What Now, Medical Device Entrepreneurs?

Years ago, new medical device companies were often formed by a small group of people who came up with an idea for a new concept and started the company by working on it nights and weekends in someone’s garage. Often, this new company had little or no real financial backing other than the money that the founders were able to put into it themselves from their own savings.

The product concept would be developed evenings and weekends to a point where it could then be shown to investors, often individuals, who would put up meager amounts, relative to today’s standards, of money to take it to the next level. Then, venture capitalists or other larger firms would step in and fund the later stages of the development.

The rewards for the entrepreneurs were sometimes quite large because so little capital went into the company at the start and their ownership percentage was so great. As time passed and both entrepreneurs and angel investors made large amounts of money for their early efforts and risks, venture capitalists realized that, if they were to step in earlier, they could take larger shares of these new companies for smaller amounts of cash. This enabled them to make bigger financial returns, as well as have better control over the trajectory and management of these companies.

So, venture capital firms started funding entrepreneurs at even earlier stages, providing enough funds to pay the entrepreneurs a full- time salary while working at the startup. New companies were often even started in venture capital offices by entrepreneurs with the venture firm providing the space and office support that would otherwise rob needed cash from the creative development efforts. Sometimes these entrepreneurs started the company with no real product in mind, except the desire to seek out and find a large market with a substantial clinical need. This position is presently referred to as an “entrepreneur in residence” within the venture capital firm.

Eventually, venture firms even went so far as to fund “incubator” companies with a small group of salaried entrepreneurs and enough capital to take an as yet undefined concept to a level where it would be fully funded by them and perhaps one or more additional venture capital firm. These incubator companies would then spawn one or more companies using the seed funds provided to them. As might be expected, this all served to accelerate the formation of companies and sped up the early stage growth of the ones that were funded in this way, a real boon to the entrepreneurs and investors alike.

Of course, it wasn’t all roses. The early bite taken by venture firms cut into the founders’ equity and the larger amounts of early money made those same entrepreneurs less cautious about how they spent their cash. It put a premium on speed. The result was

Author: Clif Alferness

Clif Alferness is the co-founder of six medical device companies that have collectively raised more than $300 million. Alferness is a director of Spiration and Calibra Medical. He is the inventor of the Acorn Cardiac Support device and founded Acorn Cardiovascular, Inc. Mr. Alferness also was a co-founder of InControl, Inc., which developed and patented technology for atrial defibrillation. Mr. Alferness has 35 years of research and development experience in the medical device industry, including management positions at InControl, Inc., Physio-Control Corporation, and Medtronic. He is the author of numerous scientific papers and holds more than 70 issued U.S. patents for medical devices. He is also a co-founder of Cardiac Dimensions Inc., Archus Orthopedics Inc., and EndoGastric Solutions, Inc.