Is it enough to simply found a company in another country and refuse to distribute within U.S. territories, or are there additional measures that need to be taken to disqualify oneself from U.S. patent enforcement?
Yes, but <i>only</i> if you're transacting <i>any</i> sort of business in the US. Under US law:<p>"whoever without authority makes, uses, offers to sell, or sells any patented invention, within the United States, or imports into the United States any patented invention during the term of the patent therefor, infringes the patent"<p><a href="http://www.uspto.gov/web/offices/pac/mpep/documents/appxl_35_U_S_C_271.htm" rel="nofollow">http://www.uspto.gov/web/offices/pac/mpep/documents/appxl_35...</a>
It's a similar challenge to that of getting out from under the FDA. (See:<p><a href="http://www.opencures.org" rel="nofollow">http://www.opencures.org</a><p>). So you might look at the medical tourism industry for pointers as to how to organize and grow markets and communities aimed at accomplishing this goal.