Medsider: Learn from Medtech and Healthtech Founders and CEOs - Managing to a Successful Acquisition: Interview with LimFlow CEO Dan Rose

Episode Date: April 3, 2024

In this episode of Medsider Radio, we had an enlightening discussion with Dan Rose, former CEO of LimFlow, which recently sold to Inari Medical. The minimally-invasive LimFlow System is designed to bypass blocked arteries in the leg and rush blood back into the foot, potentially avoiding major amputation, resolving pain, and promoting wound healing.A leader with 25 years of experience in the medical device space, Dan has worked in both multinational corporations and startup ventures throughout his career. He holds a BA and an MA from the University of Virginia, and an MBA from the Darden Business School. Most recently, he led LimFlow’s exit to Inari as the company’s CEO and has held pivotal positions at Direct Flow Medical, Sequana Medical, Medtronic, and other medtech companies. In this interview, Dan shares his extensive wisdom on M&A transactions, engaging with investors while maintaining business autonomy, the importance of developing with the ‘average user’ in mind, and the significance of early dialogue with regulatory bodies. 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 V. 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 Dan Rose.

You've got to balance the idea that the doctors that first work with you are going to understand that they have technology that isn't complete in a way, right? That this isn't the final generation. But you need to have developed in such a way that they can, there is a real path to that final generation. Welcome to MedSider, where you can learn from the brightest founders and CEOs in medical devices and health technology. 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 Dan Rose, a repeat guest here on the program and a leader with over 25 years of experience in the medical device space. Dan has worked in both multinational corporations and startup ventures throughout his story career. Most recently, he led Linflow's exit to Anari Medical as the company's CEO. and previously held pivotal positions at Direct Flow Medical, so Quantum Medical, Medtronic, and others. Here for the key things that we discussed in this conversation. First, vet your potential investors carefully and consider how their involvement will impact your business operations,

especially if there are multiple parties involved. Limit their influence on decision-making to maintain flexibility and control over your company's direction. Second, in the early development phases designed for the average user to maximize adoption rates. Always iterate towards simplicity and be prepared to pivot accordingly. Don't focus solely on cutting-edge features or only cater to the experts. And don't hold on to complex elements or features simply because they were part of the original plan. Third, understanding the reimbursement landscape and how your technology fits into that is crucial to progress your conversations with VCs. Research potential investors to ensure that they have the capacity to invest and that their interests match your company's focus.

Pursure those who can make substantial contributions streamlining your fundraising process. All right, before we jump into this episode, I wanted to let you know that the latest edition of Medsider Mentors is now live. We just published Volume 5, which summarizes the key learnings from the most popular Medsider interviews over the last several months with incredible entrepreneurs like Gabriel Jones, CEO of Proprio, Kirsten-Carrel of Can Do Health, Dr. David Alpert, founder of AliveCorp, Greg Bullington, CEO of Magnolia Medical, and other leaders of some of the hottest startups in our space. Look, it's tough to listen or read every interview that comes out, even the best ones. 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 MedsiderRadio.com forward slash mentors. Premium members get free access to all past and future volumes. 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 life. of interviews dating back to 2010. You'll also be able to see all of our playbooks, which are hand-picked collections of the most insightful interviews with the brightest founders and CEOs that

join our program. Whether you're looking to master capital fundraising, navigate early stage development, tackle regulatory challenges, understand reimbursement or positioning your venture for a meaningful exit, MedSider Playbooks have you covered. And last, considering that fundraising can be one of the most daunting tasks for any startup we created a meticulous database of investors right at your fingertips. Explore a wealth of 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 into the interview. All right, Dan, welcome back for a round two to MedSider Radio. I really appreciate you you carved down a little bit of time in your schedule to do another another MedSiter interview, but really looking forward to this discussion. Thanks, Scott.

I really appreciate the invitation. And last conversation was great. So looking forward to giving the update. Yeah. And, you know, I think, gosh, we reported that maybe back in 2020, which I think you were probably in the throes of clinical work at Limflow. And I can't imagine the hurdles that you had to cross throughout kind of the pandemic, you know, running clinical studies.

But kudos, huge kudos to your team. on what you're able to accomplish at lymph flow. So it's just rare that you see, you know, these types of success stories in MedTech. So thrilled to have you back on. So with that said, let's spend maybe five or ten minutes kind of, you know, covering the basics. So I recorded your bio at the outside of the interview.

If you're listening to this and not familiar with Dan, you can certainly go back, you know, guess four or five years now and listen to the first time he was on, which was sort of the, you know, the early stages of lymph flow at that point in time. But if you can, like maybe just give us an elevator kind of style overview of your background from your perspective, kind of leading up to your role at Limflow and now, you know, reporting this in early 24. No, absolutely. Yeah. I mean, my background is a little different than many, primarily from just a geographical point of view. So I'm born and raised American from Virginia. But I've been in Europe now since 1999.

So almost in 25 years now, which is crazy to think about. Certainly it wasn't the plan. And almost all of that in MedTech in one way or the other. So I came over after business school, did some early stage of mature capital work, ended up co-founding a device company out of that in the diabetes space, which we kind of got set up quickly and very quickly put into a short clinical trial that showed it wasn't working well enough. And so we shut it down.

And I, at that time, moved from London to Switzerland with my partner, who's now my wife, and who was born and raised in Switzerland, and went to work for Medtronic, so at the European headquarters. And I, in fact, live still in Switzerland. And I live, like, three miles from the Medtronic Europe's headquarters. So even though I moved far, I ended up staying in the same place for a long time. And so, yeah, I worked traditionally at Medtronic in cardiac surgery. which was still a very vibrant place at that time,

a lot of off-pump bypass surgery. I was doing surgical AF work. A lot of anastomotic technologies the Medtronic was looking at. I launched a bunch of products, traveled all over, seeing procedures and really getting a great experience and grounding in MedTech from a marketing point of view.

Then went up to the Nordic region and ran Medtronic vascular for three years out of Stockholm. So we had three different business units, units, five different countries, including Iceland, and had a tremendous time leading the teams up there and getting some kind of carrying the bag experience or almost carrying the bag experience, one step from it. And that was great and came back then to Metronic Europe and was the head of marketing for the coronary business, which was back in the heyday of the Dragoly Sente's $400 million in revenue just in Europe and really aggressive, competitive markets.

So that was fun. Left then to join Sequana Medical in the Implanable Pump Space in Zurich, chief commercial officer, but also ended up running clinical, which was my first kind of job, a little responsibility outside of more the commercial side of things. Then head of commercial for direct flow medical and structural heart space. That was right. We were kind of third to market in the structural, in the taver space.

You know, again, the early days of Taver, extreme risk patients, very exciting, fast-moving, aggressive market, and generated about 30 million in the first 24 months or so. So a pretty great launch, just primarily in Germany. And then left there to become the CEO of Wimphop in 2016, August of 2016, and spent the past seven years doing that. And that culminated in November and the exit with Inari. And since then, I've been acting in an advisory role to Anari as part of the transition. Yeah, very impressive background.

And for those listening, you may have heard of Limflow even for the first time, right, after Inari acquired the company. But I always like to kind of emphasize the fact that, you know, most people, if they haven't heard of Limflow, they're like, oh, wow, you know, a fast-moving startup, an overnight success story. And it's like, no, I've been working on this for, you know, the better part of seven plus years. You know what I mean? So these roads in MedTech are long and windy and full of challenges. So before we kind of go back in time and learn a little bit more about, you know,

kind of what you went through building the company and even your prior experiences, for those that aren't familiar with Limflow technology, maybe give us a really high level overview, almost as if I'm a freshman in high school trying to, you know, learn a little bit more about the technology. Sure. So, well, I mean, one of the biggest problems in certainly cardiovascular health care today, and it is related to the obesity epidemic and the diabetic epidemic and kind of cardiovascular disease, athrosis, the building up of plaque and calcium in the arteries, which blocks blood flow. All of these things leads to a high rate of amputation these days.

We have a lot of major lower limb amputation, which means basically taking off. your leg below the knee or just above the knee. And this is associated with a huge amount of morbidity mortality, early death, you know, I mean, certainly mortality rates at five years that are on par with or worse than the worst, most aggressive cancers you can think of. So, and we're doing about 100, 120,000 major low limb amputations in the U.S. every year. And the problem is getting blood flow to the foot. and limb flow does something different than just trying to open up the blockages in the arteries,

and that's to go around them and essentially use the veins, which we know run alongside the arteries, but in the opposite direction in terms of blood flow throughout the body, right? Arteries take blood from the heart to the tissue, and veins take blood from the tissue, deoxygenated blood back to the heart. So we're saying, well, maybe we can, these pathways are next to each other, Athloschorosis does not exist in veins, so the veins are often healthy when the arteries are not. So can we use the artery to deliver oxygenated blood? And that's what lympho is in its essence.

We use some wires and catheters to connect the arteries and veins, and then we place a covered stent across the artery into the vein to make sure the blood goes in the wrong direction, really, because veins are supposed to run back to the heart. and then use a tool called a valutonium to take out the valves and veins, which keeps blood from running in the long direction. And this restores blood flow, allows the foot to heal and allows amputation to be avoided and made a lot of technology development to get there, ultimately culminating in a large pivotal trial and a publication in an England journal medicine

because it's such a big problem in global health care, but particularly in the U.S., and there's such an opportunity to improve care based off of the limited effectiveness of many of the tools we have to do. Yeah, that's a great, great overview. And I think for those listening that aren't familiar with kind of the cardiovascular space and really more specific, the peripheral vascular space, this is a huge, a huge need, as you pointed out, right? I think it's not well known the mortality rates around or post-amputation, right? And so it's definitely a very significant issue in health care. There's no doubt.

One of the most, you know, I had spent some time in pro-for when I was at Medtronic, but one of the most interesting and surprising things to me, but less and less surprising as we went, is how often people, when I explained what I did, are like, oh, yeah, my uncle. Oh, yeah. I mean, one of my best friends told me, oh, yeah, that was my father died of a diabetic foot ulcer.

infection. And so it's everywhere. And particularly in marginalized communities, you know, which are over-affected by diabetes and obesity, et cetera, and access to care, where there's just a massive, massive epidemic. And we need to do something about it. And we hope lympho can really play a role in that. Yep, yep, no doubt. And if you're new to the technology, Limflow, even though it's now under the Anari family, the site still up. Limflow.com, L-I-M-F-O-W.com, LIMFLO-W.com. We'll link to it in the full write-up on MedSider, but definitely encourage you to check out the technology in more detail if you're interested.

So with that said, we'll go kind of rewind the clock and go, you know, step inside the old Medsider time machine here in a bit. But I don't expect you to kind of unveil great details around, with respect to kind of where Anari is headed, per se, But when you look at over the next 12 months, what does that look like in terms of Anari's kind of incorporation of Limflow into the company? Well, I mean, what we really feel is that, you know,

Limflow is really had a market development strategy, right? Start small, embed the technology and a limited number of sites, train them up and expand. And Anari did something similar in when they launched their technology, what, five or six years ago, in what they call the VTE space, either for pulmonary embolism or deep vein thrombosis. And so, you know, what they did back then is very much what needs to be done with lympho now.

And so, you know, and they have a tremendous, you know, therapy development mindset. They have a tremendous commercial organization and infrastructure. And so what we're going to see is, and what they have explained, I think, publicly, is that Limflow will be a kind of a dedicated business unit and be run, you know, to really focus on and develop that technology, which is in a slightly different marketplace than really a customer base than they're in today. But over time offers a huge, huge number of, you know, synergies. So, and certainly from our perspective of culture and market development mindset and infrastructure,

it was a beautiful landing place for the Limflow technology. Yeah, that's a really good point. I actually haven't thought about that in great detail because, you know, some folks would be like, wait, I thought Anari was a Venus company, right? And now they're acquiring a technology for CLI or chronic limb ischemia. That's a really good point. Like the market development kind of work that they did early on definitely applies right here. There's no doubt. They're actually quite good at that.

Absolutely. Absolutely. And we felt that from the very beginning and they felt it too. It was constantly like, oh, we have this share. vision and mindset, even if theirs was, you know, a few years before. Yeah, yeah, no doubt. Cool. So with that said, let's spend the next maybe 20 or 30 minutes learning a little bit more about some key functional areas, right, that you were able to kind of, you know, tackle

and knock off building and Ari and feel free to kind of layer in previous experiences that you mentioned, you know, whether it's at an at metric flow, et cetera. But the first one is that stands out to me kind of thinking about most recently, right, your experience at Limflow is an R&R, I think, invested. I don't recall exactly at what stage of LNFlow, only to eventually acquire the company. And I think a lot of med tech entrepreneurs struggle with this idea of like, how involved should they get with his strategic, either early on from kind of in terms of participating in a fundraise, and then maybe as they, you know, are beginning to get interest from various strategics,

you know, towards maybe the, you know, certain inflection points along along the road. How do they, how do they best kind of, how do they best collaborate, partner, work that process, so to speak. So maybe if you can touch on, maybe touch on both or maybe touch on, you know, kind of the investment side specifically and how that ended up working out for lympho and Nari. Well, yeah, I mean, this is an interesting question. And I have to say, like, I'm of two minds on it. I was at Direct Flow Medical, which had, I think, three or four strategics at one point invested. And that creates a different scenario, I think, you know, that's quite complicated.

And, you know, you never know, like, are they watching each other to make a move? Are they, you know, is knowing how, seeing how the sausages made helping or hurting? So, I mean, that experience kind of made me wary, I would say, of having strategics involved, to be honest. I mean, sometimes board meetings could feel maybe more like road shows than, you know, efficient board meetings. So, and I'm a great believer that a board meeting should be a working meeting, right? And so at Linflow, I felt similarly. I was like, you know, we had different strategic interest. I certainly, you know, was cultivating strategic interest in acquisition constantly, right?

Because I think it takes that. Over years and years, you develop relationships with that's the same people, usually. There's some turnover, but oftentimes there's a lot of consistency in who you're talking to. And it takes a long time for everyone. at these businesses to understand what you're doing, right? You think it's not just one conversation and they're magically transmitting that message back to everybody inside, you know, whatever organization you're talking to as well as you are, right?

So it's like every opportunity, every time you can tell the story, tell the story, show that you're delivering. But I wasn't excited about having investment and I certainly was very wary of, you know, having rights, right? And that's something you don't want to have because it can set off, you know, stop future opportunities. But we had had some, you know, normal discussions with an R.A over the years. And ultimately, as we were putting together our series D, they had expressed some interest. And we decided to, because of the, I think primarily because of the good relationship between us and shared culture. And we decided to,

to kind of allow them to join in, but without any rights. And I think that was quite important for us to keep our options open. And they had an observer role. And it was wonderful. They played a great observer role, helped us with certain kind of thoughts about commercialization, right, and advice that wasn't attached to anything, just kind of like, hey, we're all in it together. And it was very fruitful collaboration, but very organic in how it developed, I would say.

Yeah. Your comment around, I want to touch on a couple things that you mentioned, but your comment around working board meetings. I mean, spoken like a true entrepreneur, right? It's like the death of being when a board meeting gets turned into like some sort of like pitch and road show as you as you pointed. I mean, gosh, if, you know, for all the all the MedTech, you know, founders, CEOs that are listening, you know, try to aim for working board meetings that are actually helpful to pushing the business forward. But but you're, but Dan, you're your, your, your, your, you're, your, your, your, your, your, your, your comment around the number of conversations and sort of like the relationship building that needs to go on, not just with strategics, but even with investors that may say no, that may not do anything. Man, that really resonates with me specifically. Maybe it's just kind of where we're at with Fastwave. But like that's, that's so, so crucial. And I, and I'm sure you run into probably even more entrepreneurs that are hesitant to have any sort of conversations, right? And they want to almost keep what they're building sort of to themselves or in stealth. And they just, I just, in most cases, that's not, that's not helpful, right?

You need to be having a lot of discussions, a lot of conversations. So I think that's really, I'm really glad you mentioned that. You know, lympho is, you know, again, we, we were doing something nobody else was doing, right? So, and it was, it was hard. So nobody else was eager to go and try and do it after us until we prove it. I'm sure, you know, people are thinking today, maybe they should have been working on this, but, but it's a very long road, you know, implantables, you know, PMA process, etc. But look, the guy who tells you know in the Series C is maybe putting money into Series D, right?

And he may be putting money into your Series D because during the Series C, you, you know, he grew to know you, trust you, you told him what you were going to go and do. and then you went and did it. And now in the series D is like, oh, I've known the guy for years. He does what he says he's going to do. And I mean, that happens and that's real. So I think that it is a small world and people watch what you do.

Consistency of communication is key. You know, obviously if you have trade secrets or, you know, some kind of fast follower, there is some, you know, level of secrecy. But I've also found that most everybody knows what everybody else is doing. to trust, you know, like, you know, it's a very small world. And there are few things that are truly, you know, subversed. Yes. Yeah, 100%. Yeah, we're recording us on video for everyone listening, but I'm like totally nodding my head to pretty much everything Dan, Dan is saying, because it's so, it's so true. I mean, and it can be frustrating when you have, you know,

conversations with whether it's a strategic or a potential capital partner and you feel like maybe it's even the second or third conversation that are still not really leaning in. Don't, I mean, it's still, it's likely going to yield some sort of fruit, right? Maybe they never invest, right? But they may be in the same sort of network as someone else that may eventually, you know, invest in your company or even potentially fire. And so those conversations aren't lost and those discussions aren't lost. And yeah.

And Dan, your point about even some of those early discussions and sort of signaling what you're, what you're tempting to do and the time frame that you're going to try to execute against And then when you do that and you actually are, you can't hit those timelines, that's really, really huge, right? Because half the battle is actually just demonstrating that your team can do it. Well, yeah. And I would more emphasize can do it, right? I mean, everybody's late and everybody spends more money than I said they would.

I mean, it's very, very, not to. And the VCs are used to that. Don't, I mean, like, I'm not saying you should be proud of it, but don't be afraid to go back and talk to them about it as long as you did what you said you're going to do you deliver right and you did it in an intelligent way and a thoughtful way in a strategic way we all know that they're unexpected challenges out there i mean it's just a constant right uh i mean you you know something is going to get in your way that you didn't think about and uh and it's always going to slow you up and uh and how you work through it is the testament that you can solve the next set of problems that are always

is going to come. Yeah, that's good stuff. Let's shift gears a little bit and talk about development, because it certainly applies to how we spend money and the timelines that we're trying to operate under. But this is one of the most difficult things, I think, for any MedTech founder, because typically you have a pretty, pretty lean amount of capital or pretty reduced amount of capital to work with in the early stages, and you're just trying to get to the next iteration of that particular device, right? whether it's going from kind of concept to alpha or alpha to beta. And when you think about your experiences, whether it's at direct flow or even even limb flow, I imagine, you know, the device that you were in your in your PMA pivotal looked a lot different, right?

Than the, even the devices that you probably used, you know, for your first in human studies, right? So when you think about just that topic in general, how do you coach up other founders and CEOs to kind of move quickly, make hard decisions with, you know, with, again, kind of a like really, really limited amount of resources. I think this is one of the harder things to do, right? And we made our own, you know, kind of, I mean, we, as you say, the system we started with is not the system we finished with. And one of the things we did is we actually innovated out a huge amount of the complexity of what we're doing.

We're using ultrasound to guide the catheters and the connections between artery and vein. And we ultimately got rid of that. And which meant we had no software, no hardware, you know, and we dropped crossing times by an hour. But it was a hard decision to do because we had. got a ton of IP around ultrasound. And I had to turn around and say, well, no, we don't need that, right? Company was kind of founded around it, but we don't need that. So these are active discussions. They're hard discussions. I think, you know, one thing is that you've got to balance the idea that the doctors that first work with you are going to understand that they have technology that isn't

complete in a way, right? That this isn't the final generation. But you need to have developed in such a way that there is a real path to that final generation, right? And you need to be aiming at the average user, right? Through iterations, you have to be getting towards that average guy who can do it with the basic set of skills, you know, right, in the middle of the curve. You know, ultimately, that drives necessary and you can't wait for a strategic to do it, right, and acquire it to do it. It has to be done before then. And maybe it can be done when you have more money, but it has to be done. and ultimately I found that that conversation of taking complexity out and aiming for the average guy,

you get creative around procedure, you get creative around technology, you get creative around development because you're forcing yourself to say no, just getting a great outcome with a super complex way of doing it is not good enough, right? And again, there's going to be that tension between money, time, and, you know, perfection, right? And you won't get it perfectly right, but I think you have to keep the end in mind and keep the current user, which is against usually someone more advanced, a first-in-man guy who's going to say, yeah, I can get it done with whatever, and the end user, right? Which is very definitely not that person you're working with today. Yeah, yeah, such good comments. I was having

a conversation, Gus, it was a couple weeks ago with one of our advisors, and this is a very, very skilled operator, probably one of the most, you know, world-renowned folks, especially when it comes to CTOs. And he made that very, that very safe comment. Like, you can't be designing your device for me, right? You have to be designing it for the middle of the road user, as you pointed out. And I get such, such good advice for, you know, for those of, you know, those of you that are listening that are at the stage, right? We're trying to make some of these hard decisions, right? If you, there's a bunch of, what was the phrase you just used, Dan, even if your solution solves the need, but it does it in a very complex, kind of sophisticated way that's going to lead a lot of

friction in adoption. That's, that's going to be a tough road to all. And the strategics will understand that. I mean, like, they, they, they're very astute, right? Their advisors are very astute in this. So you can't fool anybody, you know, at the end. Yeah, no doubt. And one other thing that you mentioned, the decision around removing, I think you said ultrasound kind of from the early, early kind of versions of limb flow. I mean, I don't, probably in retrospect, it's easy to kind of say, yeah, we killed that.

It was hard. But I can't imagine like at the time, especially if like you had a lot, like to your point, you had a lot of IP around that, that was probably a very, very challenging discussion and in ultimate decision. And I think it's just important to kind of bring up. Like there's going to be a lot of those times of probably decision.

along the road, I'm sure there was, during your kind of seven plus year journey at Limflow. And man, that's part of the game, right? It's making, making tough decisions because they're never easy. Yeah, I mean, if you've got a great team, you know, and you have a culture where you can stress test ideas, you know, with each other and the best idea wins, you know, hopefully you've been iterative enough in the discussions where by the time you're ready to do it, like, you're all so convinced that that's what you need to do that, you know, and you've had those pre-conversations with the board. I think that's another thing about boards is there should be

zero surprises at board week. Zero. So, you know, from my perspective, right? Everything should be, board members should be aware of what's going on if there's something very material, you know, before they get in. So the conversation can be fruitful and everybody's had time to kind of marinate a little bit when they get in and be reactive, right? And so I think I think there's a fair amount of CEO work there to make sure that those conversations can happen the right way. Yeah. Yeah.

I think it was, I recently had Harley Sorkin on the program. He's the CEO of Intershund. And he used this analogy of like a, the best CEOs often sit kind of at that kind of in the middle of an hourglass, right, where you're, you've got to like sort of disseminate information that's kind of coming upstream from your team. And then how you, how you effectively communicate to your investors, your board members, et cetera, is really, really crucial. And I, you know, I mean, man, I can't emphasize that enough, right?

If you want, if you're expecting to have a working like board meeting, a lot of communication is needed, right? Leading it leading up to that for sure. So let's talk a little bit, kind of thinking about Flynn Reg, right? And you guys were, you and your team were able to accomplish some pretty significant or hit some pretty significant milestones through that process, ultimately, you know, conducting a full-on, you know, PMA trial. not to mention that I think a lot of your early, you know, some of your early clinical work was right around, right around COVID, which further exacerbated probably a lot of a lot of challenge. I'm laughing now. I'm sure you weren't laughing at the time. But when you think about kind of that journey, and I know you had a lot of experience kind of even leading up to limb flow, but for those that are really kind of in the throat, those, you know, CEOs founders and then throes of trying to either map out their approach or kind of figure out like what is the best path for them when it comes to Clint Rag? Are there like a couple of people?

of advice that you kind of offer up to other folks that are trying to navigate these waters. Hey there, it's Scott, and thanks for listening in so far. The rest of this conversation is only available via our private podcast for MedSider Premium Members. If you're not a premium member yet, you should definitely consider signing up. You'll get full access to the entire library of interviews dating back to 2010. This includes conversations with experts like Renee Ryan, CEO of Cala Health, Nadine Miarid CEO of CVRX, and so many others. As a premium member, you'll get to join live interviews with these incredible medical device and health technology entrepreneurs. In addition, you'll get a copy of every volume of MedSider mentors at no additional cost.

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