A Self-Starter’s Guide to Medtech

Interview with Liberate Medical CEO Angus McLachlan

Meet Angus McLachlan, the co-founder and driving force behind Liberate Medical. Born in Scotland, Angus embarked on a mechanical engineering journey at the University of Glasgow where his final project was a system that aids patients with spinal cord injuries using a brain-computer interface. Although Angus didn’t pursue this particular niche further, it did lay the groundwork for a deeper dive into the world of biomedical engineering. "That's really where I got introduced to research and to stimulation," Angus recalls.

The project set the stage for his Ph.D., during which he explored different methods of electrical muscle stimulation to aid patients with spinal cord injuries by looking at improving various things like respiratory muscle strength or aiding in coughing. It was conducted within the Spinal Cord Injury Hospital, a collaborative hub where engineers and clinicians could come together to solve real-world problems.

It was there that a clinician approached Angus with a perplexing patient case. A young man who was on mechanical ventilation had hit a plateau in his recovery. He had managed to breathe on his own for approximately 12 hours a day, but the atrophy, or muscle weakening, in his lungs, didn’t let him make further progress for about four to five weeks using conventional weaning techniques. Such stagnation poses a significant concern, as long-term use of mechanical ventilation may lead to complications such as ventilator-associated pneumonia, further muscle atrophy, and others.

Recognizing an opportunity to apply his research, Angus initiated a case study to use electrical muscle stimulation on the patient's breathing muscles to see whether it could assist in improving the breathing autonomy of the patient by strengthening his respiratory muscles. After four weeks of using Angus’s device, the patient successfully transitioned off the ventilator.

This successful case study caught the attention of Apellis Pharma, which was a budding startup in Louisville, Kentucky, at the time. They brought Angus on board to explore a potential device for patients with chronic obstructive pulmonary disease (COPD). This eventually led to the birth of Liberate Medical, with Angus at the helm.

Today, Liberate Medical stands at the cutting edge of non-invasive neuromuscular electrical stimulation. By combining a stimulator with a breathing sensor, their device, VentFree, ensures synchronization between a patient's breathing pattern and the contractions of lung muscles. Initially developed for spinal cord injury and then COPD, its focus now lies in aiding patients with invasive mechanical ventilation. Angus paints the picture clearly: "When a patient goes on a ventilator, the ventilator is breathing for them. We're trying to train those breathing muscles while the patient's on the ventilator."

Liberate has obtained CE mark from the European Commission and Breakthrough Device Designation from the FDA. Currently, the company is primarily focused on its pivotal clinical study, a crucial milestone on its way to FDA clearance and gaining the trust of clinicians.

Key Learnings From Angus’s Experience

  • During the early stages of development, there’s not an endless budget to play around with. Narrow your focus to only the core functionality that is needed, leverage existing resources creatively, and cultivate the internal passion of your team to drive innovation.
  • Rely on your in-house expertise for specialized work. A deep understanding of your product makes you the best person to oversee development or handle conversations with regulatory bodies.
  • Effective communication is vital in finding good capital partners. Learn to read the room for each pitch and adjust your narrative accordingly to best convey your message. Once you secure favorable investors, keep them in the loop and maintain a constructive relationship for long-term support.
Guest
Angus McLachlan
CEO of Liberate Medical

Angus McLachlan, co-founder and CEO of Liberate Medical, has a rich academic and professional history that intersects engineering and healthcare. Originating from Scotland, Angus began his academic journey in mechanical engineering at the University of Glasgow. This laid the foundation for his PhD research focused on electrical muscle stimulation for spinal cord injuries. His innovative work gained the attention of Apellis Pharma, leading to a collaboration that propelled the launch of his own company, Liberate Medical. Liberate is pioneering a non-invasive neuromuscular electrical stimulator to prevent muscle weakening in patients who rely on a ventilator to breathe.

Smart Prototyping on Limited Funds

Early-stage companies with limited funds and grand ambitions have to use their resources strategically. 

First things first, you need to understand the core features of your technology and focus on perfecting them. Here are the two questions you need to answer clearly: What is the main purpose of your device? Does it do it effectively? 

In Angus’s words, "In the early versions of the prototype, I do think it's very important to work out what's really the core, unique functionality with your technology." For Liberate Medical, this is synchronizing stimulation with a patient's breathing pattern. By focusing on this central aspect, Angus and his team were able to purposefully direct their limited resources, securing maximum impact from every investment.

Angus shares, "We just had to make sure we could get the device working, do its unique thing, and show that that unique thing was beneficial to patients." 

Once you know your product’s basic functionality like the back of your hand, there’s room for creativity. That being said, it’s still important to keep a pragmatic attitude and try to leverage existing resources. For example, Angus ingeniously adapted a stimulator that was already commercially available to Liberate’s specific needs instead of starting from scratch. 

He recalls, "We were able to avoid having to develop the whole stimulation circuit and get IEC testing for that stimulation circuit, which is a time-consuming and expensive process. We were able to avoid all that to get to our first prototypes and first clinical data. That was a huge time saver." 

Similarly, they used bifurcation cables to connect two smaller electrodes, creating the size they needed, and used a cheap 3D printer for the user interface — UI is important, but not in the initial stage. These practical solutions enabled them to create affordable, functional prototypes. Even though they weren’t the epitome of elegance, these first versions validated what VentFree was capable of doing.

Once they achieved positive results in pilot trials, Liberate’s focus expanded beyond their product’s core capabilities. Angus recalls, "After we did those pilot trials, that's when usability became much more of the focus of the product development." By being strategic with their changing priorities throughout the device's development cycle, Liberate was able to address all aspects of the end product.

Lastly, the challenges for new technologies don’t end when you prove their efficacy. You also need to promote the integration into existing medical workflows. That’s when it’s crucial to put yourself in the shoes of the end-users. Angus says, "We wanted to learn from them (physicians) as much as possible about their current workflow. Then we design the device around that to make sure it’s as easy as possible to use."

To Outsource or Not

In the start-up ecosystem, operating with a lean approach is not a one-size-fits-all strategy. The best path forward often depends on the nuances of what you’re developing, and while outsourcing might seem tempting, it comes with its pitfalls.

For example, when developing the alpha and beta versions of your product, one thing you need to do is to iterate quickly based on evidence and feedback. Here, full control might yield better results. Angus points out, "You just have to keep trying things to get something that works. That can end up being really expensive, even with a great outside contractor."

Angus also challenges the conventional approach of outsourcing regulatory initiatives right away. Case in point: Liberate doesn’t have a regulatory consultant. Such an absence might seem atypical to other companies, but Angus leans into his strengths and successfully capitalizes on in-house expertise before considering external assistance. He leads crucial conversations with regulatory bodies by drawing upon his clinical experience from his PhD days. He says, “You can pay a consultant to do the predicate analysis, but it's not that hard. You can also just work it out yourself, find the product codes, find devices, etc. And you're probably doing more thorough research, just because it's your baby.”

To do it yourself as Angus advises, you first need a thorough understanding of your device. Then, Angus recommends writing regulatory submissions as much as you can, especially on the technical aspects of your product, since you know the technology better than any external consultant ever will. This makes you the best person to have informed and fruitful conversations with regulatory bodies.

Angus shares, "We really had to know the literature so we could convey why we thought it was important both to clinicians or investors."

In the spirit of tackling challenges hands-on, Angus’s approach extends beyond Liberate's immediate product development. The onset of the COVID-19 pandemic put Liberate in a precarious position, as it did with countless startups grappling with supply chain chaos and stringent travel restrictions. The team's proactive stance and Angus's leadership allowed Liberate to overcome these hurdles. They were able to obtain an Emergency Use Authorization (EUA) during the pandemic. Remarkably, Liberate Medical was in production by September 2020.

Speak the Language of Your Investors

When you’re raising funds, effective communication is a must. One tenet of any successful communicator is their ability to fine-tune the messaging based on their audience. When speaking to different investor groups, like VCs or angel investors, tailoring your pitches accordingly is always a good practice. While Angus is a technical guy who knows all the mechanisms of his device inside and out, he’s capable of simplifying it all for his audience. He understands that his investors come from diverse backgrounds and may lack specialized knowledge, so he adjusts his pitch to make the complex comprehensible for them.

For example, Angus shares, "The initial rounds were all angel groups or individual angel investors. They're not all experts in medical devices or intensive care or respiration." But as VentFree matured and Liberate approached its Series B round, the company's target shifted towards venture capital groups. Angus emphasizes: ”As you get speaking to more VCs, the level of the depth of detail they go into and the technical discussion is a bit more intense." VCs bring heightened scrutiny and diligence to the table and you need to be able to address that when needed.

Persistence is another cornerstone of fundraising success. "For any fundraiser, you just have to speak to a lot of investors. I would love to say it was a quick process, but it was not. You just have to keep hearing a lot of no’s", Angus shares. However, the challenge doesn’t end once you secure the funding. Moving forward, it’s important to foster and maintain strong relationships with your investors. 

"We've always done a regular shareholder update. That's been extremely helpful. We had pretty good insider participation and they've been extremely supportive over the multiple rounds of funding that we've done," Angus disclosed. Such a relationship can determine the future of your company, not only in terms of your immediate fundraising goals, but also when it comes to long-term success.

Lastly, Angus imparts another nugget of wisdom for those looking to secure funding: don't overlook grants. Procuring grants is a detailed, elaborate process, maybe even more so if you’re not coming from an intensive academic background like Angus. However, they are extremely beneficial, especially as they are non-dilutive and can often bridge crucial funding gaps.

Download a copy of the interview transcript right here.
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Meet Angus McLachlan, the co-founder and driving force behind Liberate Medical. Born in Scotland, Angus embarked on a mechanical engineering journey at the University of Glasgow where his final project was a system that aids patients with spinal cord injuries using a brain-computer interface. Although Angus didn’t pursue this particular niche further, it did lay the groundwork for a deeper dive into the world of biomedical engineering. "That's really where I got introduced to research and to stimulation," Angus recalls.

The project set the stage for his Ph.D., during which he explored different methods of electrical muscle stimulation to aid patients with spinal cord injuries by looking at improving various things like respiratory muscle strength or aiding in coughing. It was conducted within the Spinal Cord Injury Hospital, a collaborative hub where engineers and clinicians could come together to solve real-world problems.

It was there that a clinician approached Angus with a perplexing patient case. A young man who was on mechanical ventilation had hit a plateau in his recovery. He had managed to breathe on his own for approximately 12 hours a day, but the atrophy, or muscle weakening, in his lungs, didn’t let him make further progress for about four to five weeks using conventional weaning techniques. Such stagnation poses a significant concern, as long-term use of mechanical ventilation may lead to complications such as ventilator-associated pneumonia, further muscle atrophy, and others.

Recognizing an opportunity to apply his research, Angus initiated a case study to use electrical muscle stimulation on the patient's breathing muscles to see whether it could assist in improving the breathing autonomy of the patient by strengthening his respiratory muscles. After four weeks of using Angus’s device, the patient successfully transitioned off the ventilator.

This successful case study caught the attention of Apellis Pharma, which was a budding startup in Louisville, Kentucky, at the time. They brought Angus on board to explore a potential device for patients with chronic obstructive pulmonary disease (COPD). This eventually led to the birth of Liberate Medical, with Angus at the helm.

Today, Liberate Medical stands at the cutting edge of non-invasive neuromuscular electrical stimulation. By combining a stimulator with a breathing sensor, their device, VentFree, ensures synchronization between a patient's breathing pattern and the contractions of lung muscles. Initially developed for spinal cord injury and then COPD, its focus now lies in aiding patients with invasive mechanical ventilation. Angus paints the picture clearly: "When a patient goes on a ventilator, the ventilator is breathing for them. We're trying to train those breathing muscles while the patient's on the ventilator."

Liberate has obtained CE mark from the European Commission and Breakthrough Device Designation from the FDA. Currently, the company is primarily focused on its pivotal clinical study, a crucial milestone on its way to FDA clearance and gaining the trust of clinicians.

Key Learnings From Angus’s Experience

  • During the early stages of development, there’s not an endless budget to play around with. Narrow your focus to only the core functionality that is needed, leverage existing resources creatively, and cultivate the internal passion of your team to drive innovation.
  • Rely on your in-house expertise for specialized work. A deep understanding of your product makes you the best person to oversee development or handle conversations with regulatory bodies.
  • Effective communication is vital in finding good capital partners. Learn to read the room for each pitch and adjust your narrative accordingly to best convey your message. Once you secure favorable investors, keep them in the loop and maintain a constructive relationship for long-term support.
Guest
Angus McLachlan
CEO of Liberate Medical

Angus McLachlan, co-founder and CEO of Liberate Medical, has a rich academic and professional history that intersects engineering and healthcare. Originating from Scotland, Angus began his academic journey in mechanical engineering at the University of Glasgow. This laid the foundation for his PhD research focused on electrical muscle stimulation for spinal cord injuries. His innovative work gained the attention of Apellis Pharma, leading to a collaboration that propelled the launch of his own company, Liberate Medical. Liberate is pioneering a non-invasive neuromuscular electrical stimulator to prevent muscle weakening in patients who rely on a ventilator to breathe.

Smart Prototyping on Limited Funds

Early-stage companies with limited funds and grand ambitions have to use their resources strategically. 

First things first, you need to understand the core features of your technology and focus on perfecting them. Here are the two questions you need to answer clearly: What is the main purpose of your device? Does it do it effectively? 

In Angus’s words, "In the early versions of the prototype, I do think it's very important to work out what's really the core, unique functionality with your technology." For Liberate Medical, this is synchronizing stimulation with a patient's breathing pattern. By focusing on this central aspect, Angus and his team were able to purposefully direct their limited resources, securing maximum impact from every investment.

Angus shares, "We just had to make sure we could get the device working, do its unique thing, and show that that unique thing was beneficial to patients." 

Once you know your product’s basic functionality like the back of your hand, there’s room for creativity. That being said, it’s still important to keep a pragmatic attitude and try to leverage existing resources. For example, Angus ingeniously adapted a stimulator that was already commercially available to Liberate’s specific needs instead of starting from scratch. 

He recalls, "We were able to avoid having to develop the whole stimulation circuit and get IEC testing for that stimulation circuit, which is a time-consuming and expensive process. We were able to avoid all that to get to our first prototypes and first clinical data. That was a huge time saver." 

Similarly, they used bifurcation cables to connect two smaller electrodes, creating the size they needed, and used a cheap 3D printer for the user interface — UI is important, but not in the initial stage. These practical solutions enabled them to create affordable, functional prototypes. Even though they weren’t the epitome of elegance, these first versions validated what VentFree was capable of doing.

Once they achieved positive results in pilot trials, Liberate’s focus expanded beyond their product’s core capabilities. Angus recalls, "After we did those pilot trials, that's when usability became much more of the focus of the product development." By being strategic with their changing priorities throughout the device's development cycle, Liberate was able to address all aspects of the end product.

Lastly, the challenges for new technologies don’t end when you prove their efficacy. You also need to promote the integration into existing medical workflows. That’s when it’s crucial to put yourself in the shoes of the end-users. Angus says, "We wanted to learn from them (physicians) as much as possible about their current workflow. Then we design the device around that to make sure it’s as easy as possible to use."

To Outsource or Not

In the start-up ecosystem, operating with a lean approach is not a one-size-fits-all strategy. The best path forward often depends on the nuances of what you’re developing, and while outsourcing might seem tempting, it comes with its pitfalls.

For example, when developing the alpha and beta versions of your product, one thing you need to do is to iterate quickly based on evidence and feedback. Here, full control might yield better results. Angus points out, "You just have to keep trying things to get something that works. That can end up being really expensive, even with a great outside contractor."

Angus also challenges the conventional approach of outsourcing regulatory initiatives right away. Case in point: Liberate doesn’t have a regulatory consultant. Such an absence might seem atypical to other companies, but Angus leans into his strengths and successfully capitalizes on in-house expertise before considering external assistance. He leads crucial conversations with regulatory bodies by drawing upon his clinical experience from his PhD days. He says, “You can pay a consultant to do the predicate analysis, but it's not that hard. You can also just work it out yourself, find the product codes, find devices, etc. And you're probably doing more thorough research, just because it's your baby.”

To do it yourself as Angus advises, you first need a thorough understanding of your device. Then, Angus recommends writing regulatory submissions as much as you can, especially on the technical aspects of your product, since you know the technology better than any external consultant ever will. This makes you the best person to have informed and fruitful conversations with regulatory bodies.

Angus shares, "We really had to know the literature so we could convey why we thought it was important both to clinicians or investors."

In the spirit of tackling challenges hands-on, Angus’s approach extends beyond Liberate's immediate product development. The onset of the COVID-19 pandemic put Liberate in a precarious position, as it did with countless startups grappling with supply chain chaos and stringent travel restrictions. The team's proactive stance and Angus's leadership allowed Liberate to overcome these hurdles. They were able to obtain an Emergency Use Authorization (EUA) during the pandemic. Remarkably, Liberate Medical was in production by September 2020.

Speak the Language of Your Investors

When you’re raising funds, effective communication is a must. One tenet of any successful communicator is their ability to fine-tune the messaging based on their audience. When speaking to different investor groups, like VCs or angel investors, tailoring your pitches accordingly is always a good practice. While Angus is a technical guy who knows all the mechanisms of his device inside and out, he’s capable of simplifying it all for his audience. He understands that his investors come from diverse backgrounds and may lack specialized knowledge, so he adjusts his pitch to make the complex comprehensible for them.

For example, Angus shares, "The initial rounds were all angel groups or individual angel investors. They're not all experts in medical devices or intensive care or respiration." But as VentFree matured and Liberate approached its Series B round, the company's target shifted towards venture capital groups. Angus emphasizes: ”As you get speaking to more VCs, the level of the depth of detail they go into and the technical discussion is a bit more intense." VCs bring heightened scrutiny and diligence to the table and you need to be able to address that when needed.

Persistence is another cornerstone of fundraising success. "For any fundraiser, you just have to speak to a lot of investors. I would love to say it was a quick process, but it was not. You just have to keep hearing a lot of no’s", Angus shares. However, the challenge doesn’t end once you secure the funding. Moving forward, it’s important to foster and maintain strong relationships with your investors. 

"We've always done a regular shareholder update. That's been extremely helpful. We had pretty good insider participation and they've been extremely supportive over the multiple rounds of funding that we've done," Angus disclosed. Such a relationship can determine the future of your company, not only in terms of your immediate fundraising goals, but also when it comes to long-term success.

Lastly, Angus imparts another nugget of wisdom for those looking to secure funding: don't overlook grants. Procuring grants is a detailed, elaborate process, maybe even more so if you’re not coming from an intensive academic background like Angus. However, they are extremely beneficial, especially as they are non-dilutive and can often bridge crucial funding gaps.

Download a copy of the interview transcript right here.
Share:
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