As originally asked by Giovanni Lauricella.

Startups are not perfect, but they are the primary catalyst for driving groundbreaking technology. There is always a compromise between a smooth running, “safe” company vs day-to-day changing atmosphere of a company that may change the world.

With that being said, when you have a creative company that is trying to work within the confines of the FDA, available capital, and an ever-changing market there are always “hindsight” mistakes. Mistakes that could have saved the company millions, brought the product to market more quickly, or kept the doors open a little longer in order to have a real chance to survive the obstacles.

In your opinion from experience, what are your top THREE mistakes that startups make that could act as advise for the industry moving forward?

Dr. Ramanan Lakshminarayanan
Chief Technology Officer at Sahajanand Medical Technologies and Founder of RAISE and RICE
Dear John Strupat, Chris, Bill and Many Learned Colleagues – Some of major points are

1. Failure of collective leadership .

2. Decisions on subjects, on which one is not competent

3. Not going to the market early, after successful protos & trials

IP and all other things stated by our learned friends will automatically will fall in place.

I think from my experience & learning from successful organisations in India like TVS, Reliance etc., any start-up should venture as a sole Proprietary company first & lead by a leader so that organization aligns to the traits of the Leader / owner.

William (Bill) Hulbig
50+ Years; Serial Entrepreneur, Founder, CEO and Former Super Angel Creating Quality Deal Flow
Christopher, I agree and like to add most start-up don’t seek help for one or more of these reasons
– don’t know they need it
– don’t think they need it
– don’t want it
– stupidity

Chris Hardwick
YouTube Creator at Chris Hardwick Animal Adventures
Ramanan,
Great comment, I see this almost everywhere I go, I’ve seen too much pride, ego, jealousy, etc. that drives decisions that are bad for the company as a whole. You really don’t see the impact until you get down the road when the company, department, or group folds… I think the key to solving this problem is a leader with a strong vision who can see every aspect of the company and is willing to make the difficult decisions needed to correct the problem. I’ve seen directors hired just to come in and find the problem people and fire them, sometimes a necessary evil, and a very difficult job as well.

Dr. Ramanan Lakshminarayanan
Chief Technology Officer at Sahajanand Medical Technologies and Founder of RAISE and RICE
Hello Chris – Personal Interest over People

An example: A Leader who does not share in a transparent manner with other partners and drives his own vested interests, instead of collective decision that benefits organization & people – Be it in recruitment, investment, funding etc. and in similar policy decisions.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
I have exhibited to show a new product and judge interest and all-in-all, it is an extremely low cost option to reach a very high number of well placed customers, in less than a week.

A number of now large products started about a decade & a half ago in a small 8 foot booth at MD&M, Like Alaris which later sold to Cardinal.

Jagu Barot
Design & Development Engineer, Quality Engineer, Manufacturing/Project Engineer
William, I have been to several of them.

Burrell (Bo) Clawson
I research patents & design products to get a patented competitive position: Over 30 patents.
MD&M is a must. Anaheim fills every hall and part of the underground parking. It is so large that if you are going to see all the half dozen product areas in the show, you need 3 days to cover it. I have not missed a show since the 1990s.

The new products, processes, materials, coatings, automation, etc. are simply invaluable if you are in product conception, design or manufacturing.

William (Bill) Hulbig
50+ Years; Serial Entrepreneur, Founder, CEO and Former Super Angel Creating Quality Deal Flow
Do you go to MD&M shows? As visitors? As exhibitors?

Jagu Barot
Design & Development Engineer, Quality Engineer, Manufacturing/Project Engineer
William, you are so darn right. The marketing (going to the shows, advertisements, handing out videos, literature, samples, training the sales staff, distribution, and the biggest headache in the developing world is collection). Never assume the doctors or the hospitals will pay you per agreements even though they mint money. It is very tricky. There is no brand loyalty in the developing world. Remember the customers are the businesses first, and they love to do business with your money rather than go to the banks to borrow.

Chris Hardwick
YouTube Creator at Chris Hardwick Animal Adventures
Ramanan, what do you mean by ‘personal interest over people’? Can you explain that a little? Thanks.

William (Bill) Hulbig
50+ Years; Serial Entrepreneur, Founder, CEO and Former Super Angel Creating Quality Deal Flow
Ramanan, large OEMs told us when I was CEO at MicroGroup that ‘time-to-market’ determined the market leader. What it takes to first to market involves every aspect of any business.

There’s an old saying ‘You only have to be good, not great, to win if you’re first’.

Dr. Ramanan Lakshminarayanan
Chief Technology Officer at Sahajanand Medical Technologies and Founder of RAISE and RICE
1. Not Getting into market quickly with 1 or 2 Products that are successful in clinical to stabilise the product to get the market feed back and to make a revenue for running the business

2. Increasing too many variants of the product and investing on their R&D like proto etc., before stabilising 1 or 2

3. Personal Interest over people / organizations interest

John Strupat
President, JST Limited
Matt, could you expand on the “how” of your first and last suggestions?

Who should a medical device developer partner with and how do you make that happen?
A definition of “partner” would help me follow along.
Would seem that the potential for partnering are very dependent on the end customer or the decision maker, so do you suggest inviting a physician or nurse to join the company?

How can a medical device developer finance and publish anything safely before the product is actually on the market?

William (Bill) Hulbig
50+ Years; Serial Entrepreneur, Founder, CEO and Former Super Angel Creating Quality Deal Flow
Excellent! POOR PREPARATION IS #1 CAUSE FOR FAILURE

Matt Tyler
Platform Architect at ResMed
In my experience, failure to partner closely with at least two and no more than three customers or end users during product development results in unsuccessful ventures. Some startups I’ve work with developed only a single partnership and that led to a product unsuitable for the market. Other startups I’ve worked with partnered with too many customers and were unable to satisfy any of them.

My second piece of advice if you’re engaging in a competitive marketplace is to know what your competition doesn’t know. Position your product to satisfy a new regulation, especially in overseas markets, when you know your competition will be caught off-guard.

My final advice, which works in any market, is to finance and publish research and educational material related to the clinical aspects of the product your developing. It is very likely that clinicians may be unaware of the problems you’re trying to solve. Education and awareness motivates others to take action.

William (Bill) Hulbig
50+ Years; Serial Entrepreneur, Founder, CEO and Former Super Angel Creating Quality Deal Flow
Evan Friedman made this great point on Discussion: Why Can’t I Get My Start-Up Funded?

“I think the new start-up is actually the old “Early Stage” to which my response was “I’m preaching that entrepreneurs must a plan to build ‘viable businesses’ they can quasi-equity finance.”

William (Bill) Hulbig
50+ Years; Serial Entrepreneur, Founder, CEO and Former Super Angel Creating Quality Deal Flow
I’ve was in the medical device industry for 40+ years producing producing prototype components for about 10,000 companies. These observations only pertain to the medical device industry.

#1 Started by engineers who lacked the skills and desire to be a CEO, but loved the technical side of the business
#2 Grossly underestimated cost and time to market
#3 Thought they were the only game in town

As David says… “Failure comes faster to smaller companies, under capitalized companies and start-ups.”

Chris Hardwick
YouTube Creator at Chris Hardwick Animal Adventures
Here’s my three cents:

1) Lack of funding!

2) Hire the right people! Never hire your friends unless they are the right person. It’s very difficult or most times impossible to fire your friends if you need to.

3) DIVERSIFY! I’ve known several people that have had lead roles in startups that have failed. Coming back to the table with a new company they decided on backup plans, such as one or two ‘backup’ devices that are on the back burner in the R&D department. If the ‘baby’ fails you try to get funding for the step children. For example, three devices in one small startup has three times the chances of succeeding compared to a single device. Put most of your effort towards your main device, but if things get tough you have a couple backup plans!

David W Bertoni
Managing Partner at [email protected] LLC
The same mistake that sinks medical device start-ups is made by the largest medical device companies (and, business in general). Big companies make big mistakes, but have other profitable business units to fund those mistakes. The one mistake that is always fatal is not listening to the market and not making course corrections soon enough.

Failure comes faster to smaller companies, under capitalized companies and start-ups.

Alison Keutgen
Sr. Product Marketing Specialist at Steelcase
Do we have to pick just three??
A few that stand out to me: 1- lack of thorough market analysis (includes key segments such as, defining the need and competitive analysis), 2 – the notion that because there is initial interest, the product will sell itself, 3 – lack of thorough business planning (budget planning, what is it going to take to really get this product launched successfully? and furthermore, how are we going to define success?).