Theranos' Highly-Anticipated Defense of Its Tech Is Called a 'Bait-And-Switch' | Hacker News Reader

Theranos' Highly-Anticipated Defense of Its Tech Is Called a 'Bait-And-Switch'

fortune.com

79 pointsmarcusgarvey42 comments

I watched the Q&A and part of the presentation on Periscope. It was a little hard to follow, but Holmes appeared to be on a short leash during the Q&A period, constrained to only talking about the new invention and cloud architecture, and deferring all the pointed questions about nanotainer numbers and anomalies to the three employees she brought on stage.

It also looks like they're going to attempt to get some kind of fast track approval of this new device by playing on Zika virus fears. There was one very pointed audience/expert question about the validity and inconsistency in their Zika virus claims that didn't appear to be fielded well.

As I understand it, this device will still take a small amount of blood, dilute it, and then theoretically perform up to hundreds of tests. So while Holmes made no attempt to answer the question of "how many finger pricks will it take to do these tests", one of her employees was still making the claim that a microliter dilution was enough--going from 170 uliter to 1 uliter.

The play could very well turn into Theranos waging a press and political war with the FDA around Zika in order to rush this out. The board advice may be paying off from a political/PR standpoint even though the presentation didn't answer any questions from a scientific standpoint.

Except the FDA has already cleared one Zika assay, and from this tweet at the AACC keynote the Theranos test is 50x less sensitive. And Dennis Lo isn't just some random guy in the audience.

https://twitter.com/DrDanHolmes/status/760232173836185600

The science is the science. You can't really wage a press war around the facts.

Hah, tell that to our current crop of presidential candidates!

Agree with Dr Lo as being the expert--didn't get into that detail in my comment. He was a moderator and it was difficult to tell which parts of the question he read was the original audience question versus his own--but the question was a devastating moment nonetheless, and the Theranos response was weak (something to the effect of "that 50x number isn't comparable/relevant because our measures use the new ranges the CDC gave us". It was more of an "are you lying now, or were you lying in this 2008 paper?" question. Holmes didn't open her mouth at all for that one, and there was an awkward moment of silence and glance over to figure out which employee was going to take that one.

I am less optimistic around the FDA's ultimate neutrality when it comes to political pressure. Facts certainly need to win, but Theranos didn't hire a board like they did if they were counting on facts alone to save the day. It's the same playbook from before, now pivoted to public health crises instead of a DoD endgame.

How is a person with a track record that tainted still in this position? And how is that organizations like the American Association for Clinical Chemistry (AACC) would still grant such a person access to such a large group?

"The wheels of justice turn slowly, but grind exceedingly fine."

They sure turned quickly for Martin Shkreli.

His company raised the price of a drug to an absurd level and overnight he became "the most hated man in America".

Her company endangered, and likely caused real harm to, numerous patients' health and she gets to keep on selling and is even given a platform by the AACC to due so.

I mean, Shkreli turned out to be such a psychopath that he couldn't even pretend not to be a monster for the media or a judge. I see him as the Jeffry Dahmer of that end of the spectrum to be honest, and just... extreme. Holmes seems like a much more composed fraudster.

If Shkreli was really incapable of pretending not to be a monster, then he is much less of a monster than many who lead pharmaceutical companies.

It saddens me that so many people delighted in indulging in a visceral hatred of this one individual, while seeming to be unaware that our entire system is overly influenced by many hundreds or thousands of people with similar values as him. The world would be a better place if the majority of Shkreli haters invested a tiny fraction of that energy into looking at the pharmaceutical industry as a whole, and the abuse of various mechanisms (patents included) to inflate prices and stifle competition.

Some of the other scumbags (at other pharmaceutical companies) were probably relieved that so many of us focused on hating Shkreli the person, rather than asking deeper questions about the legal and moral framework in which they all operate.

Hate the player and the game. Some of Shkreli's despicable actions were perfectly legal, so we should try to change the rules of the game (legislatively) rather than focusing so much on the character of one bad player.

Hated, yes, but the wheels of justice busted Shkreli for some other fraud in the past, not the price hikes. The most-hated-man status is in the court of public opinion, which isn't an actual court.

It does bring attention to the AACC. They also issued a pretty strong disclaimer (https://www.aacc.org/publications/cln/cln-stat/2016/july/5/t...):

> Holmes’ appearance does not reflect an endorsement of Theranos or its technology by AACC, and Theranos has not provided any financial contribution to AACC in exchange for the invitation to speak, nor has it provided any sponsorship monies or other forms of grants to AACC.

I remember having to do a lot of paperwork to speak at medical conferences because of CME credentialing. I wonder what happened in this specific case?

> “We hope to achieve FDA market authorizations of these exciting technologies in the coming years,” she said.

I've never thought about what it takes to run a medical devices company but think about that statement. It looks like Theranos just did a huge pivot and they won't be able to generate any revenue from the resulting pivot for atleast a few years?

At this point, shouldn't goal number one be to get a product, any product approved by the FDA, are they the only governing body they need to get approval from?, and then get it to market ASAP?

Someone get Holmes a copy of Ben Horowitz book "The hard thing about hard things". If she wasn't already, she is now a war time CEO.

> If she wasn't already, she is now a war time CEO.

It looks more like she's a post-Hiroshima CEO.

Perhaps, if the test offers a strategic or tactical advantage. I work in biotech on FDA regulated devices and assays. Just throwing something out there doesn't mean it has sufficient clinical utility to reach volume, and the process is very expensive.

The complete video presentation:

https://m.youtube.com/watch?v=n6JRG733ReQ

Slides:

https://www.aacc.org/~/media/files/annual-meeting/2016/thera...

Legitimate question to people involved in funding, incubators, etc. Does this hurt the perception of women founders/CEOs in the margin (where a VC or maybe YCombinator has to pick five companies out of ten where eight look pretty good)?

I mean, I've seen a lot of criticism in the non-stupid parts of the internet about Marissa Mayer, for example -- and she arrived really late to the party.

Now, I know that rushing to conclusions about "women entrepreneurs" from three, five, fifteen, sixty-seven cases is really sexist because we don't rush to say men are terrible entrepreneus because of countless projects gone awry. I mean, I can only imagine the vitriol Nick Denton would have gone through were he a woman.

But people are sexist. People are racists -- if instead of female CEOs we were talking Sri Lankan CEOs, we'd have long arrived at a cliché conclusion, I think. Am I too pessimistic?

I don't have capital, so my opinion is distanced from the point of friction. However, that said, no, I don't think they will affect other female entrepreneurs negatively.

Moreover, Mayer, Holmes, etc. will see more opportunities in the future. Once people are on this track it's seldom they fall off completely. Someone will see potential in them.

Whether you think they executed well or not, this time round, they have invaluable experience for the next company.

>Once people are on this track it's seldom they fall off completely.

Yup, and it applies to both genders. I have seen idiots running their companies into the ground only to re-surface a few years later at another company, as CEOs, because: experience.

"Once a CEO, always a CEO".

> if instead of female CEOs we were talking Sri Lankan CEOs, we'd have long arrived at a cliché conclusion

I wasn't able to follow this sentence. What is the cliché with Sri Lankan CEOs? I'm not even sure I know of any. I had to look up Sri Lanka to find out that it is not part of India because initially I assumed you were trying to say something about the Indian CEOs we see in the valley.

I think the idea is that our (American) culture doesn't have an 'immune system' that responds defensively and automatically to criticisms of Sri Lankan professionals in the way that is extended to some women today

I'm assuming it was a hypothetical. If several highly publicized Sri Lankan CEOs failed miserably - would people come to a conclusion about Sri Lankan CEO's being worse, and be less likely to support them in the future? The OP thinks people would take the pattern of Sri Lankan CEO's and extrapolate. Replace "Sri Lankan" with "Female" - and maybe this pattern will apply to future Women CEOs as well.

There are already plenty of VCs and other influencers who, knowingly or not and intentionally or not, demonstrate sexist behaviors and attitudes. You see it over and over and over.

If you're already prone to some degree of sexism, observing Theranos, Yahoo, and maybe uBeam recently might result in confirmation bias kicking in.

If you try to be rational and as self-aware as you can though, you realize these are just a handful of examples with coincident timing and there are many, many, many times as many female CEOs who are doing just fine. You also recall all the male CEOs who have been fuckups or caused tremendous damage, not only in startupland but elsewhere like Wall St, and realize that sex is probably not a significant contributor to outcome. Mindset and ethics are among the far more likely indicators.

So, will this affect things on the margin? Maybe... with people predisposed to look for negative signals about fitness of women as CEOs. Not for anyone trying to be as objective as possible.

"and realize that sex is probably not a significant contributor to outcome"

It is sort of a doubled edged sword, if race and gender have no significant effect on outcome, then in a way that could be used as a justification for blocking those people from said positions. On the other hand, if it's the opposite then is purely superficial.

There's a term for Marissa Mayer's situation: "Glass cliff"

A partial answer is that it will hurt in the following way. The main reason Theranos got so big, both as a company and (especially) as a story, was that Holmes was presented as the female Steve Jobs. In future investors might ask themselves "am I falling for another Elizabeth Holmes? I recall reading that Paul Graham once noted that he was vulnerable to giving extra credit to guys who looked and dressed like Mark Zuckerberg.Prejudice as a cognitive bias works both ways and if you are conscious of it, you might overcorrect

Substantive issues aside, Holmes seems to be getting very bad PR advice.

Which is kinda surprising. With her board of directors stacked with people coming from the politics environment, you would think they can get better PR people.

She may not be heeding their advice.

Typically people from politics don't understand business very well.

Typically people from politics don't understand anything very well - except begging for cash from sponsors.

Politics is upscale professional pan-handling - which goes a long way to explaining the quality of so many political decisions.

Sr political people don't need complex PR strategies. They have working relationships with the top reporters.

If they're unhappy with press coverage they just phone the reporters and try to explain their position.

Or her lawyers don't want her making public statements that will prove harmful in future litigation...

And very bad quality control. And an inversion of priorities.

Agreed. The bait-and-switch wasn't at all necessary. It's not like no one would show up if she held a press conference to announce a new product.

I think she's getting legal advice, not PR advice. This is almost certainly about avoiding criminal charges, and/or jail, not about saving an exposed fraud.

It somewhat indirectly highlights how much of common public understands statistics and their application.

Tigers don't change their stripes.

I'm inspired by Holmes. It's clear that she's trying to do something very hard that would benefit humanity but instead her company's failures are making headlines. People on Twitter are spewing sexist garbage about her, or trashing her character, but to me she looks like she's just soldiering on. Respect.

I don't know how I'd handle the level of scrutiny she's under.

> I don't know how I'd handle the level of scrutiny she's under.

I'd hope that you would step down from your post as CEO because you're too damaged to lead the company any further rather than to cling to your CEO position and likely accelerate the sinking of the ship.

To me it looks like she's defrauding investors and intentionally lying about Theranos' status and products. But sure, "soldiering on"...

I'm not sure if you are saying we can respect individual aspects of a person, even if they suffer moral deficiencies...

...or if you are saying you are confident that everything she has said and done was said/done in good faith.

That they are trying to do something incredibly hard doesn't excuse the fact that they did a shoddy job doing medical tests.

It's actually sort of difficult to understand what they thought they would gain by exposing the public to their experimental tests.

I've said this before, but it would make a lot more sense to me to establish an exemplary traditional lab and use that for opt-in proofing of your revolutionary tests than it did to establish a shitty corrupt lab and void thousands of test results.

It's sort of an indictment of the concept of consumer education that anyone would still trust their health to the results of a test run by this company.

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