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Part of me dislikes the title "Blood Unicorn" for being sensationalist, but part of me really likes it for being completely accurate and even a little bit poetic. It kind of feels like all titles should strive for this balance, but I also kind of hate it. I'm sure there's a German word for what I'm feeling!
"Blood Unicorn" is a great name for a metal band, though.
I'm sure there are all sorts of dark actors in the shadows on this one. Holmes is being hung drawn and quartered in public, but there were many other people involved in building up this chimera. The board of directors are an interesting bunch and Ramesh "Sunny" Balwani is a colorful character. Holmes may have been a patsy, who knows... Bloomberg and most other media companies pumped Theranos up for all it was worth,…
Also, the way she compatmentalized her business and threatened former employees proves she was complicit.
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There’s no benefit to doing so; and smaller vials are harder to preserve. Measurements on blood draws are not exact, and pre-measured preservatives in the vials and the blood have to be in the right ratios. This is easier to do consistently in larger vials, reducing the error in this part of the process to acceptable levels. It’s the same reason why a recipe will normally be more consistent when making a larger batch…
Out of curiousity, how tight are the preservative:blood ratios before Bad Things (i.e. things that would invalidate the test results) start to happen?
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Existing analysers already use very small samples. See Siemens Advia 1800 specs under "Microvolume Technology" https://www.healthcare.siemens.com/clinical-chemistry/system... It only uses 30ul of sample to run up to 15 assays. How is that any different from what Theranos was doing? Only difference is that you collect a bigger vial when using the Siemens machine. And then don't use most of it. So why not collect a sma…
There’s no benefit to doing so; and smaller vials are harder to preserve. Measurements on blood draws are not exact, and pre-measured preservatives in the vials and the blood have to be in the right ratios. This is easier to do consistently in larger vials, reducing the error in this part of the process to acceptable levels. It’s the same reason why a recipe will normally be more consistent when making a larger batch…
But, the wording of the parent comment was saying that it was supposedly clearly technically impossible because of the small sample size. The OP said "I just never, ever understood how the sampling rate could ever work" and "and this should've been screamingly obvious to everyone since the beginning." That seems very different from "this is a very hard problem due to X, Y, and Z", especially since commercial machines that everyone here gets blood results from are already only taking small samples from the collected vials so the biggest challenge just seems to be in the collection and transport.
I agree that everything is easier with a bigger collection size, however "hard" is different from impossible.
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Existing analysers already use very small samples. See Siemens Advia 1800 specs under "Microvolume Technology" https://www.healthcare.siemens.com/clinical-chemistry/system... It only uses 30ul of sample to run up to 15 assays. How is that any different from what Theranos was doing? Only difference is that you collect a bigger vial when using the Siemens machine. And then don't use most of it. So why not collect a sma…
There are a few reasons you collect a full vial instead of a tiny one: 1. Multiple tests. Most people aren't going to the doctor for a single test. A majority of the testing is Comprehensive Metabolic Panels, which covers 20-30 different things at least. Many patients get a CMP plus other stuff, so enough is drawn for all the tests at once. 2. Possible retesting. There are dozens of things that can go wrong between d…
1. Ok, so that can still be done with small samples, it's just a matter of collecting enough. The link I gave showed 15 tests in 30ul of sample. So, 60ul would be enough for your 30 tests. The amount used per test (for many many tests) is still very small compared to the amount drawn.
2. I imagine if a tube is dropped and some sample is lost they consider the whole sample lost. Since if sample got out that also means that stuff can get in, possibly contaminating it. The poor customer experience of having to go back in to be re-drawn is a poor business choice, but again, not a technical hurdle with being able to perform tests. Having enough sample for re-testing a week later is also just a matter of collecting sufficient sample. So, you would need 120+ul of sample (from previous example of 30 tests) to meet that requirement (plus some amount for loss in equipment, etc). But, it is still a far cry from the 2000+ul typically drawn.
3. You actually often have more than 2 drawn, since each tube has a different kind (if any) anticoagulant and if they get sent to different labs they may need duplicates of the same anti-coagulant. This also doesn't have anything to do with the size of the sample required for a test. So, you can collect a bunch of small samples instead of bigger samples. That's not a technical hurdle for being able to perform a test on a small volume of blood.
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A Steve Jobs-like ability to live in her own reality distortion field, plus much of the salesmanship, but minus Steve's very acute (not perfect) sense of what currently impossible problems were on the cusp of being solved, creating future practical products. There were two companies that I simply couldn't understand, at all, from media reports in the last couple decades. One was Enron, 'tother Theranos. Turned out th…
Jobs's job was to look at stuff and see what he could sell, and to demand that employees invent more stuff to sell. Holmes' job was to invent stuff on demand. She tried (and failed) at a much harder job.
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If you want completeness, there may be another possibility: we know that venture capitalists (who spend other people's money, for the most part) have used their positions to improve their sex lives (#metoo) contrary to the interests of their investors. It's just assumed none of them have ever actually handed over millions of other people's money to hairbrained projects in order to accomplish this. I very much hope th…
Well, that line of thinking opens up a whole other angle of speculation (and of course that's all it is, so I won't detail it) regarding how events may have unfolded in this debacle.
Granted, I've raised an especially unpleasant possibility (as no more than that), especially for consideration going forward; but fraud from other causes is also unpleasant and has to be considered despite being unpleasant and, according to the article, not necessarily an act of commission. To quote: "But the fact that Theranos was a gigantic fraud doesn't quite mean that it committed fraud." You've considered it, nonetheless, and I think that's reasonable - as speculation.
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If things working out better are predicated on rising tech stars admitting they're wrong and forgoing the accolades and adulation that accompany the identifier... I can see why things went the way they did. That said, from a personal perspective, I honestly hope Ms. Holmes is either a sociopath or was actually in the dark about how bad things were (e.g. her direct reports were lying to her). It seems like it would be…
Yeah, committing fraud is pretty nerve-wracking. Won't anyone think of the con men?
At worst active or passive concealment because they had a large financial incentive that the fraud remain undiscovered.
Given that Theranos didn't IPO, I have a hard time feeling bad for investors (hopefully) taking a loss on this one.
Reading this article, I've had a nagging feeling - ok, the founder may have presented a wrong picture, but isn't it the task of tech journalists to call them on that? I am sure some would always be fooled, but how comes pretty much all of them, according to the article, were fooled? And not by some ingenious heist that takes a genius to unravel, but by buying a device from another company, showing it to journalists a…
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Oh, wow.. Honest question: I know that plea deals and other rather arcane behind-the-scenes agreements are a thing, but as someone who is not all too familiar with the American justice system, is that really the only relevant difference? So, what kept Shkreli from taking a deal?
He thought he could get away with it.