Episode Transcript
[00:00:00] Speaker A: Hey, everyone. Tom Salemi here. Welcome back to Device Talks Weekly. Still getting over my cold a bit, so excuse the gravelly voice, but better than last week for sure. Fantastic episode coming your way. We're going to have as our keynote guest Ramin Mousavi, the CEO of Cathworks. Cathworks would have been a newsmaker any other week, but I was able to speak with Ramin about the company and its acquisition by Medtronic. A great story, not only for patients, not only for investors, but I think also for folks who are leading companies during difficult times and leading companies who maybe have folks who have different perspectives on non medtech matters. So Ermine's an excellent guest. He's a podcaster in his own right and he, I think, brings a real fresh perspective to leadership. So I know you'll enjoy that conversation. Before that, Kayleen Brown, our managing editor, will speak with Girish Naganathan.
[00:00:57] Speaker B: He's.
[00:00:57] Speaker A: He is the Chief Technology officer at Dexcom, so I know you'll enjoy that talk.
And finally, of course, we will kick things off with our Newmarkers newsmakers.
Chris Newmarker was out west this week at the conference that shall not be named, but he of course met with a lot of our great sponsors and we'll have some news not from there, but from the medtech industry. And we'll also talk about state of things in Minnesota. So without any further delay, we'll actually we'll get this podcast started in a moment. I did want to let you know that Device Talks Tuesdays will be kicking off in a couple of weeks. We'll have a couple of weeks. We've got our first sponsored episode. We just finished up our Cardiac Innovations Week. Thanks to everyone who participated in that and to our sponsors of that PSN Labs, Confluent Solesthesis, and Jabil Health.
And our next episode for Device Talks Tuesdays will be on February 24th and it's brought to you by Intertek. And the title is the Convergence of cybersecurity and AI regulatory requirements in medical devices. So go to device talks.com to register for that. All right, let us get this podcast started.
All right, you ready for this?
[00:02:18] Speaker B: Ready.
[00:02:38] Speaker A: Chris Newmarker. How are you, sir?
[00:02:41] Speaker B: Doing well, Tom. Doing well. Back in chilly, snowy Minneapolis after being in Southern California most of the week for a show, I guess we should name it. It's like Voldemort, right?
[00:02:54] Speaker A: Yeah.
[00:02:54] Speaker B: No, name a show that should now be named.
[00:02:57] Speaker A: It's a show that people are aware of, but it's not Device Talks and this is a device Talks weekly podcast.
[00:03:02] Speaker B: Exactly. There we go.
[00:03:04] Speaker A: How is the climate shift? Were you appreciative of the warmer temps in California?
[00:03:11] Speaker B: Man, it kind of like, if you got any lingering cold or whatever, you just get that sunshine and a little bit of he. That goes. That goes right away. So that was a good deal.
[00:03:20] Speaker A: I could use some of that. I could use some of that. And how are things going in Minneapolis, in Minnesota?
[00:03:26] Speaker B: Things are going. I mean, it's, you know, I mean, very tough times. And, you know, like, even living in the suburbs, I mean, you know, the people, you know, just talked to neighbors. Just a lot of frustration, you know, with, you know, with where the Twin Cities are being treated by the federal government right now around here, you know, but I try to grasp for hope in things. And, you know, the one thing, it was interesting when I. When I got back yesterday, we're talking on Friday. I got back yesterday, I'm getting a Uber ride home. Smally, immigrant, you know, and, like, all. All he could just say going on was, like, just like, how amazed he was that people here all came together to protest, even when it was, like, ridiculously cold for people who weren't like them, you know, just because they were part of their community.
And, you know, we just have a strong community here. I mean, he's worried driving around his Uber, you know, like, you know, like, you know, but he said it made him more brave to go out and work for his family, knowing that, you know, people all over here had had his back. You know, that's amazing how you feel.
[00:04:34] Speaker A: I know we have our playful Boston vs. Minnesota rivalry, but I'm wildly impressed with.
With you folks out there and the courage and the stamina and the willingness to brave not only the weather, but also all the other awfulness that goes with it.
[00:04:52] Speaker B: I mean, just even in my own neighborhood, there's someone down the street is volunteering, picking up people, getting released from the federal building, driving them home. I mean, we got people collecting books for families that are staying home, immigrant families, books for their children there. You know, there's, like, charities that have popped up that are delivering food to people's houses. I mean, so just a lot of volunteering, a lot of, you know, people really trying to, you know, stick, you know, stick up for, you know, the more vulnerable members of our community.
[00:05:23] Speaker A: Yep. And it's always, you know, we're careful. I always been careful on LinkedIn not to bring politics into it, but this isn't politics. This is just, I think, decency in support.
[00:05:35] Speaker B: Absolutely.
[00:05:36] Speaker A: So Much respect, much respect for folks out there in Minnesota from.
[00:05:41] Speaker B: I gotta say, Boston stood up for some. Boston stood up for some decency back in 1775. So, I mean, there's some good, good historical examples we're getting, you know, from you Bostonians and weird.
[00:05:54] Speaker A: And there was a video a couple of weeks ago of Boston protests and within it they.
I can't remember the exact chant, but basically I'm saying that we're not afraid because Minnesota made us brave. So we're following your lead and inspired by what you're doing. So we won't talk about this at every podcast, but we haven't really addressed it specifically, so I think it's important.
[00:06:19] Speaker C: Yeah.
[00:06:20] Speaker B: And you know, we've seen like, you know, like, you know, the medical device industry is a large employer here in the Twin Cities. You know, we've seen Medtronic, you know, as, you know, like, I mean, they, I mean, there's a lot of debate whether they really went far enough with the statements, you know, the large companies around here, but at least they were saying, hey, you know, our employees are going through a lot. Can we, you know, settle things down now? Have some more peace around here. And, you know, so, you know, give.
[00:06:46] Speaker A: A, give a shout out to. I think Vensana Capital put out a much more forceful comment.
Forceful in a good way, in a positive way. So credit to those who are willing to, to stand up and, and I think push for the right thing. So.
[00:07:01] Speaker B: Yeah, exactly. Yeah. So, all right, anyway, I guess there is still Medtech news out there to tell everybody. So I guess we can get on, get moving. Like talk about these new markers. New markers. Newsmakers. Oh, yeah. You know, and on a bright side, go Pats. Like, you know, hope they.
Hope I'm not jinxing them right now.
[00:07:22] Speaker A: But thank you to you and thank you to Wayne Patterson for your support of the, of the patri.
[00:07:30] Speaker B: Did Wayne really.
[00:07:31] Speaker D: Did he.
[00:07:31] Speaker C: No, I took it as non sarcastic.
[00:07:37] Speaker A: That's all I heard.
[00:07:38] Speaker B: That's what I. Yeah, that's what I heard too. I just heard. I just go fast.
Oh, gosh.
[00:07:46] Speaker A: All right, what's number five?
[00:07:47] Speaker B: Let's get going.
Number five on the list. We've got, you know, Nina Goodheart, you know, the, you know, senior vice president of, you know, you know, president in charge of a structural heart and aortic at Medtronic. She's going to be, you know, retiring after 20 years at the medtech giant. Just a really known person in the industry and actually just headline a really great women in medtech breakfast that we had device talks in the past.
[00:08:16] Speaker A: She's been a podcast guest, she was on Medtronic talks and she's been a very strong supporter of our Device talks meetings and just a really great human being. So congratulations to her. Absolutely.
[00:08:28] Speaker B: Congrats.
[00:08:29] Speaker A: She started off as a journalist so, you know, she found a way to turn it into a legitimate career. So good for her.
[00:08:36] Speaker B: Yeah, yeah.
[00:08:37] Speaker A: Someday may be the same.
[00:08:39] Speaker B: There we go. Exactly, man. Right? Yeah. Maybe our J degrees will lead us somewhere someday. So I, I think, I think we, we're, we're doing some cool stuff right here. We've, you know, it's, it's, it's been a fun, it's been a fun journey so far, so.
[00:08:53] Speaker A: Yeah. Well, best of luck to Nina Goodhart onto number four.
[00:08:56] Speaker B: Best of luck. Yeah. And number four on the list.
We've got, you know, some, we, we've had some news in the last week or two of Ireland is really becoming a medical device industry hub in Europe. And we've just had some news in the last week or two about even more support for the medtech hub in Ireland. We've got Siemens healthineers unveiling a new center of excellence for immunoassay Instrument R and D in Ireland just north of Dublin.
And we also had news of Medtronic getting a medtech prototyping center, supporting a medtech prototyping center at the University of Galway, which is actually where Medtronic is technically headquartered now.
[00:09:51] Speaker A: That's right. They're not a Minnesota company, they are an Ireland company.
[00:09:56] Speaker B: They're operated out of Minnesota and they're sea. I mean, you know, their CEO lives here, so. But yeah, but yes, they're there for legal reasons, like for some tax advantage reasons. They've got headquarters over Galway.
[00:10:08] Speaker A: So, so Ireland has of course been a medtech hub for decades, but obviously.
And there's been a good deal of innovation there as well. But this is clearly a move more toward company creation, technology creation versus manufacturing and other sort of bigger company efforts. So great news from Siemens Health for.
[00:10:27] Speaker B: The ears, you know, another country that's, I just add like another country that's really, really common to its own, like with, with Medtech. Is Costa Rica at that show I was at this week? I mean there was so there was like a lot of news among that whole contract manufacturing ecosystem exhibiting there about like opening up new facilities in Costa Rica, you know, so. And there was even a big giant Costa Rica booth right in, you know, like right in the midd of the show. Floor. So they're obviously trying to get even more people to get excited about that country, which has great trade benefits, really good education system.
There's a lot of English fluency in Costa Rica, plus really nice place to go ziplining. It's a fun country. I've always been impressed how historically, Costa Rica decades ago abolished their military to pour more money into healthcare and education, which I've always thought was a really cool thing for a. For a country to do. So it's paying, paying off well. And hopefully us talking about it too much won't like, you know, alert like Trump that it exists, you know, because we don't want him to start terrifying the heck out of them. So. But Costa Rica is part of another.
[00:11:44] Speaker C: Don't.
[00:11:45] Speaker B: It's. It's. Yeah, it's part of the United States. Don't worry about it.
[00:11:47] Speaker C: Like. Yeah.
[00:11:49] Speaker B: Are we ruining it right now talking about it?
[00:11:51] Speaker A: Tom, let's just move on to number three.
[00:11:53] Speaker B: Let's just move on. We just better move on. All right.
[00:11:55] Speaker A: Move on.
[00:11:56] Speaker B: Yeah. Just nothing to see here. Nothing to, you know, number three on the list. We had, you know, Stryker's recent fourth quarter earnings covered by our new associate editor, Skyler Rivera. And it was really. Yeah, I know. And when Skylar was listening to the earnings call, like, it was really interesting, you know, I mean, like, Kevin Lobo and the bunch were kind of just talking about it like it was business as usual, because I think they had mentioned it at a previous investment conference, but it was actually news for the general public that they've got a lot of high hopes for a new version of Mako that's a handheld version that they see being used in, especially useful in the ASC ambulatory surgery center space, the Mako rps.
So this will be really interesting to see how this plays out. I mean, Lobo was kind of saying we're using this, the Mako intellectual property to provide some like, you know, haptic feedback boundaries and, you know, give. Give surgeons some, you know, feedback in this more like kind of like, you know, handheld version of the system.
[00:13:08] Speaker A: So I haven't really seen the rps, but just the description of it reminds me of. There's a company about. I think it was acquired by smith and nephew 10 years ago called Blue Belt. That was a handheld surgical robotics, Orthopedics.
[00:13:23] Speaker B: Right. And that became their Corey surgical system that Smith and Nephew.
And it's called robotic because the bur stops if you move the tool outside of whatever the painted.
[00:13:34] Speaker A: So I'm guessing this is different than that, but similar market, I would imagine.
[00:13:39] Speaker B: And again, you want to find out.
[00:13:40] Speaker A: More, it would obviously open up opportunities in the ASC market for them where a smaller profile footprint is always beneficial.
[00:13:48] Speaker B: Definitely.
[00:13:49] Speaker A: So strong, strong move by Stryker.
[00:13:53] Speaker B: Yeah, very exciting. And then number two on the list, we've got Boston Scientific, you know, street beating Q4 sales overall up 16%.
But its stock was down this week because the analysts attributed the stock going down to electrophysiology.
Kind of this Farah pulse watchman combo that's just been so dynamic for Boston Scientific just not being, you know, not, not, not growing as, as, as much.
[00:14:34] Speaker A: As dominant as it has been in the past.
[00:14:36] Speaker B: Right, exactly. Yeah. Yeah. So, you know, and I kind of like couple that in my head with, you know, Medtronics, you know, earnings call where they were just talking about a Farah roaring forward for them. So yeah, it looks like there, there's some competition going on. I mean, Boston Scientific's been kind of, you know, kind of like the big, the big player in PFA with Farah Paul so far. But yeah, we're, we're seeing some competition.
[00:14:59] Speaker A: Yep. No competition is good. And actually competition will be, I think an element of number one as well. But it only stands to reason with all these pulse field ablation programs out there that there's going to continue to be pressure. And of course we had Steven Michelson of Field Medical on our Cardiac Innovation series this week talking about their new technology and they actually had unveiled yesterday something Field Medical had presented some late breaking clinical trial data yesterday at the AF symposium here in Boston.
But they're really pushing their new technology as sort of the next generation for pulse field ablation. So innovation never stops.
[00:15:42] Speaker B: Innovation never stops. And getting more competition.
Fantastic. So, I mean, we'll see.
This will be really fun to see how this continues to evolve like as the years, as things progress.
And then number one on the list, really interesting. Our senior editor Sean Hulley covered this news.
This is Friday. This news just came out today.
But I first wrote about this lawsuit back in 2023.
It was filed by Applied Medical Resources, which they're a privately held company.
I've just noticed they're not generally covered as much, but they're based in California actually. We get their annual revenue from them every year for our MedTech Big 100 report. And they came in at 76 on the list. Last year they had $875 million in revenue.
Not a tiny company.
They sued Medtronic for antitrust.
They went against the biggest medical device company in the Saying, hey, you're monopolizing US Market competition for advanced bipolar devices that are used to cut tissues and seal blood vessels. And a federal jury now in California has agreed with Applied Medical and they're saying that Medtronic needs to pay $382 million.
So like a Medtronic lost an antitrust case here and they're saying they're going to appeal. But yeah, it's like a legal win for this much smaller company.
[00:17:31] Speaker A: Yeah, it's interesting issue within MedTech. I mean, bundling. I don't think bundling is illegal and in fact, I think it's talked about as a strategy for companies like Intuitive and jj. When they get their robotic system, they'll be able to more easily sell their surgical robotics. I'm sorry, their surgical devices because they have a surgical robotics system. So the implication being that there'll be some sort of bundling with that.
And it also seems to me that lower cost is sort of what the healthcare systems are after.
So they would benefit from this sort of packaging. So I don't know, it's an interesting question as to whether this is whether this will hold up in appeal or not. I mean, the other thing with MedTech is you would think that if your device is superior to the other device and has a better clinical outcome, that the price is almost secondary, not naive. But if your device is better and allows people to heal faster and cost less, that your device would be chosen. So if underpricing like that really has an impact, it's just an interesting question. I think bundling is a big part of MedTech. So we're going to see how this plays out.
[00:18:46] Speaker B: Yeah, because I mean there actually have been, we've now been covering a number of cases involving big med tech, skinning, inclusive anti trust over like some kind of bundling, you know, and some of some they're winning, some they're losing some. I mean the, the primary legal concept that I'm seeing behind all these is tying the idea that, you know, if it's antitrust, if you force customers to buy a less desired product because they're not going to have access to a very desired product or product that you have, you know, if they don't, you know, you know, also buy product they don't like as much. So, I mean, I think, you know. Well, yeah, it's going to be interesting. I mean the jury.
Jury. I mean the jury agreed with Applied Medical, but yeah, now as this goes to appeal, I think I suspect a lot of the stuff you're going to See in appeal is like did you know was this federal court in court for California really, you know, really, really like kind of, you know, accurately going with the precedent on what tying is, you know, with those types of cases. So yeah, we'll keep on following this. This will be another one to keep track of over a mass device.
[00:20:01] Speaker A: Absolutely. All right. Well, Chris Newmark are great newsmakers and of course if folks want to catch up on that D&D Mr. Conference or whatever it's called, I can never remember the name they can go to Metal Design and Outsourcing. I know you and Jim Hammer and were out there and Skylar Rivera are out there at the conference covering some of our great sponsors and happy to share the news from our great sponsors. Happy to see on your pages at Mass device and design and outsourcing and people should also what should they do? What's the best way of getting the medtech news from those two great publications?
[00:20:38] Speaker B: Get a like follow and subscribe. So get going.
[00:20:41] Speaker A: That's right. Subscribe to your newsletters, right?
[00:20:43] Speaker B: That's right.
[00:20:44] Speaker A: So lots of news coming from all different areas.
[00:20:47] Speaker B: Yeah, we've got daily newsletters coming from mass device. So like yeah, get subscribed to our mass device plus 5. Then we got our BI weekly MDO newsletters that give you good technological deep dives. So.
[00:20:58] Speaker A: All right, Chris Newmarker, great job as always.
[00:21:01] Speaker B: Good always. And since it'd be incredibly depressing as a Vikings fan to see Sam Darnold lead the Seahawks to victory.
Go Pats.
[00:21:09] Speaker A: We will take whatever we can get. Apparently we're the underdog.
[00:21:12] Speaker B: I know. Oh yeah, I like an underdog. Yeah, make sure you get your underdog.
[00:21:17] Speaker A: Make sure you get your pick into the company super bowl prediction contest.
[00:21:22] Speaker B: Oh yeah, there we go. Yeah, I want to get that free lunch.
[00:21:24] Speaker A: Free lunch, baby.
[00:21:25] Speaker C: Woo hoo.
[00:21:27] Speaker B: There we go. All right, have a good one, Tom.
[00:21:30] Speaker A: All right, thanks again, Chris Newmarker for this week's newsmakers. Now we'll begin our FOMO interview led by managing editor Kayleen Brown.
[00:21:47] Speaker E: Girish Naganathan, CTO of Dexcom. Welcome to the future of Medtech opportunities. Thank you so much for joining me.
[00:21:54] Speaker D: Great to be here, Kayleen.
[00:21:55] Speaker E: I have so many questions that I want to ask, but I'm going to start with my favorite topic, artificial intelligence. So what drew you specifically to generative AI and glucose biosensing? Can you help us understand your background? What brought you to where you are today?
[00:22:12] Speaker D: Glucose biosensing is tremendously insightful to patients and consumers that are trying to manage their health and take control of their glucose.
But data can also be overwhelming as glucose biosensing is impacted by food, activity, sleep, stress, medication, and even social situations. And when you start combining all this information, you want a synthetic input to give you a clear insight. There are many companies, many products that's available that provides data in numbers, but that could be overwhelming. But Dexcom has taken a nudge, not judge, an approach where it combines and uses generative AI as a way to bring in synthetically all this information as an action and empowers the patients to take control of their own health.
[00:23:07] Speaker E: Do you have a personal interest in generative AI? Is there a passion behind that?
[00:23:12] Speaker D: My passion is about using data. And when you give data, it starts to help people to understand what is truly happening. And when you give data with insights, it becomes even more valuable, that it's more actionable and it starts to change the behavior. For me, changing behavior is the most important thing. I have my mother, who's a type 2 diabetic, and my wife, who's type 2 diabetic at home, and both of them are users of G7.
And we see that when they are eating certain types of food that their blood sugar rises. The impact of activity, all that information, they can now start to see in one place. And that's a personal thing for me.
[00:23:55] Speaker E: It's amazing.
My father has.
He's passed now, but he had type 2 diabetes, and we were told when I was only 12. I'm 40 now. Had I had this potential back then, I think it would have. I know. Not even. I think. I know it would have changed the way that we approached his diabetes management. I think it would have made us feel more in control, which is so important. And to your point, it would really change that behavior because he would have had the data to support it and we would have understood it because we didn't really understand what it is. So what you're doing really matters.
[00:24:30] Speaker D: Yeah. Thank you so much. That's the most important thing. It's fulfilling and rewarding because you're impacting patient lives and you're impacting lives of people and your family, your friends and your colleagues. And that's very fulfilling and rewarding. And I get emails and notes on LinkedIn thinking in terms of how their nephew was saved or their niece was able to go to school again, all kinds of things. That's very rewarding.
[00:24:58] Speaker E: This really is the best industry in the world. I say it all the time, but just. It just is the meaningful impact. Is everything all right? Enough about Us, let's, let's kind of, let's, let's paint a picture.
So what are the current challenges when it does come to diabetes management?
[00:25:16] Speaker D: Behavior change is a single biggest thing and it's really hard to change behaviors.
When you start providing people with data, you are laying the first brick of the foundation to change behavior.
But then you add more insights to the data, you give them more actionable insights, then you have a very high chance of changing behaviors.
This is the most difficult challenge that we have in terms of diabetes management.
Generative AI comes in in these circumstances where you go from a reactive management with data. You go to your primary care physician or your medical checkup and you have feedback from there and you try to adapt your new lifestyle, you make your choices and try to affect your health outcomes at the same time.
Continuous glucose monitoring with generative AI can give you real time insights, takes you from a reactive management to a proactive management.
But just like in everything else, with a new technology, we take a crawl, walk, run approach where we have started very small, to give people weekly insights. Eventually we could imagine us giving daily insights, hourly insights, so that people can change their behavior. Put the data, like I said before, nudge, not judge.
[00:26:40] Speaker E: I love that.
It's an old statement, but I think it's very applicable. Knowledge is power.
[00:26:45] Speaker D: That's right.
[00:26:46] Speaker E: I think it goes back to what I was saying about my father. Had we had this knowledge, we would have approached it very differently.
His interactions with his clinician. He would get information that wasn't disseminated to us, so we didn't know how to support him. So if that information can come in the way that you're displaying it, crawl, walk, run, then I think it would have been, instead of this individual story, it would have been a family effort to help support again. That goes back to what we're talking about as meaningful. That matters.
You wouldn't think 10 years ago to have this conversation that I would say that data could be so meaningful to life.
[00:27:26] Speaker D: That's right.
[00:27:28] Speaker E: So let's talk about what led to the creation of your solution.
[00:27:35] Speaker C: What?
[00:27:36] Speaker E: We understand the need, we understand the challenges, but can you talk us through the technical aspects?
[00:27:41] Speaker D: The need was we were serving type 1 patients that were on insulin and type 2 patients that were on insulin. But then we asked ourselves the question, what about the millions of adults who are trying to improve their metabolic health or type 2 patients that are not on insulin? And that's what conceived us to get a product called stelo that we launched last August, FDA approved and first over the counter biosensing product for glucose monitoring. So this is something you could buy from Amazon.com and you don't need a prescription for it.
Having introduced that product, we started getting tremendously, overwhelmingly positive feedback and we said how do we make the consumers lives even better?
And that's where we started introducing glucose biosensing with generative AI. And with generative AI we could personalize it and personalize it at scale.
A solution could be specific for you to give the activity and sleep and food that you've had and what it means to you for you. Glucose levels would be very different for me and we could provide those types of insights.
The messaging is also crafted and it's very encouraging, very empathetic, very optimistic and it's, it's adaptive based on how much of exercise you've had at that week or how much of sleep you've had at that previous day. And by combining these things it becomes very personal, very, very unique to you.
[00:29:15] Speaker E: Really caught my attention, was adaptive. So I understand personalized. We've been trying to get to personalized medicine for decades, but adaptive. That's so interesting. Did you go into, you and your team go into the build with this idea that it would be adapted to the how much exercise you did or.
[00:29:35] Speaker C: What food you're eating?
[00:29:36] Speaker E: Was that always part of the concept?
[00:29:37] Speaker D: We tried to combine different pieces of information.
I could have walked 5,000 steps a day on an average this week and 8,000 steps a day the previous week. I want different messages to me when I change my behavior and that's what I mean by adaptive.
[00:29:56] Speaker E: All right, so let's take us into the future. If we were to look at the future of Dexcom in the next, let's call it five years and if everything goes right, everything continues to go right. And again, I'm not gonna hold you to this, but what could the future of Dexcom look like and how would that impact medtech industry?
[00:30:14] Speaker D: Biosensing is tremendously powerful and today we are talking about glucose biosensing. Five years from now we might be talking about other analytes, other types of biosensing that could happen.
You're going to see a lot more proliferation of the ecosystems and partnerships, connecting to other connected devices, other solutions and bringing a hoard of information back at the fingertips of the patient or the consumer. That's going to make them very powerful and generative AI is going to be even more evolving, it's going to become more sophisticated, more reasoning engines built into it where it can combine different pieces of data real time to provide inputs. It can also connect the patient with the provider and the provider has access to real time information that they can change your care plan adaptively based on the real time data.
These are the kinds of progress that we see in the next three to five years.
But more importantly, overall in medtech you might find with generative AI becoming more and more powerful, you might find companies or organizations or startups that are trying to invent the next biggest thing using generative AI in either in the pharma or the med tech industry and bring it back into their design processes.
[00:31:41] Speaker E: What a hopeful future.
Thank you so much for sharing your time and your insights inspiring me. Thank you for joining us on our FOMO series and Device Hacks Weekly. I have had a terrific time.
[00:31:53] Speaker D: Thank you so much. Thank you so much for having me.
[00:32:01] Speaker A: All right, thank you Girish Nagarnathan for joining us on fomo. Now it's time for our keynote interview. Once again I had the great pleasure of speaking with Ramin Mousavi. He is the CEO of CathWorks.
Well, Ramin Mousavi, welcome to the podcast.
[00:32:18] Speaker C: Thanks Tom, thanks for having me on.
[00:32:19] Speaker A: Thanks for hopping on so soon after your big news this this week, exciting acquisition news that Medtronic is acquiring your company Cathworks after an investment partnership that I want to unpack.
But first I'd love to learn a little bit more about you and your path to Cathworks and to MedTech. So how did you find your way into the medtech industry?
[00:32:42] Speaker C: You know, I, at some point in life I was an engineer. It's been too long that if I claim I'm an engineer, my R and D team would be really mad.
But I spent the beginning of my career in actually high tech and aerospace. So not in Medtech. And when I went to grad school, my grad school is here in Southern California. It's five minutes from the headquarter of this small company called Edwards Life Sciences.
And so, you know, I drove by it every day dreaming that that's where I would one day work. As luck had it, I was lucky in grad school. One day I had a chance to listen to the former chairman and CEO of Edwards Microsoft give a talk. And exactly 21 minutes into it, a life changing event, I turned next to a cohort friend of mine in the program. His name is Tim Patz. He's not by president of bd, spunoff of Edwards. And I said I want to go work for that guy. He worked at Edwards, you know. So my path to Medtech started with this dream come true of going to Edwards, working and then I spent the following decade there. Amazing, amazing experience.
After having had chance to play a role in launching Transcatter, Hard Valve and other transformative technology in the U.S.
one of the key opinion leaders involved in a matter when they reached out to me and asked if I ever considered doing a startup. And the truth is there are people who, you know, you hear that, oh, there were eight, they had a lemonade stand and they were entrepreneur. That was not me. I had mapped my career to its final stages 37 different ways, all at Edwards, you know, so he gave me the courage of, hey, take a risk and say you're young enough. What's the worst that could happen? If it fails, which most likely you will, then you go back to a large company, you know. So that's how I ended up at cabworks. I came here and you know, it's been a fun eight years being here. I've had a small sabbatical during COVID where I became the leader of what become digital and patient monitoring division for Baxter. But I came back to cafars and I've been at Cafworth and born in Tehran, Iran, which, you know, most of the times not in a good way these days, left when I was 16, I came to the States. The reason I share that is I am a proud Iranian American leading an Israeli founded company, you know, which is by itself a whole different thing. And up until yesterday's announcement. And in these jobs you try to keep your internal opinions to yourself. As you know, last few years been challenging for Israel as well.
So yesterday I made a conscious decision. I'll share how I feel about this. And I've never been more proud of leading my team and my people in Israel. You know, an amazing group there. It's an amazing group of people.
So that's how I end up at this venture we call Catherine.
[00:36:09] Speaker A: That's quite a ride. So a few things I want to unpack. Do you recall exactly what was it that Mike Musallim shared that made you decide you wanted to move to Edwards? I mean, the Edwards campus is lovely, so driving by that I could see wanting to work there just for that, just for the cafeteria itself is appealing enough. But what was it that Mike shared that resonated with you?
[00:36:30] Speaker C: Well, Listen, back in 2008, the cafeteria didn't look like that.
There was no transportation, kind of hard map. It was mostly like this big startup spawning out of out of Baxter.
You know, they had just found a way back to profit Great point. I. I remember exactly what he said, because remember this is pre taber days. And he was talking about the reason that he believed spinning Edwards out of Baxter was a good idea.
And he basically talked about this notion that the most probable way he said changing healthcare is difficult. The most probable way you can impact changing medicine is through innovation.
And people talk about helping patients. Hopefully that's one of the drivers for most of us who are in medtech. But as he articulated that, I feel like I have goosebumps. I'm saying it now.
I had this out of body experience of that's a calling for something you do in your career. And at that moment it dawned on me. We just had our firstborn, was now 17 at the time, and I'm like, oh my God. Looking back at your career, you want to have a reason. You want to be able to say, I did something. And I'm like, this guy has a purpose. I want to go. And I'm so lucky because at some point towards my end of time, I had a chance to interact with him a lot more.
Once in a lifetime, generational leaders that, you know, you can continue to try to emulate for the rest of your career. So that's what he said. And he changed my life. So I'm a Musalam fan between now and end of life forever because of that.
[00:38:22] Speaker A: That's a pretty big fan club.
What about the moment of leaving the safety of the ship and starting your company? That's something that, that we talk a lot about here in the podcast.
You're never sure what you're going to, what the right path is. What was it that tipped the scales for you to decide to go out on your own?
[00:38:44] Speaker C: I was super lucky that in my tenure at Edwards, I touched this Transformative technologies, seeing them change, create categories.
Smart people had come up with ideas that could change a category. When you're part of that, you get to experience this thing that kind of stays with you. And I was at the point where it was really hard to repeat that experience. You know, it's like, how do you top that? How do you, you know, how do I get to do this again? And it doesn't feel like it's boring. And, and it wasn't. It should for me, that was. And so it wasn't one of, as I mentioned, it wasn't one of those, like, oh, you know, what's my next job that I want to do? I wanted to have an impact. And when I heard the vision behind Cathworks was transforming routine X rays to get a comprehensive view of the heart.
It felt to me like one of those improbable things that if you ever get to do it, you're going to change patient care. In fact, later on, when we rewrote the mission for Cat Force, we made the mission to partner with physicians to transform how cardiovascular disease is diagnosed and treated. A really bold mission for a startup. So that's what it was. But to be real, because the only things I love about your podcast is that you created this Howard Stern thing that you do that you get people to get vulnerable, and then that becomes the thing that you want to listen. Oh, they said that this is the truth as. As creative idea was as I left. And I was so lucky that even on my way out, I was treated so well at Edwards.
When I packed the last bits of things that I had left in my office and I left my office for the last time, the moment I got to my car and I closed the car door and switched it, I went into a panic attack. Is the only time in my life I've had panic attack. I know it, because then I looked it up to see what is it that I experienced. It was a panic attack. So for 45 minutes, I cried. Really unstoppable.
[00:41:09] Speaker A: Really.
I can understand that for sure.
[00:41:11] Speaker C: This rush down on me of, what have I done?
I was so lucky. Given this decade of opportunities, most of the time, I didn't deserve.
Why? Why? Like, it just. It. I couldn't control it. 45 minutes. I was actually later on thinking that if somebody saw me in the parking lot, they probably. If there's a video with somebody, they're like, oh, this poor guy got fired, probably so. So it didn't. It didn't. It was that moment, you know, but when I came here, you know, I felt like, we're gonna try to apply all the learnings, and boy, what a journey it's been.
[00:41:48] Speaker A: That's amazing. I mean, you could have changed your mind right after the 46 minute, maybe go back inside and say, forgot about this. What am I, crazy?
[00:41:57] Speaker C: You know, I think that they would have been gracious enough that they would. The leaders there have always been so good to me.
But, you know, at that moment, I'm like, okay, we are part committed to this. Let's out of it.
[00:42:09] Speaker A: That's amazing. The final thing I wanted to revisit, just your lineage, your. Your family's heritage, your leadership team. I mean, you were leading a team of folks with complex backgrounds, and I don't think you're alone in that especially these days in this country where folks are working side by side with others who have different opinions.
How did you sort of make sure that folks stayed on mission and that they, you know, cooperation was primary, but also that that differences were respected. Did you ever sort of figure that out? Because I'm sure others would love to know how you did it.
[00:42:47] Speaker C: Yeah, you know, it's funny, as part of the kind of getting on board at catworks, I remember asking the founders, you know, we have three co founders in Israel. I was speaking to one of them, I wanted to make sure he realizes I was born in Iran. I'm like, like, are we good with that? You know, I'm an American, but are we good with that? You know, and I remember like he, it was, it was a call at 11pm my time, 9am his time. And he kind of looked at me, he was like, yeah, so what? You know, and it was just like, to me, it was like one of those amazing things you hear, it's like, okay, all right, we good? Like this is not his priority. So, you know, here's. I tell you, similar to other companies, we have a diverse group of people across the globe that we have rallied people around a common mission that I just told you, I can tell you that every single person that we have in our team cares deeply about that mission of helping patients because otherwise there are easier jobs that probably pay as much or better for them to do.
That has been the unifying factor because whenever we are in encourage difference of opinions. But whenever we are at a strong disagreement, we go back into what is the best thing to do for patients and that solves the disagreements. Now there's another human element of what you said. I think our story, if I can add my part saying my story cat works actually is the very microchasm we need in a world that our agreements and alignments are far more than our disagreements. I think we live in this world that people tend to zero in on the one or two things that we can never agree and then that becomes our defining things. And then sadly we move from disagreements to it's black and white, good and bad. So if I don't agree with you on something because you don't agree with me, you're a bad person. I think an Iranian born American leading a team of Israelis. And I can tell you this, not only they embraced me and I've embraced them personally, but when things have been difficult and things have been geopolitically challenging, at least for those two countries to be able to stick Together tells you that as humans we just need to make the choice to find a way to have a dialogue. There's a human thing. I tell you the number of times we're where this personal thing has happened, where somebody in our team and you know, luckily sometimes I've done that, has reached out to the other side, say, hey, are you good with what's happening? And I was just like, you know, that goes a long way. It goes a long way for me. You know, it has built such a belief in me that we could do well together as people. So, you know, I hope we do better as a society. And I do think that we in Medtech, in healthcare, because of that common cause of rallying around, doing what we can do to help physicians who help patients, we can have that common cause that can rise above all the other disagreements.
[00:46:05] Speaker A: I hope so. I hope so as well. And obviously there's a lot going on in this country where division is possible and one of them is in Minnesota where Medtech is the major industry. So hopefully it'll be the unifying mission, will help smooth things out and help us find a broader path forward.
That would be ideal.
Great thoughts. So let's unpack Cathworks a bit. So what was the problem that Cathworks was created to solve?
[00:46:33] Speaker C: So well known fact number one cause of death around the globe is Cardiovascular driven death.
18 million sadly globally as of last year die off of this. About a million people in the US last year.
When you look at the contributor and by the way, that is more than the other two causes combined. So more deadly than any other cancer. You know, that's out there.
When you look at the different contributors to the cardiovascular related deaths, the largest part of the pie, about 43% it's coronary artery disease.
This very simple concept that a blockage gets formed in your arteries that bring blood to your heart.
As a result of it, a patient will end up having basically a heart attack and very deadly. We all know someone that we heard that so and so was so young and they just had a heart attack or they had a heart attack out of nowhere. The reality is that that's not the case. It's not out of nowhere it builds up and then becomes very deadly.
Unfortunately dad, as well known as it is, and despite the fact that there are fantastic clinical evidence, high quality A level 1A in the guidelines, evidence to be able to detect coronary artery disease because of the limitations of the current technologies, they are invasive, basically technologies invasive wires or catheters that have to go Inside the heart, they require other sort of drugs that needs to be administered. They impose risk, they only provide limited information and they don't always work very well.
Only two out of five patients get any sort of diagnosis.
So the unmet need was can you find a innovative technology solution that can fit within the current workflow that can be a better alternative that well vetted and clinically evaluated invasive coronary physiology that is not really well adopted and utilized? You know, that was the vision behind now. It sounded crazy when the founders of Capra thought about this idea of taking routine basically X rays and giving you a comprehensive understanding of the coronary artery disease. But that was the problem that we've been going after.
[00:49:13] Speaker A: Basically what part of the body are you looking at specifically? Is it the whole system or is it the arteries around the heart specifically where are we looking?
[00:49:20] Speaker C: So we take three routine X ray of the entire heart and then we use basically geometry to build a full, in fact cathros, the only technology that builds a true multivessel view of the left and right side of the heart, the true heart. So we looked at the entirety of the arteries across the heart that goes and basically leads into a potential coronary artery disease.
[00:49:49] Speaker A: And how does that compare? I mean there's what cardiac there, there's CT scans, cardiac scoring out there that's being done. Now.
Does this fall in line with that or where, where does it fit in, in with that?
[00:50:01] Speaker C: Yeah, they're, they're very complimentary. I think in our world there is a movement, as you can see, around CT driven physiology led by heart flow, you know, and others that are following that pathway.
The CT models is complementary to what we do. So if you think about a patient journey, CT is targeted in becoming a much better alternative to nuclear medicine and stress echo outside of the lab lab as a screening tool that will eliminate the patients that shouldn't come to the lab because they don't have the disease from coming to the lab. And now if you carry that forward, when a patient comes to the lab, one of the very first things that takes place is the physicians take angiogram and we work off of an angiogram. It's meant to be an intra procedural device inside the cath lab. I always get this question, people say, as that market grows, does that pose a risk we actually see as a very complementary thing? In my ideal world, every patient receives a ct. So none of the patients who shouldn't be inside the lab will be in the lab. Because again, if you zoom out, if it was my family Member, I don't want to go inside the cath lab if they don't have to take the cath lab and then if that happens when they come to the cath lab, we will provide, you know, an intra procedural solution. No, there's a main difference. By doing what we do off of angiography, we provide a real time solution that can be used within the workflow. So it takes just a couple of minutes to do a kafworks analysis. So unlike the CT solutions that have to be sent to a cloud and somebody manually has to do them and takes a few hours to send them back, this happens, you take the shots. And most of the times actually at this stage of our technology, by the time somebody takes the left shots, we are done with the analysis while they're doing the right hand side image.
So immediately, not only you see the full comprehensive physiology view, we now have augmented the technology by adding additional workflow related a suite of tools that allows the physician, for example, to be able to virtually look at the sizing of the PCI that will be optimal for a patient. And what is the burden of the impact of the blockage if it went away? And so we give them a virtual pullback curve so you don't have to pull a catheter wire back inside the artery, risking a dissection. So we kind of focus on that workflow, which I think has been one of the key reasons why the technology has been utilized more and more in the last few years.
[00:52:59] Speaker A: So what is the origin of the company and the technology? How is this first devised and then we can sort of move forward again as to how it's being used?
[00:53:07] Speaker C: Yeah, I mean it was found in Israel. One of the co founders, a world renowned inertia cardiologist named Professor Rand Karnowski, a brilliant mind. The other two co founders, you know, collaborated with him with expertise in computer vision and a background in dad. And basically it started with a bad case that required an invasive wire and it took a long, long time to do the invasive wire. And the thought was there's gotta be a better way that we can do that. That's where it started, you know, within the workflow. It was founded. Now we have transformed the technology. So we had a first run at Kafworks back in 18:20.18, 2019, right when we got FDA approval that a great validation study showed a high diagnostic accuracy when you compared it to invasive wire. But you had to do it manually. You had to draw these arteries. You know, you would take the three images and you had to Draw the orders in each of the images manually before you formed it. It would take 21, 22 minutes to do that. And so we, like in most of the startups, failed very bad at that loss because the feedback was, listen, the concept is really cool. No way we're going to spend 22 minutes in a lab letting somebody do a Picasso while we're waiting.
So we had to go back to the drawing board and add artificial intelligence as a way to automate that space. So take that version of 22 minutes and then bring it to the version that I'm selling you now.
It's down to about two minutes and it is about 95% automated. You know, some user confirmation of decisions by the machine, but most of it is done automatically.
[00:55:01] Speaker A: And how. And the findings are used, how exactly are they used as mapping for. For treatment or.
Yep, mapping for treatment.
[00:55:09] Speaker C: So this is being used inside the lab. You know, we shared, I think a little bit earlier this year that over 100,000 patients have been helped by this globally. It's being used for diagnosing and treat the patient.
So both in real time inside the lab, they use it to diagnose whether the disease is there, and more and more routinely being used by inertial cardiologists to also plan their treatment. So not only knowing that they have to treat, but finding the right size stent and where they want to put the stent. So fitting well within the workflow.
[00:55:48] Speaker A: Interesting.
So how did the company, once you got the. So when did the AI sort of come into place? And what does that mean? That, I mean, you don't go on the shelf and buy an AI bot and just throw it in there.
How did you begin to incorporate that technology?
[00:56:06] Speaker C: Yeah, so for us, the AI part is kind of a path to survival because I told you, we failed and tried to launch the product. So we have a choice. And it's a whole different story. But, you know, the company came very close to not existing, so. Well, how are we going to. How are we going to solve this? And there's this other thing happened in the world of time called Covid, so you can really launch new products at that time Anyway, so our technical team thought about, well, we use images, you know, so that's a data set that you have, that.
When you have a data set and you're trying to automate something, how can you do that? They thought about creation of these neural networks, that basically automated processor, rather than the same concept of what a end user would do manually. We've trained a machine to do that automatically. So that's how it does it. It takes the three images, uses a series of neural networks to be able to organize them and detect the traces and basically your main vessels and side branches in the artery. And then we use a proprietary algorithm, a validated algorithm that basically it's called a resistance model. Think about it this way. Once we build that 3D model, we convert the heart to an electrical circuit. We take all, pull the nodes and we treat them like your electrical circuit and we calculate basically how much resistance are in each of the nodes and we convert that to a visualization of the blockage. So that's how it works. You know, it's a. It's a pretty genius actually a way of doing it.
Removing the need for the invasive wire, the drugs and all the stuff that goes. So it's better for the patient and it gives more information to the physician. Solutions.
[00:58:01] Speaker A: How did you envision that this would be, that you would sell this? Were you going to sell directly to hospitals? Did you envision working so closely with a medtech company? What was the plan?
[00:58:13] Speaker C: So, a couple of things.
We have been very lucky as a startup that we've had multiple strategics.
Medtronic obviously well known at this point. And since Mike Minot made it public yesterday, Abby, now J and J, another one and a third one, which I really appreciate their investments. I've been investors in capital, so we've been very close to strategics. Having spent all of my career up until that point at a strategic, I was one of those less ambitious guys who, I don't believe the world needs one more sales channel. I think in the cath lab, if you go to any cat lab around the globe, especially in the U.S. you have sales reps waiting to get their five minutes minutes. You know, in the break room, it's 90% sales reps, 10% hospital staff. So I believe that if the technology was ready, you would go to somebody who already has a global reach. Because there are two things, Tom. It's money, but it's also the time that it takes to get that expertise. Even if you gave a startup all the money in the world, which nobody ever does, the time that it takes for you to go find the similar level of expertise and hire them, convince them to come to work for your nobody company and then train them, is value loss.
One more thing that I believed, and it turned out to be a great commonality between us and the leadership at Medtronic was ultimately the physicians want to treat the patient. Their job is to treat the patient we're providing, I think the Porsche of diagnosing CAD inside the Cath lab. But then the second after they know they have a disease in that patient, they have to decide to treat them. And finding the right partner who had a portfolio of therapeutic solutions to how to treat that patient was the only way to take this from diagnosis to treatment treatment because really they didn't have much of a business on the treatment side. So that was the vision. And that's by the way why we entered into the structured partnership that we entered with Medtronic. Because in Medtronic we found a partner that has the brand, the legacy, the mission, the commitment to this space.
They love and thrive off of innovation.
But they already had the existing channel and a big part of our deal. So the strategic partnership that we did with Medtronic in 2022 had different elements into it. Medtronic has been a minority investor in cappers since 2018, but as part of the deal that we did in 2022, so they believed in this. And I'm going to come back to this in a second because I think there's a credit due to the business development team of Metronik in that regard. But the structure deal was that they invested in Catworx in a non dilutive setting. So our current investors like that idea and we did the best of both worlds. The money invested in Catworx empowered us to put our heads down and innovate and generate clinical evidence which takes money and time but as a startup you can do it faster and cheaper.
And co promotion where we got access to this vast global, you know, world class channel where the technology was approved in the us, Japan and Europe and we co promoted together and the 100,000 patients that I said would have been impossible to do as a startup. So yeah, this was kind of part of the view that we have. Some would say maybe that's not aspirational enough because you don't want to build something on its own. I always believe this will be better within somebody else's portfolio and that's around me west.
[01:02:04] Speaker A: So Medtronic was an investor in 2018 before the incorporation of the LLM and then they came back and sort of liked what they saw with the revision and recommitted. Is that how things shaped up?
[01:02:17] Speaker C: So I'm glad you went there because it allows me to give credit to Medtronic business development team and specifically Chris Isso, who's now the head of business development for entire Medtronic. At the time he led the cardiovascular PD in 2018, Chris along, he brought our largest investors, Deerfield, you know, Andrew Albert, the CEO of Deerfield, to lead a round of investment. So he saw a potential in this technology before it was ever commercialized. And when we went and failed at the first attempt of bringing this to market, Chris provided and his team provided us some unsolicited feedback, which I hated at the time, about what needs to happen with the technology. They want to talk to customers. And that was, by the way, same feedback we got from the customers. I just didn't like that we were getting the feedback.
[01:03:08] Speaker A: It doesn't matter who said it, you didn't like it.
[01:03:10] Speaker C: But we did take his feedback to heart. So the development of AI and addition of it was to address those limitations. You know, now we brought this back and this is where the credit I want to give credit. He saw the vision at the beginning. We came back to them, I went back to them saying, hey, we listen to you. This is what we have done. And I think this is where in any deal that needs to go successful, we found an unbelievable partner in the president of Medtronic coronary renal derivation business, Jason Weidman, who was willing to take the risk with a technology that had failed.
We came back and said, listen, we took the feedback you gave us. This is what we have done.
And they said, okay, let's go try it together and see, you know, so we tried to bring it to market in a limited format and get customer feedback. And then after they saw the same thing that we saw, which was the same improvement that we were all hoping for, we worked together to develop the deal that we have done. I say this because as somebody who runs a startup, there's always this mistake for us. You know, in a startup world level, how do you get, you know, strategics to be, you know, involved and can you really trust what they tell you? You know, like the BD teams, they're playing games because, you know, at this, I can tell you in this experience that I've had and in other strategics that I've been involved with Baxter, this has been similar. You know, that if you really listen to what they're telling you, they're telling you what they need to see before they can go the next level, you know, and we got really lucky that we got both look at key leaders in Medtronic to be willing to take the risk.
[01:04:57] Speaker A: And you mentioned you had a few other strategics investors as well.
After 2022, was it clear that it was kind of Medtronic or bust or Were you still playing as an independent and going to where the best opportunity would be?
[01:05:11] Speaker C: Listen, in 2022, when we chose this deal, we could have sold Cathworks.
We had other deals that we had on our hand that we could have chosen.
We made a conscious decision to choose Metro Electronic. And the reason for that was as much of an improvement as we had made at a time we were still in very early commercial days.
And having experienced this on the strategic side, one of the most common things that happens to great technologies when they get acquired by larger companies is that there's a period of oh, there are other things that's wrong with the product that you still have to fix and there's no good established process for the business model.
These are a lot of disruptions to inject into a sort of when you acquire and most of the times you lose the people and then things fall apart and the technology never fulfills its true promise because it wasn't quite ready. The vision that our investors and our board had and the reason we chose Medtronic, we talk about trust a lot is that we believe, I think together that the structure of this deal will give both parties the commitment needed to have a skin in the game and will give us time to bring it to a place where it will have a much higher chance of becoming a standard of care. And it did. You know, we took a company that was very early, early stage. When I say early early, like a tiny, tiny microscopic revenue to a company that to state the exact wording of the press release it says immaterial to current fiscal year and neutral to accretive going forward for Medtronics. So we did well on that. 100,000 patients talks about the range and I can tell you we have done nine product releases as a result of this partnership. I think fair to say that only a startup can do that and we now have close to 5,000 patients in body of clinical evidence for this technology. We took it from one impressive validation study, FAST ffr.
It was really, really good. Now we have five separate validation studies. We have clinical outcomes in global registry, you know that we ran, we did a randomized control trial called Provision in Japan last year and we showed clinical outcomes being non inferior carrier to current gold standard wire based ffr. And there are now two late breaking presentations planned. One at CRT that will look at Medicare patients for the first time for FFRN, Geo vs Wire and I think last week the American College of Cardiology announced that on March 29th the results of our large 2000 patients randomized controlled trial called ORAD size will be presented as a late breaker. So. So you know, we've done a lot of things that you couldn't do if you went and just handed to someone else. So this is why we chose Medtronic and once we did that, I mean, you know, you, you keep having conversations. I think as a, as a management team of startups, you, you got to keep in touch. And I had three of them in my cap table so I can't really stop talking to them. But the commitment has been too with Medtronic to get this deal done. So we didn't go in our own island. For the last 42 months we have dealt with each other every day. Even in the days we didn't want to deal with each other.
[01:08:52] Speaker A: That's great. Talking about bringing different people together. Final question.
Your comments got me thinking. As a startup CEO, is there a struggle or a tension between.
You want to get this life saving product into the hands of as people as quickly as possible.
But I also want to build a cool big company.
Is there a conflict there? Do you have to give up one for the other? Do you have to say we're going to sell now because we want this to reach more people or do they sort of go hand in hand?
[01:09:25] Speaker C: Yeah, there is.
The two of them most of the times conflict with each other. Right.
I think you can be bold and I think, you know, my tracking says I'm actually a bold person but an aspirational try to build something, you know, you feel like if I control it, I can do it the way I want to do it.
[01:09:45] Speaker A: Right.
[01:09:45] Speaker C: Versus handing it someone else. I think it's different from one technology to another. But at the end of the day, when it comes down to if you have something that is proven the fastest way to be able to get this to as many patients global, globally is true an established setting. It's not always easy to find the right partner who shares your vision because you wanted to carry it the way you want to think about it.
I would say two things. One, we are lucky that I can speak at least to the cardiovascular, which is where I spent all my career. There are a number of strategics with a track record that they would do that. So it's not like there's a shortage of strategics who can do that. That's number one. As is specific Catwoman. I have very high confidence and hope for the leadership that Medtronic has in the space. They've demonstrated the willingness and the boldness to invest in this route that we want to go and I'm hoping that actually the digital platform that cappers can become in actually creates door to for other things that we couldn't do as a startup. You know, they can maybe take this to other places beyond its current vertical that feels needs, you know, different, you know, parts of their business that we couldn't do on our own. But it is, it is a choice you have to make and you have to choose one over another because they are very different. Building a an enterprise takes more time and money and risk. You know, when you bring in I think sometimes as a CEO of metro backed companies, the one thing that we forget is a very basic concept that the VC backed companies require an equity exit of some sort, you know, to get the money back to the investors. You know, there was a fund has a time people want their money back.
[01:11:39] Speaker A: Yep, absolutely. That's the primary driver Ravine. It's a great story and I'm so glad you could join us on the podcast. Congratulations and thanks for for being with us today.
[01:11:49] Speaker C: Tom, thanks so much for having me and big fan of your program and thank you for highlighting the key things that matter in our space space.
[01:12:00] Speaker A: All right, well that is a wrap. Thanks so much for joining us on this episode of the Device Talks Weekly podcast. Love to have you at our future Device Talks meetings Device Talks Minnesota on May 4th Device Talks Boston on May 27th and 28th. Go to device talks.com to find conference pages for both. You can register to attend them there, to attend them there. And of course make sure you sign up for our upcoming Device Talks Tuesdays feature featuring Intertek that's happening on February 24th. Please connect with all of us on LinkedIn. Connect with me, Connect with Kayleen Brown, Connect with Chris Newmarker. Make sure you follow Mass Device and device talks on LinkedIn and of course, of course, of course. If you haven't already, please subscribe to the Device Talks Podcast network.
And I don't often ask this, but please do give us a ranking. Let folks know what you enjoy about it. It does help other folks folks find the podcasts that we're putting out, including Device Talks Weekly and of course Kayleen Brown's Women in Medtech podcast series. All right folks, thanks so much for joining us on this episode of the Device Talks Weekly podcast.
