Regulators Propose Banning Theranos Founder from Blood Testing • Hacker News Board

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#191

Post by neurotech1 » Thu, Apr 14, 2016, 5:05 PM UTC

jonnathanson wrote: post #183

neurotech1 wrote: post #158

Earlier quoted context omitted.

IMO The Theranos basic concept is viable, but their implementation is flawed. There have been somewhat recent cases of the SECDEF firing a General or Admiral if a development or acquisition goes awry. The JSF Program Executive Officer, MG David Heinz [0] was one example. I doubt a senior officer would risk a $10Bn acquisition program on unverified technology. Development programs are another story. The Defense Contra…

"IMO The Theranos basic concept is viable, but their implementation is flawed." Can you point to any sources indicating that the basic concept is viable?

There is a market for low cost, minimally invasive lab tests.

Using a smaller needle can be done. A skilled doctor or nurse can use a butterfly needle [0] with a fine tip, and the patient barely notices. As I recall, a 27G needle is about the smallest and not damage the blood cells.

Microfluidic Arrays [1] are one way to carry out some lab tests with smaller samples. What steps are required to get the results from the array would vary between tests.

YC (W16) funded Unima [2] is working on reducing the cost of certain lab tests with paper test strips.

[0] https://en.wikipedia.org/wiki/Winged_infusion_set

[1] https://en.wikipedia.org/wiki/Microfluidics

[2] http://www.unima.com.mx/nsite/index.html

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#192

Post by mathattack » Thu, Apr 14, 2016, 7:21 PM UTC

rzt wrote: post #40

dcgudeman wrote: post #9

The more I read about theranos the more apparent it is that there is something fundamentally wrong with it's core goals, leadership and technology. One easily identifiable red flag is the composition of its board. It's nearly all ex-military and government officials not veteran entrepreneurs and technologists. Just to name a few: George Shultz (former Secretary of State), Sam Nunn and Bill Frist (former U.S. Senators…

In discussion on other HN threads, some commenters suggested that the board was composed that way to grease the wheels of a DoD acquisition of the company's "tech". As OP put it [ https://news.ycombinator.com/item?id=11403165 ]: John the more I think about Theranos the more I think this “mess” is actually deliberate. Looking at the history of Theranos and the composition of the board it appears Theranos was designed…

The plan appeared to be to use their connection and access to some rather “helpful” high brass to offload the technology for billions and then later sweep the fact that it didn’t work under the rug (this tactic has worked fabulously for the last 20 years). Avoid the FDA altogether.

While I'm sure this has happened in weapons technology, can you give an example in Health Care? (Where people deliberately avoided the FDA this way) I know there's a ton of waste in the military, I wasn't aware it spread this wide and deep.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#193

Post by NN88 » Thu, Apr 14, 2016, 7:26 PM UTC

transfire wrote: post #181

My personal opinion is that their technology was too disruptive and would have ultimately undermined too much money making in the industry so it had to be stopped. The whole things smacks too much like a witch hunt. Including the fact that whenever I mention my opinion is gets down voted to oblivion.

I hear you, but it always seemed like snake oil to me considering that we're essentially dealing with physics here on a fundamental level and no amount of trickery using minimization will change any of that.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#194

Post by NN88 » Thu, Apr 14, 2016, 7:29 PM UTC

drcode wrote: post #8

Medical research is in great need of a major shakeup, because I feel like current research models have seriously underperformed in recent years... ...but now that isn't going to happen, primarily because of this debacle. It's so sad that the "keystone cops" at Theranos have done so much damage to the reputation of the medical startup community- Possibly, they've set medical research back by several years with their b…

I hear you, but it always seemed like snake oil to me considering that we're essentially dealing with physics here on a fundamental level and no amount of trickery using minimization will change any of that.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#195

Post by vonmoltke » Thu, Apr 14, 2016, 7:47 PM UTC

shawn-butler wrote: post #154

vonmoltke wrote: post #79

Earlier quoted context omitted.

No, the traditional cab companies do not have to cover this market by law. I am aware of only one cab company in the DFW area (Yellow) that offers wheelchair vans as an option. A quick search shows that there are plenty of cab companies around the US that do not have wheelchair capabilities at all. Also, for the record, small cab companies were allies of Uber here in Dallas.

You are entirely mistaken. It is required my municipal and county code that taxicab companies in Dallas dispatch wheelchair accessible vehicles[0]. The extent to which it is enforced I have no idea but that would be up to consumers to make complaints to the regulatory body. [0]: http://dallascityhall.com/departments/codecompliance/Pages/T...

The exact wording of the code:

"When a wheelchair accessible vehicle is requested, the operating authority must provide a wheelchair accessible vehicle, or cause one to be provided, without unreasonable delay."

Highlighted for emphasis. The cab company does not need to own or operate the vehicle. They just need to make sure the customer is provided with one at the same rate they would charge a customer who did not require one. This is not the same as what was originally stated above.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#196

Post by shawn-butler » Thu, Apr 14, 2016, 10:07 PM UTC

vonmoltke wrote: post #195

shawn-butler wrote: post #154

Earlier quoted context omitted.

You are entirely mistaken. It is required my municipal and county code that taxicab companies in Dallas dispatch wheelchair accessible vehicles[0]. The extent to which it is enforced I have no idea but that would be up to consumers to make complaints to the regulatory body. [0]: http://dallascityhall.com/departments/codecompliance/Pages/T...

The exact wording of the code: "When a wheelchair accessible vehicle is requested, the operating authority must provide a wheelchair accessible vehicle, or cause one to be provided , without unreasonable delay." Highlighted for emphasis. The cab company does not need to own or operate the vehicle. They just need to make sure the customer is provided with one at the same rate they would charge a customer who did not r…

The level of hair-splitting you are engaging in is absurd.

Your exact statement was "No, the traditional cab companies do not have to cover this market by law."

That is simply false.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#197

Post by gozur88 » Thu, Apr 14, 2016, 10:16 PM UTC

dv_dt wrote: post #90

jobu wrote: post #84

Earlier quoted context omitted.

The first part seems probable (sell to the DoD), but intentional fraud is unlikely. Remember Hanlon's Razor - "Never ascribe to malice that which can be explained by incompetence." It seems more likely they were very close on the science, and decided to run with it while they worked out the last 10%. That works great for most tech companies, but healthcare technology is very different.

A simpler theory might be that once the board picked up a couple of members in certain areas, it expanded along the social network of the board.

That's my read on it - the board members probably all know each other, or are friends-of-friends. Just like you and I, corporate board members recommend their friends when positions are open.

It probably doesn't hurt to have people like that on your board when you go looking for funding.

Being on a corporate board has got to be the easiest job in the world. When things are going well you collect a six or seven figure paycheck for doing almost nothing.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#198

Post by danieltillett » Thu, Apr 14, 2016, 10:57 PM UTC

specialist wrote: post #170

danieltillett wrote: post #133

Earlier quoted context omitted.

Tillett’s Razor - ”Never ascribe to incompetence that which can be explained by corruption”

Specialist's Corollary - "To observers, corruption and incompetence are indistinguishable."

Unless you get to see the offshore bank balance.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#199

Post by jonwachob91 » Fri, Apr 15, 2016, 12:11 PM UTC

lmeyerov wrote: post #185

nmrm2 wrote: post #97

Earlier quoted context omitted.

> I thought one of the key ideas of a MVP is that it's something you put in the hands of customers... Internet-type startups, at their core, are about marketing more than they are about technology. Getting the technology right is absolutely no guarantee of success, but you can hack together some PHP and -- if you get the marketing right -- make a shitload of money. Psychology is kinda hard to do rigorously, so you te…

Not true, plenty of biotech startups fail because they believe this. Consider the pharma route. Does it solve something that slots in, or will the process be hard, or maybe they have something close enough that disrupting the pipeline isn't worth it? Many projects don't get into testing, many testing projects don't get purchased, and as generally only one pharma will want to purchase, scale won't be hit (so you're de…

Can you name one that fits your line of thinking?

> Does it solve something that slots in

I'm not sure what you mean by this...

> they have something close enough that disrupting the pipeline isn't worth it

This is another incident of thinking that IT startups are the same as Biotech startups, or any science startup. Marginal increments in IT can be worth BILLIONS, marginal increments in Biotech aren't worth the paper they are printed on (that may be a bit of an exaggeration), and the biggest reason is cost to get into market. IT has low costs if any to enter a market place, except in the rare exceptions where the FCC is involved, the average cost to get a drug to market is something like $500MM and YEARS of regulatory approval. It's not worth investing in a marginal increment, you invest in moonshots and as you collect more data and better understand how the drug performs to either continue to invest (if it remains promising) or shelve it if it only looks marginally better.

While the market analysis needs to happen it is much less rigorous than IT startups. Hey 100,000 people die every year from infections acquired in hospitals, great lemme call around see what hospitals are willing to pay and sell to them. Lets not forget the other 600,000 that acquire infections from hospitals, for which under the Affordable Care Act the hospital has to pay for. Great sounds like I have a business as long as my product doesn't surpass a certain price threshold. In biotech you are either a billion dollars or a bust, there is no in-between because new products cost so much you have to have those high returns.

Not many IT startups NEED $500MM just to get their first sale.

Re: Regulators Propose Banning Theranos Founder from Blood Testing

#200

Post by nmrm2 » Mon, Apr 18, 2016, 12:26 AM UTC

lmeyerov wrote: post #185

nmrm2 wrote: post #97

Earlier quoted context omitted.

> I thought one of the key ideas of a MVP is that it's something you put in the hands of customers... Internet-type startups, at their core, are about marketing more than they are about technology. Getting the technology right is absolutely no guarantee of success, but you can hack together some PHP and -- if you get the marketing right -- make a shitload of money. Psychology is kinda hard to do rigorously, so you te…

Not true, plenty of biotech startups fail because they believe this. Consider the pharma route. Does it solve something that slots in, or will the process be hard, or maybe they have something close enough that disrupting the pipeline isn't worth it? Many projects don't get into testing, many testing projects don't get purchased, and as generally only one pharma will want to purchase, scale won't be hit (so you're de…

> The MVP / market analysis process is different for biotech, but still should happen. It's pretty fascinating!

Right. I think we're all violently agreeing.

Biotech companies do need MVPs and market analysis. My observation is just:

1) The idea of testing product-market fit by building a complete product and putting it out there in uncontrolled settings doesn't really work for a lot of biotech companies. Especially anything that's going to need regulators' approval.

2) Compared with IT startups, Biotech companies are more likely to fail due to having the wrong answer for "but can we make it work?" rather than "is there a market?". So the MVPs optimize for testing former question, which usually means controlled experiments in a lab. There are counter-examples on both sides, I'm sure, just in general.