David Haggerty, Vine Medical - Soft Robot Platform for Endoluminal Navigation | LSI USA '24

David Haggerty  0:03  
Hello, everybody, thank you all for bearing with me this late into the conference. Hopefully we'll keep it short, sweet and fun. My name is David    Haggerty, co founder and CEO of Vine Medical. And today I'm going to talk to you about a problem that kind of just underneath the surface of awareness, it's kind of like a is water wet kind of problem. And that's the, you know, the over 100,000 miles of pathways to the human body, every single inch is traversed in the same medieval way. Effectively, we take a rigid tube, and we shove it through soft stuff. And you can imagine that, you know, in routine cases such as this, oftentimes, we don't have a lot of issues, right, you know, you might have a patient who's sedated but writhing in pain, you might have an a rare example, you know, some perforation, but unless you kind of routine example, you might have to wait a little bit longer, your case might take longer. But you know, in more advanced contexts, like an ERCP, you have an expert in daska post, you might have to drive 1000 miles to get there, it might get canceled, because you can't just calculate the damn papilla. And, you know, all was for naught. But oftentimes, these cases can also be critical. Many of us probably remember, a couple years ago, we had an NFL player who collapsed on the field. And everybody, Doc, everybody.

And once of the airway, doctors Comm, it's not a slam duck. Here we have airway doctors struggling to do the kind of two key features of intubation. Step one is you got to visualize, it's not going very well with the state of the art technology. Step two is you got to place the tube, which now that we start to see some larynx, the tube isn't going around the bend. And the reason for this is because we have a significant drop off in the skill paradigm. Whenever we talk about trying to push and slide a rigid tube through a torturous sensitive path, we have this high expertise requirement to not injure the patient and to effectively traverse that device, which comes with a high cost, you know, you might have some marginal technical benefits with an inflated cost that still requires some medical expertise and technical skill to ultimate ultimately concentrates care amongst you know, the experts of the expert that have gone through residency, internship and fellowship to develop the skill. So you know, we see it really clearly in airway management anesthesiologist, they don't feel it that much. They have done hundreds of 1000s of airway is not really a problem for him, but you step into the less controlled environment of the IDI, and they fail almost 20% of the time, you step out of the hospital, and it's about a 40% failure rate. And then you go out into the austere setting of the military. And it's a bloodbath, legitimately. And we kind of follow this rule of less training plus fewer resources equals worse performance. And we're trying to bring a new mindset to this problem. Where a Vine Medical, we create robots that grow instead of slide, these eliminate friction that reduce forces and most importantly, they decrease difficulty. So we can renormalize the requirement to traverse some women, these things can be very simple, you know, you take a tube, you seal one, and you shove it inside itself, you inflate it, it starts to grow. But they exhibit these nice behaviors of squeezing through small gaps or stenosis. They This is a straight blue tube that traverses 15 feet of torturous clear tube, and about 15 seconds less than a psi, we can outfit these with cameras and effectors tool channels, you name it. And that's enabled us to start with our first product, which really tries to address the skill gap and airway management. You basically just drop it in you advanced the E TT, and our growing system intelligently finds the airway, which you'll see here on the left isn't from above view on the right is from below. You shove the thing in, and as we grow, we intelligently find the hole. And in the last 30 cadavers we haven't missed with a lot of medical laypeople. We're competing with anesthesiologist. This part, you can pull that introducer out, you're left with a traditional ATT, a little bit of extra plastic around the end. But what's important is of those, you know, of the about 20 million intubations done in the United States per year one six of which are these like difficult and failed airways. And about 50% of them correspond with high complication rates on the order of like 50%, severe hypoxemia cardiac arrest, even death. But you know, that's a relatively small opportunity. and it doesn't hit the entirety of the problem which is in the hospital. There's pediatric airways, there are anatomically difficult airways, there are physiologically difficult airways that are still in this high resource setting for which visualization in the paradigm of physician empowerment still remains. So the step two in this product, we're starting pediatric airway case for the pain point is the highest, you know, stick a camera there rethink how we visualize, we see the vocal cords and see the petiole, we see the red retinoid, we know where we are, boom, now we are getting to the point we're finding an airway is in fact a slam dunk. And with this new paradigm, we also have the ability to hit this mass market opportunity of the remaining 2.3 billion or so per year. And in this paradigm, we invert the scales now we have a low expertise requirements to deliver high quality care, and so doing and doing so at competitive prices. We deliver extremely high value to providers. And we ended up distributing care such that nurses physician's assistants, paramedics now can deliver the same sort of care as MDS. So we're really here to reinvent how we access the human body. And we're starting with this low resource skill free device for austere medicine supported by the DOD, followed by a mass market version starting in in hospital pinpointed pediatric patients expanding to the daily driver indication of adult airway management, followed by endoscopy, endovascular, and ultimately endoluminal surgery. And all the while we're basically building on additional capabilities at marginal cost and lower marginal cost. We've done so with broad IP portfolio that started out of my research lab at UCSB, we have an equity free license on about six different cases that cover the core technology. And our company has built on top of these, we've gone through rapid r&d iteratively testing in over 100 cadavers with now over 25 users for both the first and second gen product. We've frozen the design, and now we're kicking off manufacturing about a year out from first in human. So we've reduced the technical risk as far as possible. And we've gone on to interview about 150 providers from every point of care, done pricing services where use expectations and willingness to pay were exceeded. We've brought on cables from anesthesia, emergency medicine, military medicine, and more. And we have a path to $100 million in revenue developed alongside veterans in the industry. And then finally, we've aligned with the FDA on actually a 510 K regulatory pathway. We anticipate breakthrough device for all the reasons previously outlined. We fit in existing codes for both routine and emergent airway management hospital and pre hospital if we do in fact get breakthrough device we have n tap and TPT to pursue. And importantly, we've done so all with very high capital efficiency. We raised now over 1.5 million in our seed round still have 400 grand left there. And we've raised almost 2.4 million in grant money with over 2 million left to deploy. We see our market entrance in about 12 months with our first product followed quickly thereafter by a visualization device about five years or so for interventional platform, and about 10 years to get to endoluminal surgery in the way that we envision it. And this is the team that we believe is going to be integral in getting to that point, myself David    Haggerty I did my PhD in soft robotics and vented a lot of the technology shown here today, alongside my adviser Elliot Hawkes and David drover. We've built the team out to include operators like James khazali, regulators like Todd Courtney NMDs, like Jose and Aman. And if you have any questions, please take down my email and feel free to reach out. Thank you all for taking the time.