“He may not make it another day.”

I wasn’t fully alert when the doctors gave that bad news to my wife, Marla. At the time, I was in an ICU battling a life-threatening illness that I had been fighting for several years.

I had lived a good life and had an amazing spouse for over 20 years with five great kids in our family. And by all accounts, I had had a pretty successful career, having built and sold two medical device companies and was now leading a third.

But that was all about to come to an inglorious end; at least, that’s what the physicians were telling my wife. Thankfully, that God-like prognostication proved inaccurate. In fact, although I now go through life without pancreatic function and no spleen, it was that moment (and the moments leading up to it) that put me where I am today as founder, CEO, and chairman of Xenter™.

The beginning: Merit Medical to starting my first company

Although I was born in northern Virginia and spent my earliest years in the shadow of Washington, D.C., I moved with my mother and siblings to Utah after my parents divorced in 1983. 

After high school, I attended Ricks College for a brief time, then continued at Brigham Young University before moving on to the University of Utah. When I first met my future wife, Marla, I was head over heels in love with this beautiful girl from Texas, and she’s supported me in doing the things I’ve done in my career. Over the years, I have traveled the world, often working seven days a week for two months straight. Thankfully, Marla was very patient, accommodating, and encouraging.

Merit Medical was my first real job out of the U. When I started at Merit, I was very impressed with the way CEO Fred Lampropoulos motivated his people. Back then, I didn’t know much about medicine at all. Everything I learned in the early days about interventional radiology labs, interventional suites, or cardiac catheter labs I learned at Merit Medical.

I started Rubicon Medical in 1996, but I didn’t have any money. 

I wondered, “How is this young, driven individual going to go out and build a company when he doesn’t know venture capital, he doesn’t know a lot of the physicians, and he doesn’t have physician contacts?”

So I literally had to learn on the job. I could recall a lot of the things I had seen Fred do, but I didn’t have the benefit of climbing the ladder of a big company—going from organizational development to sales, or from sales to marketing, or marketing to clinical, all the varied leadership roles that would give me a well-rounded perspective of the business. 

Getting a call from USC 

The first thing we did at Rubicon was contract manufacturing of medical device sub-assemblies for other companies, something I had experienced at Merit.

One day I got a call from the tech transfer office at the University of Southern California (USC), and they asked, “Have you heard of embolic protection?” I had not.

They said they’d like me to build an embolic protection device for carotid artery stent procedures—essentially an occlusive balloon on a guidewire. I said, “Great, I’ll come down and take a look at it.” So I went down and met with the physician inventor and the tech transfer team at USC. That was around 1997/1998.

As I learned about embolic protection in the carotid artery stenting field, I found it absolutely fascinating. At the time, vascular stents were being proliferated throughout interventional medicine. After that USC meeting and deciding to take on the project, I attended a medical conference where I soaked in everything I could and introduced myself to every physician that would give me their time.

Some of these docs were the most influential thought leaders in medicine: Marty Leon from Columbia University/New York Presbyterian Hospital and chairman of the Cardiovascular Research Foundation (who was at Lenox Hill at the time); Barry Katzen from Baptist Hospital – Miami Cardiac & Vascular Institute, who’s probably the father of interventional radiology and one of the most influential endovascular experts in the world; and Bill Gray, now at Lankenau Heart Hospital in Philadelphia.

I quickly got comfortable working with physicians. I learned all the little things that would make Rubicon successful, like how to listen to physicians and let them determine what they needed, then building technologies that met those needs. We had assembled a small but very experienced team of advisors at Rubicon. It was largely me leading the team; we didn’t have enough money to pay for a big management team anyway, so that forced me to learn a lot. 

I’m not an engineer, but I understand technologies and medical devices intuitively. I can say, “Build this,” and, “It’s got to work like this.” The engineers and I would collaborate with the physicians, build a device, do the bench testing, and test it in vascular models. We’d then translate the design for human use and deliver the final version to the marketplace.

I also learned about reimbursement, clinical research, and the regulatory approval processes at Rubicon, both in the United States and internationally. I also spent time learning about quality issues, then going deeper into manufacturing. 

Eventually, we took Rubicon public through a reverse merger (of all things), which was not ideal. 

We were always starved for cash, though, so we pitched Rubicon to everybody—J&J, Medtronic, Boston Scientific; each had a sales force and a lot of money. I think the only people we didn’t pitch was UPS, but you do what you have to do—you have to talk to everybody. 

In 2005, Boston Scientific acquired Rubicon. After we sold Rubicon to Boston Scientific, I was asked to stay and learned even more. 

Coherex, BioUtah, and The Valley of the Shadow of Death

In 2006, I was invited to join Coherex Medical, a local structural heart disease company, as president and CEO. 

At the time, Utah Technology Council represented the life science industry and the software technology sector, kind of a combo tech world of Utah. But it quickly became clear to me that Utah’s life science industry needed a focused organization that could better serve its needs.

So I approached Scott Anderson, CEO of Zions Bank, who happens to be a wonderful friend of mine (he and I were serving on the USTAR governing authority at the time), and said, “I’m starting Utah’s life science industry association.” His response was quite straightforward, “We’re in. We think that makes a lot of sense.” That was the encouragement I needed to found BioUtah.

I turned BioUtah into a 501(c)(3) nonprofit organization and gave it to Utah’s life science industry because I felt industry CEOs should run the board. I think that independence and lack of conflict of interest are very important if you’re going to have an industry association. In fact, I’m not even on the BioUtah board today.

Eventually, Johnson & Johnson purchased Coherex because of our innovations. After selling to J&J, I started an orthopedic company called CoNextions Medical. But it was during the ending days at Coherex and the beginning of CoNextions that I became ill and began what became a nearly nine-year fight to stay alive.

During my last days at Coherex, I took a trip to Prague to attend the surgical procedures where our device was being implanted into the hearts of patients with atrial fibrillation and stroke. On the way there, I stopped in Boston to have one of my doctor friends perform a quick outpatient procedure, an endoscopy. And it went great, at least I thought.

Several hours later, I found myself in excruciating pain and heading to the emergency room of that same hospital, unable to get myself out of the taxicab. Turns out I was suffering from pancreatitis due to the pounding on the pancreas during the endoscopy. This eventually led to recurring necrotizing pancreatitis and pseudocysts, a journey that often found me in various hospitals and ICUs.

I faintly remember one day when my heart monitors were going to zero. I lost consciousness—a Code Blue. My family was there, and they ran out as doctors were running in to get my heart beating again. It was crazy.

Given that I had been in the healthcare field for over 20 years by then, including being in hundreds of interventional heart procedures, I began to see medical care from a new perspective: that of the patient. I realized what devices and processes were working in healthcare and which were not. 

For example, healthcare is a very connected industry with large capital footprints and carts/machines that are rolled around the hospital for an ultrasound and vascular imaging, among other things. Unfortunately, because of the lack of wireless technologies, things aren’t fast or simple. And you can’t put all the data into a single database that enables large-scale analytics.

Additionally, hospital systems each have Electronic Health Record applications today, and in many instances, you cannot get your data from one healthcare system to another. Often, if you’re traveling and get sick and need your healthcare data, you can go from one healthcare system to another, but your data can’t travel with you. 

These are just some of the problems I wanted to solve with Xenter.

I decided that when and if I came back, I would do something about the problems associated with the lack of smart/wireless medical technologies that empowered and informed global healthcare datasets.

Starting Xenter

Xenter officially launched in February 2020, but I had been working on it for over two years. At Xenter, everything is focused on helping patients and physicians through a transformative approach to interventional healthcare. 

Specifically, I realized that I needed to build a TechMed company, one that is led by a vision that says revolutionary change in healthcare will be driven by a Technology in Medicine approach. In other words, I needed to reverse things. So instead of MedTech, it’s TechMed. This requires new engineering solutions to be merged with the historical engineering that has built our industry.

So I needed semiconductor engineers who specialize in MEMS and ASIC chip designs, as well as electrical engineers, software developers, cloud experts, and new signals technology engineers to bring completely new technologies and techniques to bear. We’re building new wireless intravascular ultrasound imaging and wireless guidewire-based pressure mapping technologies for interventional procedures like implanting stents in blocked arteries. 

These engineering professionals are completely new to medicine and have a major impact on Xenter’s technologies and solutions. It’s exhilarating to see the innovation that comes from the cross-pollination of engineering and scientific disciplines. In fact, I’ll sometimes tell people that we’re a semiconductor company that happens to make medical devices, and that’s an important nuance. 

That’s why I needed to build a very different company from the ground up: to address these gaps in technology and the way our industry works. That’s why I believe Xenter is truly poised to change the world.

To be clear, a lot of companies talk about this: Medtronic, J&J, even Google and Apple. But at Xenter, we’re actually melding digital technologies with medical technologies to create new smart medical devices that are part of our wireless ecosystem tied to a HIPAA-compliant healthcare cloud, making it possible to share outcomes data globally. 

As an industry, we don’t have the ability in surgery and internal medicine to get multiple pressure sensors into an artery to measure blood flow using guidewires. It just doesn’t exist. So that’s the first thing that we’re working on at Xenter. 

Additionally, we want to have a wireless vascular imaging system. That’s intravascular ultrasound, or IVUS, which is basically an ultrasound image of the inside of the artery.

Conversely, today, a non-sterile $100,000 to $200,000 imaging machine is rolled into a cath lab by a technician where another tech awaits with a sterile IVUS catheter. Together they put sterile bags over the cables connecting the catheter in the heart to the imaging cart so images inside the artery can be obtained during an interventional procedure, like a procedure to open an artery in heart attack patients. Such prep work typically takes 30 minutes or longer.

Unfortunately, these carts aren’t always available, nor are the teams that do the preparatory work. Additionally, getting the images from a cart into an Electronic Health Record application is not easy. In fact, none of the systems really talk to each other, which makes this entire “dance” problematic at best. As a result, we’re also designing smart wireless IVUS devices as well, which should reduce prep time by more than half.

The plan is that all of our medical devices will be based on our own silicon chips, use Xenter’s healthcare cloud, and enable the global sharing of outcomes data. And once we’re cleared by the proper regulatory agencies, patients will have instant access to all of that digital data as well. 

Today, no patient in the world gets any of their physiology and imaging data on their phones from any hospital anywhere. So this will be a massive change in terms of how patients can access their data, store their data long-term, and have data control.

Four final thoughts

First: Looking back on my life, if I listened to most people, I never would have started a company. If I listened to a lot of physicians, I would never even leave my house. There are people who always have to engineer risk out of everything. 

Second: I remember reading James Allen’s “As a Man Thinketh” as a boy. I believe everyone should read that book before they turn 12. It’s about seven things: 

1. Becoming what you dream; 
2. Being willing to have a dream; 
3. Developing the courage to go out and pursue that dream; 
4. Not listening to naysayers; 
5. Respecting other people’s honorable pursuits; 
6. Respecting yourself; and 
7. Acting like a gentleman.

Third: I have seen more fear, uncertainty, and doubt disrupt good ideas than I’ve seen good ideas. My advice is don’t listen to the people who say “no.” Ego, jealousy, and competitiveness are almost always at the root of criticism. Don’t let other people stop you from achieving your dreams. Have the courage to go do something and have the courage to fail. If you’re not failing, you’re not working hard enough, and failure is just part of innovation. 

Fourth: I’ve got a saying in our company that is an essential for the success of a startup. Some people might think it’s harsh and that is this: 

“We’re going to change people, or we’re going to change people, and you have to have the courage to do both.”

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This article was finalized on 2 December 2022; as of that date, all of Xenter’s products and services were in various stages of research, development, and engineering, and none had been commercially deployed or cleared by the US Food and Drug Administration (FDA). Additionally, statements made in this article have not been evaluated by the FDA nor has the efficacy of any such product or service been confirmed by FDA-approved research.