Health Tech: Dan Rose on How LimFlow’s Technology can Make an Important Impact on our Overall Wellness

Keep your eyes on the prize but don’t get overwhelmed with the long road ahead. Never forget the problem you are trying to solve and the people you are trying to heal, but also know that you don’t have to solve it all today. Resetting every morning by remembering who you are trying to help will give you the energy to fight and bring others to your side. Someone once said, “You don’t have to have the courage for the entire journey. You only need the courage to get through today.” I think of this often as I lead LimFlow.

Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?

I grew up in Virginia — born in Richmond and attended middle and high school in Williamsburg. I actually had a part-time job in high school as a historical interpreter (in 18th-century costume!) at Colonial Williamsburg. I was lucky enough to travel a lot, cycling one summer the entire coast of Maine and the next from Seattle to San Francisco. I also traveled through Europe as part of the Presidential Classroom and Egypt as a Malcolm Kerr Scholar. I went on to attend the University of Virginia, ultimately completing a double major BA, MA in Foreign Affairs, and an MBA at Darden.

Can you share the most interesting story that happened to you since you began your career?

In 1999 I co-founded a medical device startup in the UK focused on continuous glucose monitoring. We were able to raise substantial money and start the device in clinical trials, but we determined quickly that the device was not going to work. Consequently, we quickly shut down the company and returned the intellectual property and remaining capital to the investors. While it would seem a failure on the face of it, this experience got me hooked on medical devices, leading me to join the global medical device giant Medtronic for eight years and to spend the rest of my career in the space.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I would have to say my wife has been the greatest factor in my overall success. Regarding purely professional help, I would say Pat Mackin (current CryoLife CEO) played a key role in me getting to where I am. I was a young, relatively new-to-Medtech manager working in marketing in the Swiss headquarters of Medtronic Europe in the Cardiac Surgery Division. Pat, who ran the much larger Vascular Division, asked me to lead the Vascular Division in the Nordic region (with five countries and three business units) based out of Stockholm. It was a fantastic learning experience for me managing a large team across multiple cultures and healthcare systems and getting some real field sales experience. Those three years in Stockholm taught me many lessons I still use today, and I am grateful to this day for Pat putting his trust in me that I could take on that challenge.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

A venture capitalist I worked with once told me, “There are a lot easier ways to make money than Medtech,” which I thought at the time was both funny (coming from a MedTech VC) — and true. When working to develop new medical technologies, the challenges are incredibly daunting. The road is long, and there are hundreds of ways to fail (technology, funding, clinical trials, regulatory requirements, etc.). If it is just about the money, there is no way you can create success and you should choose another path. The driving force has to be on the value you will deliver for the patient and society. This fundamental goal kept me moving forward on those long days and sleepless nights. It continues to provide context and motivation for everything we do. I know my work has real meaning, and my efforts can make a significant difference.

You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

Curiosity, grit, and authenticity. Curiosity is critical on many levels; it leads to both engagement and knowledge. The medical device business involves the intersection of medicine, engineering, regulation, and business. Curiosity is constantly rewarded since there is always a new subject or function to master. A cultivated interest in how things work, why people want what they want, and identifying the key influencing factors are critical disciplines that can provide important insights into what to do (or even more importantly, not to do!).

Grit, to me, is the self-driven ability to overcome adversity. Being CEO is a lonely job, and the only real problems you get are the ones no one else has figured out how to solve. The ability to battle through to a solution is critical, no matter how long, difficult, or challenging the path. No one will be there to hold your hand; in fact, you will likely have many people who don’t want you to succeed. If you can’t keep your own energy, focus, and determination up, you will fail.

Finally, authenticity is at the core of leadership. Only a small part of communication is verbal, and any dissonance between your words and actions will eventually undermine the team. I was once on a leadership course at Medtronic, and they took us to a horse riding facility. Each person needed to lead a horse through and around a set of cones, just walking and holding the bridle. It was amazing to see how the same horse behaved differently with each person. Some couldn’t get the horse to move an inch. Others went through the cone maze without a pause. The horse doesn’t understand your words but does sense your stance, the timbre of your voice, and the confidence you feel. I don’t think humans are that different. Everyone is watching all the time. If they know you’re being real with them, they will accomplish amazing things.

Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?

LimFlow is currently exclusively focused on the problem of what we call chronic limb-threatening ischemia (CLTI). Essentially, we’re talking about cardiovascular disease and atherosclerosis, or the accumulation of plaque and calcium in the arteries throughout your body. People often think this occurs only in the heart, but it happens everywhere. Our patients accumulate blockages in their legs that obstruct blood flow to the feet. If they don’t get relief, they’re likely to develop a nonhealing ulcer or wound and end up with a major limb amputation.

Losing a limb has incredible high mortality rates, being a death sentence for many patients and tipping other patients over into a rapid decline of their health. Because CLTI is common and deadly, more patients die within five years of a CLTI diagnosis than with any type of cancer except lung cancer. It’s a massive problem, and hundreds of thousands of people in the U.S. and Europe have major limb amputations every year.

There currently aren’t good options available for these patients. Doctors have tried to apply all the technologies developed for treating the heart — balloons, stents, atherectomy — and they often do not work for patients in the lower leg. In many patients, the disease is so advanced that they are not eligible for any kind of endovascular or surgical intervention to restore blood flow, and their only option is major limb amputation. These are the patients that LimFlow is focused on, solving this massive unmet need and avoiding major amputation.

How do you think your technology can address this?

LimFlow uses a completely different approach that flips the script and uses the anatomy in a different way to solve this problem. LimFlow utilizes the veins, which run alongside the arteries and normally move blood back towards the heart, to deliver oxygenated blood to the foot. We channel red blood from an artery just below the knee into an adjacent vein and then place covered stents to channel the blood flow down into the foot where it is needed most. This bypasses the blocked arteries in the lower leg and can relieve pain and heal wounds in the foot, taking the patient off the path to amputation.

Can you tell us the backstory about what inspired you to originally feel passionate about this cause?

I had watched this space for a long time, first when I worked with the peripheral vascular business at Medtronic. When I was approached about taking the CEO role at LimFlow, I was shocked to see how little effective innovation had occurred over 10 years and how many patients were still suffering. This is one of the greatest remaining challenges of interventional vascular medicine. It is barbaric that with all of our technological advances in the 21st-century, hundreds of thousands of patients in the U.S. and Europe still lose their legs every year.

How do you think this might change the world?

CLTI impacts millions of people worldwide as the modern diet and lifestyle drive the incidence of diabetes and cardiovascular disease. The impact on a family when someone loses their leg is devastating. The additional care requirements, costs, and potential loss of income can impact an entire family and community. For people living in challenging economic circumstances, the implications are catastrophic. We believe LimFlow will provide the only solution for many people suffering from end-stage CLTI and allow them to keep their leg and quality of life. The opportunity to change the future of these patients is what drives us every day at LimFlow.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?

We are still in the early days of developing the procedure and therapy. There are always many unknowns when you develop a new therapy. Therefore, we have to remain highly attentive to how it is deployed and how patients respond. The early clinical data is hugely encouraging, but we have much to learn, especially in how best to care for patients in the time it takes to heal the wound after treatment.

Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)

1. Understand the problem. Oftentimes, technologies are invented before looking for a solution. To make the most impact, it is much better to really dive into the problem you are trying to fix and then create a solution that fits the need. In the case of LimFlow, we knew that surgeons had tried to use veins to deliver blood to the foot, but those surgical approaches created large surgical wounds and other complications. We aim to accomplish that goal with tiny tools and only two small punctures. This means delivering maximum benefit with minimal trauma.
2. Make sure the future users are on board with the approach. At LimFlow, we have spent a lot of time understanding the needs and concerns of physicians who treat CLTI patients. This has changed how we developed the technology and designed our clinical trials, and now they are very excited about the solution we have developed.
3. You will need money to complete the project. Attracting capital is highly time and energy-intensive. The earlier you can understand the expectations and biases of potential investors, the sooner you can adapt your pitch to meet with success. Also, building long-term relationships with investors is key. Even if they say no the first time, if you come back later after accomplishing what you said you planned to do, they are much more likely to have the confidence to invest. At LimFlow, every investment round has been successively easier to raise for this very reason. Do what you said you were going to do, and the world (and wallets!) will open up for you.
4. You don’t need to always shoot for the moon but, instead, make sure to make it the next milestone. Staying focused on what is possible and achievable on a reasonable timescale is critical. Ultimately, our job is not to solve everything in the first iteration but to get the technology into use to start demonstrating its capabilities. At LimFlow, we believe the technology and mechanism of action have potentially extensive future applications for CLTI patients. But we choose to initially focus on a reasonably narrow indication (patients with no other options for revascularization) where we can prove the system works. Once that is achieved, we can then work on future technology iterations and clinical trials to grow to our fullest potential.
5. Keep your eyes on the prize but don’t get overwhelmed with the long road ahead. Never forget the problem you are trying to solve and the people you are trying to heal, but also know that you don’t have to solve it all today. Resetting every morning by remembering who you are trying to help will give you the energy to fight and bring others to your side. Someone once said, “You don’t have to have the courage for the entire journey. You only need the courage to get through today.” I think of this often as I lead LimFlow.

If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?

If you want to positively impact the world, it isn’t enough to have a “disruptive” approach. Ideally, you should be disruptive in the value you bring and fit well with the systems and pathways already in place today. Ultimately, you need people to want to use your approach. The easier you make it to do that, the greater the chance for adoption!

Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)

I am a big fan of Mike Horn, the South African explorer who swam the Amazon, completed a solo crossing of Antarctica, and many other exploits in the natural world. Even though we often feel like every part of our world is known, there are many different ways to continue to explore the boundaries of what we know and what is possible. I take a lot of motivation from seeing people like Mike challenge themselves and bring awareness about wild places. He doesn’t live too far from me, so maybe I will get my wish!