Foreword: The following is an abbreviated and edited transcript from the latest Medtech Trailblazers, the real stories behind the Innovators, Fogarty Innovation’s series of casual, in-depth conversations aimed at discovering the people who are forging our industry. To view part 1 of the videocast, click here; to listen to part 1 of the podcast, click here.
A prolific serial entrepreneur, Mir Imran has played a key role in shaping the medical technology industry. Over the span of 40 years, Mir has founded over 20 medtech companies, including Ventritex, Cardiac Pathways, Percusurge and most recently, Rani Therapeutics. Most of these startups have been acquired by larger companies or gone public. Mir is credited with the invention of multiple technologies that have advanced healthcare, including the first FDA-approved implantable cardiac defibrillator. The incubator he founded, InCube Labs, led to the formation of many of these inventions.
Born in India, he came to the U.S. to pursue his dream of applying his creative spirit to new technologies. Mir attended Rutgers University where he obtained a BS in electrical engineering and an MS in biomedical engineering. He also attended three years of medical school.
Mir (MI) sat down with Andrew Cleeland (AC) to share the insights he’s gained over his remarkable career, what drives him to identify problems, and the events and people who shaped his views about innovation. The following is an excerpt of that interview.
AC. Tell us about your early life, where did you grow up and what was it like?
MI. I grew up in Hyderabad, India, with a father who was a physician and a mother who was into literature and poetry. Even though I didn’t have entrepreneurs in my family, I was fortunate that they worked to understand my mindset which gave me the intellectual freedom that many others don’t have.
When I was young, I liked to break things, but only to learn how they worked. At first my mother would scold me for what looked like destructive behavior, but eventually we came to an agreement. She agreed with my request that she buy two of any type of machine or tool, and give one to me to take apart so I wouldn’t touch the other one. She gave me a room to use as my lab, and word got around my community that I could fix anything. Eventually I started building things like toys that I would sell to my friends. I would use the money I made to buy tools and instruments.
My curiosity had no boundaries; I was interested in anything from radios to sewing machines and wrist watches. When I was in eighth grade I got into electronics. Someone had left us a Popular Electronics magazine that I read over and over, and I saw an advertisement for a vocational institute for radio repair that I ended up attending after school. Along with the many textbooks I would buy for only a few pennies, these really opened up a whole new world. I then started to build tiny transistor radios in a matchbox and sell them. I used those funds to start applying to universities when I was in 10th grade.
AC. Why did you come to the U.S. for your college education?
MI. Growing up, my grandmother would send me to pay the utility bills once a month. You couldn’t mail a check, you would have to stand in line in the hot sun, with cash. And there was always someone who would cut the line by giving a bribe to the cashier. This also happened in schools; you could “buy” a degree, which made me furious.
The lack of ethics I saw made me realize I could never have a fair chance growing up in India unless I played the same game, so I started contacting universities in English-speaking countries. I went to the American Consulate, which was 500 miles away, to take the SAT. I ended up getting admitted to a number of universities, including Rutgers University. Because I didn’t have enough money for the full four years, I completed the degree in half the time by taking 30 to 32 credits per semester. All those projects I worked on during my childhood came to life as I was taking those courses.
I had my first experience with medical technology the first summer I spent at the university when I saw a notice on the bulletin board seeking help making communications aids for children with cerebral palsy. I went to the Matheney School, where I learned they needed help developing a communication tool for Jenny, a beautiful quadriplegic girl with cerebral palsy who didn’t have voluntary control over any muscle group. I took on the challenge. As I spent time playing with Jenny, I soon realized she had some voluntary muscle control when she wanted something so I designed a sensor that would allow her to move a cursor on a screen. It took an entire summer to build it from scratch. The experience was so powerful as I was watching the impact on that young girl.
AC. You did a stint at med school. Tell us about it.
MI. One of my professors strongly encouraged me to go to medical school. I really didn’t want to, but he introduced me to the head of surgery at Rutgers Medical School, Dr. Mackenzie, who was also a tinkerer and had many ideas for projects but no one to help him. So he agreed to help me get into medical school and give me a stipend if I helped him with his projects during my spare time. I set up a lab for the department of surgery and worked on a lot of interesting projects. But I didn’t enjoy medical school because the knowledge of medicine was quite rudimentary at the time, and there weren’t clear answers for so many of my questions. As an engineer, I was very frustrated.
Despite that, it eventually ended up being one of the best things that happened to me because there was an amazing list of problems that I kept thinking about. I then met a brilliant cardiologist from Johns Hopkins, Dr. Michel Mirowski. Sadly, his best friend had died from sudden cardiac death, which put him on a mission to create an automatic defibrillator. I had similar experience developing a deep brain stimulator. So, thanks to a project I had worked on with the department of psychiatry and, since electronics was second nature to me, I thought we should create a fully implantable defibrillator rather than a wearable one. So we started a company and went out to raise funds, which included a sizable $12 million investment from Eli Lilly. We conducted clinical trials and got FDA approvals, and Eli Lilly bought the company which eventually became part of Guidant.
I later met Ray Williams, a big contributor and investor in the medtech industry, and Bill Starling and we started a company named Ventritex. That’s how I met Dr. Fogarty, who also invested in the company, among many others.
AC. What was the inspiration behind Rani?
MI. I’ll start by saying that taking injectable biologic drugs and converting them to oral formulations has been a dream of every pharmaceutical scientist. And for the last 50 years, there have been at least 150 attempts at converting insulin or parathyroid hormone from injections to pills, yet these attempts have failed because the bioavailability – the amount of the drug that enters the circulation – is really low. The digestive enzymes just break down the proteins. And in the cases where it is successful, the bioavailability is very low — between a 10th of a percent and a half a percent.
This is where my medical school education came in handy. I remembered that intestines don’t have pain sensors like the skin does, so I thought why not create a pill that goes through the stomach intact, goes in the intestine, which is highly vascularized, transforms itself into an injection, and delivers a pain-free shot while the remnants are passed. So I created a single-use robot that does that.
The company is now doing very well and went public last year.
AC. Lastly, are you optimistic or pessimistic on the future of medtech and what advice would you give to young entrepreneurs?
MI. I’m super optimistic. I think we’ve done all the easy things, and now we can strategically utilize artificial intelligence where needed. But don’t start with AI and think of solving a problem with AI—that’s backward. Instead start with the problem and see if it can benefit from AI applications and algorithms and then a combination of electronics, software and wireless technologies—all of these things can dramatically enhance a therapy.
In terms of advice, when I started my journey, it was very lonely as I didn’t have role models or mentors. Today there are hundreds and everyone should take advantage of that. Also, everything requires a multidisciplinary approach. You might only have expertise in one or two areas, so figure out what additional skill sets are required and surround yourself with those experts, whether it’s a co-founder or an advisor or a set of advisors. One of the things that is beautiful about this multidisciplinary approach is that you work with a lot of different people, which can also provide an opportunity to learn various disciplines and develop a wide range of expertise.