## Facts

- N.A.D., Inc. sought registration of **NARKOMED** for “anesthesia machines for use in surgery,” claiming first use in 1972 and filing in 1980.
- The USPTO refused registration under **Lanham Act § 2(d), 15 U.S.C. § 1052(d)** based on two prior registrations owned by Narco Scientific:
  - **NARCO MEDICAL SERVICES** for rental/leasing of hospital and surgical equipment and related consultation services.
  - **NARCO** (and design) for various medical devices, including “apparatus for administration of anesthesia.”
- The examining attorney and the Trademark Trial and Appeal Board (TTAB) treated the anesthesia-related goods as overlapping and viewed the services as closely related within the medical equipment field.
- N.A.D. and Narco Scientific executed a **consent agreement** in which the registrant consented to N.A.D.’s use and registration of **NARKOMED** for N.A.D.’s anesthesia machines.
- The TTAB affirmed the refusal, giving limited weight to the consent agreement and finding likely confusion notwithstanding purchaser sophistication and the high cost of the goods.
- N.A.D. appealed to the Federal Circuit.

## Issues

1. Whether registration of **NARKOMED** should be refused under **§ 2(d)** as likely to cause confusion with **NARCO** and **NARCO MEDICAL SERVICES**.
2. What weight the USPTO and TTAB must give a negotiated **consent agreement** between sophisticated trademark owners in the likelihood-of-confusion analysis.
3. Whether purchaser sophistication and the nature and cost of specialized medical equipment materially reduce the likelihood of confusion on these facts.

## Decision

- The Federal Circuit **reversed** the TTAB’s decision and set aside the § 2(d) refusal.
- The court held that the Board gave **insufficient weight** to the parties’ consent agreement and did not adequately account for the marketplace context.
- Considering the consent agreement and the conditions of purchase for specialized medical equipment, the record did not support a finding of likely confusion barring registration.

## Legal Principles

- Likelihood of confusion under **§ 2(d)** is determined case-by-case based on the full set of relevant facts.
- A **reasoned, arm’s-length consent agreement** between sophisticated parties is strong evidence that confusion is unlikely and should be given substantial weight absent persuasive reasons to disregard it.
- The USPTO should not impose rigid, extra-statutory formal requirements that effectively nullify a consent agreement where the agreement reasonably addresses confusion concerns.
- Purchaser sophistication and careful purchasing conditions for complex, high-cost goods can materially reduce the risk of confusion and must be meaningfully evaluated in the § 2(d) analysis.

## Conclusion

The Federal Circuit permitted registration of **NARKOMED** for anesthesia machines, holding that a detailed consent agreement between the applicant and the owner of cited registrations, together with the sophisticated purchasing context for expensive medical equipment, outweighed the asserted likelihood of confusion under § 2(d).


In re N.A.D., Inc., 754 F.2d 996 (Fed. Cir. 1985)