersClaimedMark Drawing Code (4) STANDARD CHARACTER MARKSerial Number 86353680Filing Date July 31, 2014Current Basis 1AOriginal Filing Basis 1APublished forOpposition June 30, 2015

Registration Number 4811166InternationalRegistration Number 1254118

Registration Date September 15, 2015Owner (REGISTRANT) SpineCraft, LLC LIMITED LIABILITY COMPANY DELAWARE 777 Oakmont Lane, Suite

200 Westmont ILLINOIS 60559Attorney of Record Alan W. CannonPrior Registrations 4442648;4571074Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "SPINE SYSTEM" APART FROM THE MARK

AS SHOWNType of Mark TRADEMARKRegister PRINCIPALLive/Dead Indicator LIVE

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Word Mark XCELL PRP BY APEX BIOLOGIXGoods andServices

IC 010. US 026 039 044. G & S: Blood containers for medical purposes; Blood component separation apparatus formedical purposes; Blood drawing apparatus; Blood filters; Blood testing apparatus, namely, blood collecting tubes;Blood tubing sets for medical purposes; Medical gloves; Medical syringes; Sterile sheets, surgical; Apparatus fortaking blood; Apparatus for the regeneration of stem cells for medical purposes; Blood collection kit comprised ofblood collection bag, holder for medical sample tubes and vials, and medical sample tubes and vials; Filters forblood and blood components for medical purposes; Medical specimen collection devices in the nature of tubes forthe collection of blood. FIRST USE: 20180201. FIRST USE IN COMMERCE: 20180201

MarkDrawingCode

(3) DESIGN PLUS WORDS, LETTERS, AND/OR NUMBERS

DesignSearchCode

26.17.12 - Angles (geometric) ; Chevrons27.03.01 - Geometric figures forming letters, numerals or punctuation

SerialNumber 87590312

Filing Date August 30, 2017CurrentBasis 1A

OriginalFiling Basis 1B

PublishedforOpposition

February 6, 2018

RegistrationNumber 5623696

RegistrationDate December 4, 2018

Owner (REGISTRANT) APEX Biologix LIMITED LIABILITY COMPANY UTAH 5650 S. Green St. Murray UTAH 84123Attorney ofRecord Christopher Droubay

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Disclaimer NO CLAIM IS MADE TO THE EXCLUSIVE RIGHT TO USE "PRP" APART FROM THE MARK AS SHOWNDescriptionof Mark

Color is not claimed as a feature of the mark. The mark consists of two shapes overlapping each other creating theletter "X". The shape to the right overlaps the shape to the left. The left shape has a gradient from dark at thebottom to lighter at the top. The letters "C", "E", "L", and "L", appear right after the "X" shape. There is then astandard space after the "L" which then continue with the letters "P", "R", "P". All letters are capitalized and thewording "BY APEX BIOLOGIX" is underneath.

Type ofMark TRADEMARK

Register PRINCIPALLive/DeadIndicator LIVE

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6/26/2019 Trademark Electronic Search System (TESS)

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Word Mark YELLOFINS APEXGoods and Services IC 010. US 026 039 044. G & S: Surgical table accessories, namely, stirrupsStandard CharactersClaimedMark Drawing Code (4) STANDARD CHARACTER MARKSerial Number 88218071Filing Date December 5, 2018Current Basis 1BOriginal Filing Basis 1BPublished forOpposition April 23, 2019

Owner (APPLICANT) Allen Medical Systems, Inc. CORPORATION INDIANA 700 State Road 46 EastBatesville INDIANA 47006

Attorney of Record Clay A. TillackPrior Registrations 2480855;2506398Type of Mark TRADEMARKRegister PRINCIPALLive/Dead Indicator LIVE

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