Medsider: Learn from Medtech and Healthtech Founders and CEOs - How to Build a Community of Investors: Interview with Pirouette Medical CEO Conor Cullinane

Episode Date: July 10, 2024

In this episode of Medsider Radio, we had a fun chat with Conor Cullinane, co-founder and CEO of Pirouette Medical. The company, founded by three rocket scientists, is developing a low-profile, disc-shaped injector designed to deliver medicines as easily as pushing a button.  Conor studied Aeronautical Engineering at Clarkson University and graduated with minors in Biomedical Engineering and Mathematics, followed by his PhD in Medical Engineering & Medical Physics at MIT and Harvard Medical School. He is also a mentor for Field X at Harvard Business School and a NASA Space Technology Research Fellow.In this interview, Conor shares learnings from launching a community fundraising round, insights on selective innovation, identifying different value propositions for diverse stakeholders, and building strong investor relationships.Before we dive into the discussion, I wanted to mention a few things:First, if you’re into learning from medical device and health technology founders and CEOs, and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.Second, if you want to peek behind the curtain of the world's most successful startups, you should consider a Medsider premium membership. You’ll learn the strategies and tactics that founders and CEOs use to build and grow companies like Silk Road Medical, AliveCor, Shockwave Medical, and hundreds more!We recently introduced some fantastic additions exclusively for Medsider premium members, including playbooks, which are curated collections of our top Medsider interviews on key topics like capital fundraising and risk mitigation, and a curated investor database to help you discover your next medical device or health technology investor!In addition to the entire back catalog of Medsider interviews over the past decade, premium members also get a copy of every volume of Medsider Mentors at no additional cost, including the latest Medsider Mentors Volume VI. If you’re interested, go to medsider.com/subscribe to learn more.Lastly, if you'd rather read than listen, here's a link to the full interview with Conor Cullinane.

The biggest learning for me and the biggest excitement with the community round is every time somebody invests, there's a little box on that investment where they get to put in information about why they're investing. You know, and some folks, you know, don't say anything, but a lot of them do. And it's been so exciting for me and rewarding for me to read through those comments and just hear the stories about, you know, family members and, like, loved ones and even folks themselves who see how they could use our technology. Welcome to Medsider, where you can learn from the brightest founders and CEOs in medical devices and health technology. Join tens of thousands of ambitious doers as we unpack the insights, tactics, and secrets behind the most successful life science startups in the world. Now here's your host, Scott Nelson.

Hey, everyone, it's Scott. In this episode of MedSider, I sat down with Connor Coloning, co-founder, and CEO of Pirouet Medical. Connor obtained a BS in aeronautical engineering from Clarkson University with minors in biomedical engineering and mathematics, followed by his PhD in medical engineering and medical physics at MIT and Harvard Medical School. Here a few of the key things that we discussed in this conversation. First, be selective with where you innovate. Disrupt where it matters most, but don't reinvent the wheel unnecessarily.

By aligning with established practices, you can streamline your development processes, reduce costs and ultimately leave room for creative freedom where it counts. Second, although less common in MedTech, community fundraising rounds may offer benefits like brand awareness and direct engagement with potential end users. View all investors as valued partners to foster a strong community around your product and make sure to maintain open and consistent communication with all of your financial supporters. Third, everyone in the healthcare supply chain from payers to providers needs a reason to choose your product.

To successfully launch a medical device, it's crucial to understand. understand the needs of all stakeholders involved and don't assume anything. Talk to your potential audience directly regardless of the role or level of expertise. Before we jump into this episode, I wanted to let you know that the latest edition of MedSiter Mentors is now live. We just published Volume 6, which summarizes the key learnings from the most popular interviews over the last several months with incredible entrepreneurs like Dan Rose, former CEO of Limfloe, Dr. Stephen Michelson, founder of Ferapulse, and current CEO of Field Medical and other leaders of some of the hottest startups in the space. Look, it's tough to listen or read every Medsider interview that

comes out, even the best ones. But there are so many valuable lessons you can pick up from the founders and CEOs that join our program. So that's why we decided to create Medsider mentors. It's the easiest way for you to learn from the world's best medical device and health technology entrepreneurs in one central place. To check out the latest volume, head over to medsider radio.com forward slash mentors. Premium members get free access to all past and future volumes. And if you're not a premium member yet, you should definitely consider signing up. In addition to every volume of Medsider mentors, you'll get full access to the entire library of interviews dating back to 2010. You'll also be able to see all of our playbooks, which are thematically handpicked collections of the most insightful interviews covering topics like capital fundraising, early stage development, regulatory challenges, reimbursement, M&A, and much more.

And last, considering that fundraising could be one of the most daunting tasks for any startup, we curated a database of over 700 VC funds, private equity firms, angel groups, and more, all eager to invest in medical device and health technology startups. Access to this database is a premium member exclusive, so don't miss out. Learn more about Medsider Mentors and our premium memberships by visiting MedsiderRadio.com forward slash mentors. All right, without further ado, let's jump right into the interview. All right, Connor, welcome to Medsider Radio. Appreciate you coming on. Oh, absolutely.

Thank you for having me. Yeah, looking forward to the discussion. But let's start at the top. I'm looking at your LinkedIn profile right now in front of me. And you've got an incredibly impressive background, right? I feel like I'm talking to the Ironman himself. Background, right? MIT, the NASA, obviously co-founder and running Piroet, but I'd like to hear it in your own

works, right? Without going sort of line by line, so to speak, on your resume, give us a high-level sense where you've been leading up to co-founding the company. Yeah, I think the broad strokes are, I grew up in southern New Hampshire, about a mile from a grass strip airfield and basically just watched airplanes fly by my window all summer long. And that kind of sparked an interest in aviation. and I started into that space by flying RC airplanes and moved up to flying real airplanes and went to and get my undergrad degree in aeronautical engineering. But I still always had a love for human health. And so I minored in biomedical engineering.

And then when I received my PhD in medical engineering and medical physics, and it was really focused on health care innovation. But at the same time, I still concentrated in aeronautics and astronautics. And I was in a specialized training program for bioastronautics. So yeah, it was always the combination of aerospace and human health. And that really ended up bringing me to designing me and working on spacesuits at NASA. And I think the big common thread that I've always followed is very tightly coupled mechanical systems with the human body. But I think the thing that I always think about that has allowed me to follow that path where I've done a lot of

what I would think are really cool and interesting things. Is that all always ask myself, is this going to be awesome? And if the answer is yes, then I do it. And that's really the only decision making that I look at. I love that framework. I'm trying to remember where I first heard. I think it was on a 10 Ferris podcast, like way back of the day. But it's the guy, it's the founder, Derek Sivers.

Do you know Derek at all? Have you familiar with him? No. Yeah, he's the founder of CD Baby. And he's more of, I don't even know what he does anymore, like a philosopher, or entrepreneur type of guy. But he had a little bit of a similar framework where it was like, If I approach decisions, if it's not a hell yes, then I don't do it in that sense.

Yeah. I love the fact that clearly you're an extremely sharp guy, that that simple framework sounds like it's been, it's held a lot of value, right? As you traversed, traversed various fields, if you will. With that said, let's talk. We'll go back in time and learn a little bit more about your journey with Pierrette. But give us a sense for kind of what the quick push is, maybe frame this up as if I'm in high school. I have no idea what you guys are doing. And maybe layer in kind of how it differs from, you know, what most people may be familiar with.

in the Epipen. Yeah, absolutely. So at its base form, just starting from the beginning, injectable medicine is the realm in which we work. So thinking about drugs that have to be delivered via an injection. And traditionally, thinking all the way back to the first technology there, you had the standard syringe. And that still exists today with a few minor innovations. But it started with a syringe. And then there was this thought process of how do we make this easier for folks in certain situations like emergency use where you're out in a non-clinical setting. So auto injectors were developed and they were basically a bunch of plastic around a syringe and essentially automating that injection process. But unfortunately, they didn't really

achieve the true objective that they were, that they set out to achieve, which was really making it foolproof and easy for folks to use. So that's really where we focused on our technology to start. We basically said we're not going to just make an iteration of something that has existed in the past. We're going to start with a blank sheet of paper, or in our case, in almost all instances, a blank whiteboard, and draw up a delivery system that we personally would want to use. And so what we ended up coming up with is, as you had indicated, the quick push technology, is a low profile disc-shaped injector, which a few have experience with auto-injectors of any kind. They're typically pen-shaped, long six-inch long pens, and you swing and stab those against

the injection site. We tried to make performing an injection as simple as pushing a button, and I liken it to hearing the Staples Easy button to the injection site and pushing it down, and that's really the core of our technology. Does it make that sound too? No, it doesn't, but typically the end user will say, that once they've used it. Yeah, that's cool.

I'm looking at the site now. It's pirouetmedical.com. We'll link to it in the full write-up on Medsider, but it's just for everyone listening. If you don't get to that full write-up, it's D-I-R-O-U-E-T-E, Medical.com, as you think it would be spelled, pirouet and medical.com. Really interesting and cool technology. Before we get any further, though, you're at NASA, right? And then basically, in LinkedIn profile, it looks like you co-founded maybe technically

pirouette in January of 17. So what, your seven-ish years or so plus in the making, maybe you were working on a little bit before then. Why this space? Like, was there something that kind of caught your attention or like what drove you to this? Solving for this particular challenge versus maybe others that were maybe interesting at the time. Yeah, absolutely. So it's twofold. One was just thinking about in general what I wanted to do next.

If I thought about working at NASA long term, I could tell you exactly how much money I was going to make 50 years term now. and probably exactly what I was going to be working on. And that may have been a little bit too much stability. I hadn't really thought about entrepreneurship ahead of that, but as I became exposed to entrepreneurship, it became clear right away. That was the direction I wanted to go. But why drug delivery and why injectable medication

and these applications that we've started with, it actually came about when I was neck deep in the medical engineering, medical physics space, still in my PhD program, still working with NASA and just happened to come across an article about a child that was exposed to an allergen. In one case, it was a bee sting, didn't receive a life-saving dose of epinephrine in time, and unfortunately passed away. So a really sad story.

And literally four or five days later just happened across another story. A child exposed to an allergen. In this case, it was a bee sting. Didn't receive a life-saving dose of epinephrine in time and passed away. And both of those stories brought me back to my childhood where one of my brothers had done. severe allergies and actually carried an epipen with them. And right away, I thought to myself, wow, has this technology not changed? Is there still such a big issue? And patient advocacy is a huge piece of what we do. And I always say to your question, it could have been

pirouet aerospace or pirouette defense because ultimately what my co-founders and I like to do is solve really difficult engineering problems. But there's a patient advocacy piece that comes along with Aeroat Medical. And, you know, as you said, it's been a number of years in the making. And every single day, I jump out of bed, willing to walk through walls to take our technology to market and to support those millions of patients that we hope to help. And it's really that patient advocacy piece that I think about on those mornings where it might be a little tougher getting out of bed. It's not just a new widget. It's really something that can save lives. Yeah, that's probably one of the most compelling things about working in healthcare or med tech specifically is,

and I see it all the time is like really smart entrepreneurs like yourself and incredible backgrounds. Choose to work in a field that's like highly regulated, especially a startup. You're pushing a boiler up a hill, but it's a really steep hill in this instance. But that aspect that you just point out is always like really rewarding. It's not like you're working on a new fabric for a T-shirt, right? It's like life-saving, life-altering technologies. That's really cool. Before I did, we go back in time a little bit.

We're recording this in early Q2 of 2020. You've been at it, whatever, seven years or so. Where's the company, can you give us a sense of where the company's at and the supply cycle now? Yeah, absolutely. So I think one thing that I always convey is what we're doing is almost startups on difficult mode, right? You indicated highly regulated industry.

Obviously, we came from the aerospace background. So a very high reliability, highly regulated industry and moving into a high reliability, highly regulated industry. So a lot of good crossover. but Med device in general, it's not easy. It takes a long time, costs a lot. There are a lot of hurdles that we have to overcome, but we've been very successful at doing that,

which has been really exciting. Today, we are basically at the tail end of the design verification stage. So for folks who know the med device development pathway and the pathway to regulatory approval and market introduction, we basically have progressed through showing that the technology, is feasible and then moving forward to taking that to basically a final design, right? So that was really difficult to do. It takes a long time, but we're really excited about the technology and its current stage.

And I think as we think about kind of the next milestones as we move forward, we're thinking about registration batches where we're essentially building a large number of our devices so that we can go through final design validation testing and on to, regulatory submission and approval for market introduction. Two other aspects that I'm really excited about in terms of what we've built to date are not only have we built the technology, right, the innovative drug delivery system. We've also spent a lot of time focused on the manufacturing capability to actually produce that technology and then the infrastructure to test and release that device as well.

which you don't always see with a small med device company like Pirouet because it's very complicated, obviously, just to develop the product itself, but to add on the manufacturing and testing infrastructure on top of that, it can add cost and it can add complexity. But we've felt for a number of reasons that it was really important for us to own that capability internally. And so to have achieved that simultaneously has been really exciting. Got it. So this is, if I'm not understanding that correct. You're not, you don't envision handing off a design to a contract manufacturer and then scaling up production. So I'm like you're building that core competency internally. Yeah, and I think there are opportunities where we could see working with a contract manufacturer, especially at larger scale. But for us to own the core competency, especially for new product introduction, is really useful for us to internalize the learnings that we go through from fully manual assembly to semi-automated to automated, to automated,

assembly so that as we roll that product out and have a potential partnership with a contract manufacturer later, we're able to also transfer those learnings. But to do it ourselves first has actually saved us time and money. And in terms of time, it's really short-cycled the period between which we produce a device, test that device, update the design and produce another device, having that capability all in the same building really allows us to move quickly and achieve the milestones that investors want to see and gets us to that finish line sooner so that we get this product to patients as soon as we can. I definitely want to dig in that a little bit more detail.

And let's actually use that as an opportunity to get to the next question. And we'll spend maybe the next 20, 30 minutes talking about various functions, right, that almost any MedTech or life science startup will get through. But first one on the docket is this kind of development-related question, right? Seven plus years in the making now. One might are you looking at your background? Oh, Connor, like you've gone to the best schools when it comes to and studied really deep in terms of biomedical engineering.

You were at NASA, et cetera. This must have been easy for you. I'm sure probably wasn't, especially working on a much, what sounds like a much better way to deliver medication. But when you think about that journey, going from sketches on a whiteboard in your case, I was going to say sketches on a napkin. It sounds like more. You're a whiteboard guy getting to maybe the first alpha and then maybe versions of alpha and into beta.

When you think about that journey, are there like a couple things that you either really stand out that you maybe wish you could do over again or things that maybe you guys really did right or maybe even the better question, not to throw too many out in one sort of segment here. But if you had to start now, would there be some things that you do differently this time around? Yeah. So I think in terms of what we did right, you could essentially fill an entire dumpster full of the devices that we've designed and built and tested that didn't work that we've had to iterate on since the beginning.

And I think we set ourselves up for a little bit of a longer time arrives and just knowing that we were ultimately focused on the external interaction of the device or the patient experience first, which meant that we had a significant amount of innovation downstream of that that we had to come up with in order to make. all the internal mechanisms work to keep that external patient interaction the same. And what we did right was that we really focused on the fail-fast mentality and we built a lot of prototyping capability into our infrastructure. So we've got 3D printers, right, and we would have an idea on the whiteboard in the morning. And by the afternoon, we had that part physically in our hand when we were testing it, breaking it and showing whether, oh yeah, this was great, greater. Oh, that was stupid. We didn't think of this. Let's do another one. And the next day,

you've got another version, right? And 3D printed parts are really great thinking about geometric capability of parts and how they fit together, but they're really not that great from a functionality perspective. So we built in the next level as well with a bench top injection molding capabilities, CNC, and multiple levels to try and internalize and short cycle the design iteration process so that as soon as we had an idea, the sooner we could have those parts in our hand, the better. So we knew if we were going in the right direction or not. And things we did wrong, that I'm not necessarily wrong, but had to learn the hard way that I would give myself advice. If I were to start it all again today, it would be spend a bit of time thinking about the

existing infrastructure in whatever industry you're in. And so for us, obviously, that's a biopharmaceutical space. What are the industry standards that rule manufacturing? What are the industry standards that rule fill finish? And take that into account from the beginning of the design so that you don't have to have delays downstream and you realize, I thought I was being really innovative by doing X, Y, Z, and it turns out it's just totally opposite for them the way the industry wants to do it. Sometimes it's great to think outside the box and certain aspects of your technology obviously have to be outside the box to have your competitive advantage and then bring your specific value proposition. But you can also do yourself a favor by taking specific areas and

saying, okay, we're going to align with the industry standard here. And I guess the big example, because I know I'm talking high level there, the biggest example I would give of that is if you don't, in our industry, fill finish is huge. That's actually packing the drug into a primary container right and sealing that container. If you go away from industry standards there, you're talking about probably a year plus of delays of developing your specific container type or enclosure or fill-finish process and millions of extra dollars, right? It behooves you to adopt industry standards where possible and then focus on your core competencies and what you bring to the table but not try to change things that you don't need to. Yeah, yeah, that's really good.

It reminds me of a conversation I had with Gabriel Jones. He's the co-founder and CEO of ProPrio. And they're based in Seattle. And I had him on the program maybe, I don't know, six, nine months ago. When you're talking about this, something somewhat similar, if you're working on a startup that you think has legs, right? And your ideas maybe far enough along, start to think about the ecosystem that you're building in essence, right? Because in his case, there's a lot of AI and software with their device.

And so he had to think, am I in Seattle, do I have access to the right talent I'm going to need? in a year from now, two years from now, et cetera. And if not, what does that mean for the business? And it sounds like that thought process is something similar to what you mentioned. It may not be totally pertinent now, but you're going to eat that costs in six months, nine months, 12 months down the road. Yeah. And even if you don't have to spend that specific capital because you've learned, oh, hey, if I do it this way, it's going to cost me a lot of extra capital.

Even if you're not going to go down that road and spend it, you still had to come to that realization and then back up and go the opposite direction on the road. and find another direction. The time wastes is also important as well. And when you can think about too, as you're going through that ecosystem development, you've brought investors on it all along the way and you've got to go back and explain to them, hey, here's what we learned and why we're changing this or whatever it may be. So I think that's important too. Yeah, no doubt. We talk a lot about on this program, this idea as a startup. You need to be getting to your next milestone, right, on hopefully on time and as fast as possible, right? And any, you know, do, Delays are sort of part of the norm, but shouldn't necessarily be expected and so critical,

especially for any startup, let alone in the early years. But on that note, let's transition to talk a little bit more about fundraising, right? Because this is obviously pirouette, to your credit, has raised a fair amount of buzz recently with your success with a community round. And I'd love to get your thoughts on a couple things with your perspective that. Is one, first or foremost, why did you decide to pursue that route? Because it's pretty atypical. And I love the approach. It's actually a lot more, it's becoming a lot more popular kind of with whatever. I would say with traditional kind of Silicon Valley startups, but not necessarily as a con yet in MedTac. So one, part one of the question would be like, why you decided to go there out?

And then two, anything that stand that has stood out as you've worked through that process, you guys have had a lot of success. But yeah, two-part question there with respect to community rounds. Yeah. So to answer the Y piece, I think for us, it was a really nice addition. I always call it like a bolt on addition to our standard fundraising process. I think, and standard kind of in fundraising is not really an accurate word, but more traditional kind of private fundraising.

And the reason I call it a bolt on is the round that we're currently adding this community round into was a round that we didn't necessarily need to have that community round. Be a part of it. We're raising that capital from a lead investor VC. We have additional angel investors, accredited investors, and other notable investors that are driving the sort of significant portion of that capital. But I would say that there's a really unique aspect to the community around that I just fell in love with, which was that as we talked about earlier, I really love the advocacy piece of

pirouette medical and helping to develop something that can help those individuals in need. And I saw the community around moving in the opposite direction of that, which was that those folks that we're really working diligently to support and help downstream have the ability to be a part of that future success and help accelerate what we're doing at pirouet to bring a device to market even sooner. So I thought that was really exciting and didn't really know who might be a potential kind of community round investor and who we might touch or interact with. And I think that's been the biggest learning for me. The biggest excitement with the community round is every time somebody invest, there's a little box on that investment where they get to put in information

about why they're investing. And some folks don't say anything, but a lot of them do. And it's been so exciting for me and rewarding for me to read through those comments and just hear the stories about family members and loved ones and even folks themselves who see how they could use our technology to make improvements in their lives and the lives of their loved ones and how exciting or how excited they are to be able to participate in that. And that's how I knew we made the right decision was opening that door to those folks that we truly love and want to help and give them the ability to be a part of what we're doing, which has been a lot of fun. Hey there, it's Scott. And thanks for listening in so far. The rest of this conversation is only

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