Spinal fractures from osteoporosis cause many to lose their independence. Industry veteran Dom Messerli has a better way of fixing the problem than the risky practice of injecting liquid epoxy into the spine. Using engineered human bone, Lenoss Medical is offering a treatment that is safer, effective and easier to administer than the current standard.
Highlights:
Sal Daher, CFA Introduces Dom Messerli, Founder of Lenoss Medical
“Many times, the patients lose their independence when those fractures happen.”
Current Standard of Care is to Inject Liquid Epoxy into the Spine – What Could Go Wrong?
Liquid Epoxy Can Leak into Blood Vessels and Create Blockages
“When it's in the heart, usually what's prescribed is open heart surgery to take out the piece of cured cement out of the heart.”
Lenoss Medical’s Solution: Engineered Human Bone Material to Build Up the Weakened Spine
Grafting of Same-Species Bone Material Is Decades Old – What’s new Is Applying the Approach to Spinal Fractures
“...conducive for new bone formation.”
There’s No Donor Matching or Donor Rejection Issue Since No Living Cells Are Implanted
Lenoss Medical Was the Subject of Dom’s MBA Degree Project
Lenoss Medical Plans to Go to Market Via Distributors Specializing in Products for Spinal Treatments
The Argument for Hospitals Is Reducing Risk and Simplifying the Process
FDA Approval Process Was Relatively Low-Burden, Human Cell and Tissue Product Pathway
Dom Messerli’s Immigrant Story
“Eventually, I was affected with the layoff. I was waiting for that day. The next day is when I started Lenoss Medical.”
“...I feel we can have a positive impact with these patients with osteoporosis and the spinal fractures. That drives me.”
ANGEL INVEST BOSTON IS SPONSORED BY:
Transcript of “"Treating Spinal Fractures Better"
Guest: Dom Messerli, Founder of Lenoss Medical
Sal Daher: I'm really proud to say that the Angel Invest Boston podcast is sponsored by Purdue University Entrepreneurship and Peter Fasse, patent attorney at Fish & Richardson.
Purdue is exceptional in its support of its faculty, faculty for its top five engineering school, in helping them get their technology from the lab out to the market, out to industry, out to the clinic.
Peter Fasse is also a great support to entrepreneurs. He is a patent attorney specializing in microfluidics and has been tremendously helpful to some of the startups in which I'm involved, including a startup that came out of Purdue, Savran Technologies. I'm proud to have these two sponsors for my podcast.
Sal Daher, CFA Introduces Dom Messerli, Founder of Lenoss Medical
Welcome to Angel Invest Boston, conversations with Boston's most interesting angels and founders. I'm Sal Daher, an angel who delights in speaking with founders and angels to learn more about better ways to build really interesting technology startups. Today we have a wonderful founder whose name is Dom Messerli. Welcome, Dom.
Dom Messerli: Good morning. Thanks for having me, Sal.
Sal Daher: Awesome. Dom is the founder of Lenoss Medical. I'm very grateful to John Williams for engineering this connection for Dom to be on the podcast because John is a happy investor and also has a hand, he's involved, he's in the marketing/sales at Lenoss. Anyway, Dom, what problem is Lenoss Medical solving?
Dom Messerli: Well, again, thanks for having me, Sal. It's great to be here. Happy that John was able to make the introduction as well, him being an investor and now actually a member of our team.
Sal Daher: [laughs]
Dom Messerli: It's been fantastic. The problem we're solving is, in simple terms, fractures of the patient's back, specifically fractures of patients that have osteoporosis. If it's an elderly patient population, just by sometimes lifting a small flower pot-
Sal Daher: Oh, very sad.
“Many times, the patients lose their independence when those fractures happen.”
Dom Messerli: -they actually fracture their vertebral bodies. They fracture their spine. Those fractures are extremely painful and many times very debilitating. Many times, the patients lose their independence when those fractures happen. They have to be treated surgically so that the patients get their mobility back and also, certainly, the pain levels are being reduced. Today's standard of care, the surgical treatment actually involves an injection of liquid epoxy. It's called a PMMA bone cement, but what it is it's an epoxy.
Current Standard of Care is to Inject Liquid Epoxy into the Spine – What Could Go Wrong?
If anyone is in the boating industry or ever had to fix a hole in a boat or anywhere with an epoxy, you know what I mean by an epoxy. It's something you mix together and then over time, it hardens. That's the current standard of care. An epoxy is being mixed in the operating room and then is injected through a small incision or two small incisions from the back, inserted, and then injected into the spine. The patients undergo this treatment in about one hour. Usually, it's outpatient. They go home. The pain reduction is quite significant. They get their mobility back and they do quite well.
Unfortunately, the problem is it's a liquid epoxy and there's a lot of arteries and veins or blood vessels going into the spine.
Sal Daher: Oh, no.
Liquid Epoxy Can Leak into Blood Vessels and Create Blockages
Dom Messerli: Unfortunately, in some cases, that liquid epoxy actually leaks out into the patient's vascular system. It can end up just in the vein, or it can actually travel up into the patient's heart, get stuck in their heart-
Sal Daher: Oh my gosh. Oh, no.
Dom Messerli: -or sometimes, when the patient is lucky, gets through the heart and it rests in the lung. Now, once in the lungs, there's nothing that can be done. When it's in the heart, usually what's prescribed is open heart surgery to take out the piece of cured cement out of the heart.
“When it's in the heart, usually what's prescribed is open heart surgery to take out the piece of cured cement out of the heart.”
Sal Daher: Oh, no.
Dom Messerli: We've done some research. We've found 40 publications of case reports of where there was an open-heart surgery to remove the piece of cement out of the heart.
Sal Daher: Oh my God. If there'd been one, this would have been justified, but just 40, it's probably 10 times that.
Dom Messerli: Correct.
Sal Daher: It just hasn't been reported.
Dom Messerli: We spoke to a cardiologist, these are the physicians who then actually have to treat the problem, spoke to him who actually published his case in the New England Journal of Medicine. We spoke to him. He said, "Dom, I think this is a public health issue. It's very underreported." He is very interested in solving the problem.
Sal Daher: How does your formulation solve the problem?
Lenoss Medical’s Solution: Engineered Human Bone Material to Build Up the Weakened Bones in the Spine
Dom Messerli: Yes, exactly. Right on cue, how do we come in? Our experience and my experience have been in spine my entire career. We've worked with a material called allograft tissue. What that is, is bone that's harvested from people that have passed away. The bone is really suitable to be used for surgeries. Actually, has been used over three decades in orthopedic and spinal surgery where the bone, again, it's called allograft bone, is then being used to treat any kind of bone maladies and has worked extremely well, specifically for spinal surgeries. Specifically, when there was back pain because of disc has been degenerated.
Grafting of Same-Species Bone Material Is Decades Old – What’s new Is Applying the Approach to Spinal Fractures
We have a lot of experience of innovating implants made out of allograft bone and has never been used to actually treat these osteoporotic spinal fractures.
Sal Daher: This is a well-established material for doing these grafts of same species biological material bone from humans into the vertebrae with surgery. Your innovation is creating some kind of an injectable formulation of it? Is that the point?
Dom Messerli: Very close. Injectable is maybe not the appropriate term because it is a structural piece of allograft bone.
Sal Daher: It's like minimally invasive piece of bone that can be put into the fracture.
Dom Messerli: Correct. Yes. I'll explain it to you so you can visualize it. It's like a string of pearls. The cortical bone is a string of pearls. The way we engineer it, it's all 100% cortical bone. Even the string is actually cortical bone and there’s...a lot of our innovation is within how we fabricate the allograft implant and how we fabricate that string. It's all monolithic piece of bone, but then it goes through a specific processing in our tissue bank, which right before surgery, makes the string flexible.
Now the implant can be inserted in the same surgical technique as the current standard of care in a minimally invasive fashion, it's either one stab incision or two stab incisions and inserted in a minimally invasive fashion and pushed into the spine or pushed into the vertebral body and then filling that vertebral body that was weak with bone or didn't have enough bone and was fractured, now we inserted new cortical bone. Again, it's called the allograft bone. Then that bone also has been studied for many years to then be conducive for new bone formation.
“...conducive for new bone formation.”
Sal Daher: Oh, okay.
Dom Messerli: Not only are we treating the acute fracture, stabilizing the acute fracture with really pushing in this, we call it the OsteoPearl implant, push that in, and then over time the natural healing process occurs and the patient's own nutrients and stem cells come in and generate a new bone formation because we just added a bone material that's conducive to new bone formation and now there's physiological fracture healing.
Now the patient goes back to normal biomechanics and normal bone like where it was before, or actually even better, because we just added new bone, or we're actually regenerating new bone over time. Again, I always have to say, it's like, "We didn't come up with the idea of the new bone formation and an allograft bone."
Sal Daher: Right. You are creating a formulation which can be used in a minimally invasive setting instead of requiring full surgery.
Dom Messerli: Yes, right on. That's exactly what it is.
Sal Daher: Okay. Now, how is it held in place? By just jamming it into the crevices?
Dom Messerli: Think of it this way, the spine consists of vertebral bodies and the vertebral bodies are like little boxes. The outer shell of that box is also stronger structural cortical bone, and the inside is, we call it cancellous bone, weak bone, more kind of mushy bone, so as the OsteoPearl implant is inserted, pushed in, it fills that inner box. It's almost like if you think of a bag that is filled with granules or, what do you call it, rocks that are used to create barriers for watersheds or so. As you push in these pearls or as you push in granules in a bag--
Sal Daher: Like these wave breakers, the sea walls.
Dom Messerli: Right.
Sal Daher: It's just the weight of it, it holds it down into the crevice and then jam it in. Actually, if you have some graphic assets showing this, I would love to put it on the episode page so people can look at it.
Dom Messerli: Yes
Sal Daher: I'm seeing behind you right now. I'm seeing a bunch of pearl-like things being jammed into little holes.
Dom Messerli: That's it right there. I think those three images that you see behind me are the ones really, I can share with you. The mental visual image as well is if you think of the sandbags that are filled with sand and you can stand on top of it once it's filled. It's the same concept. We're filling the vertebral body with these structural OsteoPearl implants and it gets very dense.
Another feature, which is quite amazing, is actually as the implants are implanted inside the vertebral body, over the first two hours, they actually swell up with the patient's own blood. They fill up with the patient's own nutrients and stem cells. As they fill up, they actually swell up almost a little bit like a sponge, about 40%. It actually even creates more pressure, more stability to make the fracture stable.
Sal Daher: It strengthens the material immediately.
Dom Messerli: Correct.
Sal Daher: Part of the problem with osteoporosis is that as human beings our ability to bring the nutrients necessary to form bone is impaired. As we age our ability to extract that and to put it into place is impaired. What you're doing is you're coming in with an external...you're cheating nature by coming in with bone material ready-made and put into place to supplement that person's deficient ability to produce the nutrients. The body says, "Oh, great, I've got all this material. All I have to do is just integrate it into the system that I have here." Which brings to mind, any problems with rejection since this is tissue from another human being?
Dom Messerli: That's a very important point. That's something I've had to learn myself as well, is because when you think of, let's say, organ donation, that there is tissue rejection. That's always associated with organs that have really living cells in the organs. Now, with bone, that is different because it's just the bone that we take.
Sal Daher: It's just mineral.
There’s No Donor Matching or Donor Rejection Issue Since No Living Cells Are Implanted
Dom Messerli: It's just the mineral of the bone. There is no donor matching or donor rejection. The human body just immediately accepts that new bone. The patient doesn't have to take any drugs for potential organ rejections or something like that. It's just literally a perfect match. That's why it's been used for many decades now in orthopedic surgery.
Sal Daher: It's remineralizing bone and then allowing the natural processes to integrate that mineral into the structure of the bone.
Dom Messerli: We call it, from a scientific perspective, the material is osteoconductive and osteoinductive. Essentially what that means, it provides the proper perfect scaffold for bone formation. The osteoinduction provides, actually, the infusion of the bone formation.
Sal Daher: Induction is to trigger creation of bone?
Dom Messerli: Correct.
Sal Daher: This is really, really fascinating. Let's get to the business side of Lenoss. How is it that you're hoping to become a profitable company with this very clever product?
Dom Messerli: Someone told me at one point, it's like, "Dom, just remember, hope is not a plan."
Sal Daher: Right.
[laughter]
You spent many years at Johnson & Johnson and other big players, so you understand the business side of it.
Dom Messerli: Absolutely. My background was mechanical engineering, but then also I was lucky enough to go through MBA at Penn State. Then, certainly, at my function at Synthes and J&J, I was a business leader and certainly needed the business acumen as well. Luckily enough, actually, when I did go through my MBA at Penn State, this business here was our entrepreneurship class.
Sal Daher: Wow.
Dom Messerli: Which was fantastic. We already put together a lot of the business plans and where we want to go. Eventually, I actually started doing this business.
Lenoss Medical Was the Subject of Dom’s MBA Degree Project
Sal Daher: You've gone pretty much according to the original plan?
Dom Messerli: Yes, I have. [laughs]
Sal Daher: Whoa. This is one for the record books. Michael Mark says-- one time I was interviewing him, at that point he'd invested in like 200 start-ups, and I asked him, "Michael, how many of the start-ups you invested in didn't have to pivot, didn't have to change from their original business plan?" He said, "None." Then he thought a little more [unintelligible 00:15:33] "No, no, one. One."
Dom Messerli: [laughs]
Sal Daher: "It was one out of 200." Explain to me what the business model is then.
Dom Messerli: It was actually remarkable too, on our P&L statement, the profit and loss proforma that we still have today, the base template and the base function we have is actually from the business program, the Penn State MBA program.
Sal Daher: You've been meeting your milestones and so forth. That's a miracle.
Dom Messerli: Well, we've changed some of it, for sure-
Sal Daher: [laughs]
Dom Messerli: -some of the milestones and some of the projections, pressure check them as we move forward and just honed in to get them even more accurate. The business plan, specifically in the spine market, the spine space, is that-- Generally what it is, we have a single-use disposable instrumentation kit that's used for performing the surgery, then we have the allograft implant that's used to then supplement the fracture and heal the fracture. We're selling our system to the hospital customers. Hospitals, they pay Lenoss Medical for the product that we deliver, so we're selling our product.
The hospital on their turn, they're reimbursed by Medicare or private insurance to pay for the devices, the system that we sell to them. The way we are selling it to the hospitals and sometimes outpatient surgery centers is through distributors. As a start-up, it's very difficult to build an internal sales force. Very expensive also to do that, to hire all these salespeople. The better way to do it, more cost-efficient and faster way to do it is by going to specialized distributors.
Lenoss Medical Plans to Go to Market Via Distributors Specializing in Products for Spinal Treatments
Specifically in the spine market, there are quite a lot of specialized spine distributors. We're picking spine distributors, which then go to the customers, to the hospitals, they help with the sales, but also, they support the surgeries. The first few surgeries, and sometimes all the surgeries are always supported by a salesperson. In our case, the spine distributor. That's how we're scaling the business, going through distributors.
Sal Daher: The argument to the medical provider or the hospital or the surgical center is in a situation where they are reimbursed on value-based, on outcomes, meaning basically paid a lump sum for a particular condition, and then if they're able to treat that condition more effectively for less money. They get to keep more money. They have that incentive in a value-based compensation versus the-- Even fee-for-service, they don't have as much incentive to get it right the first time. What you're offering perhaps then is you're going to have a condition that is going to be addressed with a lot less surgical intervention.
Basically, instead of doing a surgery, you can just inject a thing minimally invasively or you don't run the risk of using the epoxy and then having these terrible outcomes. Now, is that quantified? Is that something that the medical centers are looking at as a real risk for them?
Dom Messerli: Yes. I think you nicely explain how the situation is. I have to say even the standard of care today is minimally invasive surgical treatment. It's the same similar surgical treatment, except what we did as well is now there's a lot of tools required to prepare the epoxy because you have to mix it before surgery, so there's a lot of single-use disposable tools. All of that is eliminated. That means a lot less technical aspects on the back table, a lot less inventory for the hospital as well. What we've learned as well, more or less zero training on the back table to use our system because you don't have to go through the process of mixing the epoxy cement.
Technically, we make the surgery simpler. For the hospital, also less inventory, less medical waste as well, but then also for the hospital versus department is their risk management or risk exposure. The hospitals are aware of the risk associated with surgeries or risks associated by using epoxy. Certainly, some of our early adopters that we have as well, they share with us the risks that they had, so they're keenly aware of-- In one case, actually, the patient was paralyzed because of the injection of the epoxy cement and then there was implications for the hospitals with the lawsuits.
Speaking with the hospitals in regard to risk exposure and reducing that risk exposure is where they also see the value. There's multiple aspects there. Simpler surgery, technically simpler, less inventory, and reducing the risk exposure to the hospital, certainly, to the patients as well.
The Argument for Hospitals Is Reducing Risk and Simplifying the Process
Sal Daher: Excellent. You got FDA clearance for your material. How did that work?
Dom Messerli: This is a very important aspect. For people in the life sciences, medical device space, most of them are very familiar with some of the regulatory approval processes. Most people are familiar with two aspects. One of them is drug approval. The IND drug approval. The other one is device approvals, which for IDEs are 510(k)s. A lot of people are not aware of the regulations for tissue. Like bone tissue, there's specific regulations for bone tissue. It's called a human cell and tissue product.
FDA Approval Process Was Relatively Low-Burden, Human Cell and Tissue Product Pathway
Our product is regulated as a human cell and tissue product, HCT/P. We fit squarely into these regulatory pathways and our product is commercially available through the human cell and tissue product pathway.
Sal Daher: Which must be very different because there's a whole tradition of allografts going way, way back.
Dom Messerli: Correct.
Sal Daher: It's not as if you're introducing a new molecule or something like that. It's just bone material they're looking at making sure that it's sanitary and that it's pure, that kind of thing, more than looking at new effects.
Dom Messerli: That's 100% correct.
Sal Daher: Okay. The regulatory burden here was pretty low.
Dom Messerli: Correct. That was one of the reasons me as an entrepreneur doing the first startup, I was keenly aware of being in the medical device space of the regulatory hurdles and how lengthy and expensive it can be. I knew that categorized as a human cell tissue product, there's not such a big regulatory burden from a time and money perspective, made it very suitable for a startup.
Sal Daher: Excellent. Is there a metric that you're willing to share with us that exemplifies the progress you've made? Perhaps the number of units you've sold, or number of sites where they're using the product.
Dom Messerli: Yes. I think one thing I'm often reminded of by other people in the space, one thing that they comment is, from a metric perspective, "Dom, here at Lenoss, you raised $3 million and you get from starting the company to initial commercial use, which is fairly unheard of in medical devices."
Sal Daher: Yes, that $3 million is-- Look, I have seen a company that John is also involved with as an investor do with less, but it's an external device. It's not something that goes inside the body. It's an external thing, but they cheated because they have government funding.
Dom Messerli: There you go.
Sal Daher: Yes, but you went fully dilutive. Basically, you're just beginning now commercialization?
Dom Messerli: Maybe it's something with the number three. Actually, just last week, we had our thirtieth case, human collective case. We've done 30 cases thus far.
Sal Daher: It's been used in 30 different patients.
Dom Messerli: Correct.
Sal Daher: So far.
Dom Messerli: On one hand, we can say we're very early stage, but on the other hand, we also say, with 30 patients being treated with some of them over one or two years out, we're starting to really see good, in investor-speak, de-risking of our business where we see it works well.
Sal Daher: Yes. Those 30 were done at the same surgical center, more than one?
Dom Messerli: Different surgical centers, but one center is now our first really limited-release site where it's actually commercial cases where it's done the majority of these cases.
Sal Daher: Excellent. Okay. You're just beginning commercialization, what's your dream for the company? Where do you want to see Lenoss in five years?
Dom Messerli: I would say my biggest dream and all along has been that I was aware of the issues with the current treatment and I saw in front of me an opportunity to make it better. My dream is that really eventually all these treatments are done mainly with a better solution like our solution where it's a physiological fracture repair that helps the patients and it completely eliminated the current associated risks.
My dream is really that there's broad adoption of this new solution and really helping the patients. I think the best way for that to happen is that we at Lenoss, we built a foundation with key early adopters, key stakeholders, physicians using it and treating the patients successfully, then having a large spine organization taking this on into their portfolio where they can further scale it with their sales teams that they already have out in the market. That's really the dream, the broad adoption, so the physicians can treat their patients with a better solution.
Sal Daher: The next five years you see scaling.
Dom Messerli: Correct.
Sal Daher: You're probably going to have improvements in the process and so forth.
Dom Messerli: Correct.
Sal Daher: Very good. Very good. Well, at this point I just want to invite listeners who are fascinated by what Lenoss Medical and Dom Messerli and John Williams are doing. Let me tell you, people are going to have a growing need for this in the future, particularly, the half of our population, women, who tend to be smaller and have less muscle and they build less bone as they age. Women are much more frequent that they have problems with osteoporosis.
It's something they have to fight very hard against. Having tools like this is extremely very helpful. You're really helping humanity by doing this. I hope that you make tons and tons of money doing it because what you're doing is really, really, worthwhile. If you like listening to podcasts like this, you can help us by first following the podcast in your podcast app. What that does is it doesn't cost you anything. It shows up every week when we launch a podcast, the podcast automatically pops up in your feed.
Another thing you can do is a rating, which is just give us five stars. I hope we've earned that. Also, a short, written review. Doesn't have to be much. That will get the algorithm attention and will show that particular podcast episode to a lot more people. Anyway, thanks for helping us out.
Dom, I understand that you were not born in the US. You have a very tiny hint of an accent. I was born outside of the United States, so I'm always listening for accents. English is a second language for me, I assume it's for you as well.
Dom Messerli: Yes, Sal, that is correct. Yes, absolutely. I think that's something that will never go away, which is perfectly fine.
Sal Daher: Sure.
Dom Messerli: As long as people understand what I'm saying.
Sal Daher: They understand you perfectly. See, that's the whole point. It's like a delicious dish. It has a different flavor. Instead of a dish that's inedible because you can't understand the person. That'll be like an inedible dish. Language with a slight accent can be very interesting. You were born in Switzerland?
Dom Messerli: That's correct. I was born and raised in Switzerland. Did all my education or the early education in Switzerland.
Sal Daher: Which city?
Dom Messerli: In Biel, which is about 20 minutes north of Bern, right along Lake Biel. Beautiful area.
Sal Daher: I spent a very wonderful 10 days in the Bernese Highlands.
Dom Messerli: Ah, there you go.
Sal Daher: Oh, I was hiking up there. Oh, God, that was so beautiful.
Dom Messerli’s Immigrant Story
Dom Messerli: Absolutely. I was 24 years old, just finished my engineering degree after 9 years of high school. After high school you do an apprenticeship. In my case, I did four years apprenticeship as a mechanical draftsman. Then the engineering school, graduated as a mechanical engineer. Had the vision of learning the language I speak now. As an engineer, I thought that would be important, but also, I wanted to learn a different culture. Switzerland is nice and beautiful, very small, as probably everyone knows.
I was always drawn, for whatever reason, to the United States. I was hoping I could spend a year in the United States to learn the culture, learn the language and see something different. I was fortunate enough, after looking anywhere to find any kind of job, to actually find a job with Synthes at the time. I was very fortunate that the owner, Mr. Hansjörg Wyss, gave me an opportunity.
Sal Daher: Would you spell the name of the company, please?
Dom Messerli: Absolutely. That's Synthes. S-Y-N-T-H-E-S. It was fabulous to be able to start working for the company.
Sal Daher: Where did you start?
Dom Messerli: I started out in their Monument, Colorado facility.
Sal Daher: Oh, Colorado.
Dom Messerli: In Colorado is where I started. Then after being there for about a year, I moved over to their facility in Pennsylvania, Westchester, Pennsylvania, and spent about 19 years in Pennsylvania all the way through when Synthes then was sold in the merger to Johnson & Johnson.
Sal Daher: Yes. You stayed on with Johnson & Johnson.
Dom Messerli: I stayed on with Johnson & Johnson for a few years. It was a great, fantastic experience of being part of that merger of these two companies, of Synthes being merged within Johnson & Johnson, specifically Synthes Spine was merged with DePuy Spine. Going through that was a fantastic experience but also difficult, because you're putting together two large spine companies, number two and number three. Certainly, that was not easy specifically.
Sal Daher: No, no. Yes, different cultures, overlaps.
Dom Messerli: We had to lay off a lot of people through that process. Eventually, I was affected with the layoff. I was waiting for that day. The next day is when I started Lenoss Medical.
“Eventually, I was affected with the layoff. I was waiting for that day. The next day is when I started Lenoss Medical.”
Sal Daher: Oh, wow. You had this idea percolating in your head.
Dom Messerli: Correct.
Sal Daher: When did the idea start?
Dom Messerli: I would say the idea started many years ago at Synthes. Over 15 years ago is when this started with seeing this and seeing this idea. It wasn't until my departure from J&J a few years back when then I was finally just able to grab it and run with it.
Sal Daher: Awesome. Did you have a co-founder?
Dom Messerli: I think that is a very important point. That's something I always say, is if I could do this different, I would do this different. Early on I actually was in discussion with a, I would say co-founder. She was part of the MBA program with me as well. We said we're going to do this together. She is an American citizen. Funny enough, she actually moved to Switzerland. No relationship.
Sal Daher: [laughs]
Dom Messerli: It's total coincidence.
Sal Daher: That's how life is. The most unlikely things happen. It's talking to a Swiss immigrant about starting a company together and then you move to Switzerland.
Dom Messerli: Right.
Sal Daher: You can't make things up like that.
Dom Messerli: I would say I should have done a better job to try to make it work. I know it's difficult because now her being in Switzerland, but maybe somehow to figure it out, because it is, I think, a multitude more difficult to start a business when you do it on your own.
Sal Daher: It is.
Dom Messerli: If I can do anything different, I would work harder to make sure I have a co-founder and do it with a co-founder. She would have been a perfect fit to do it as well.
Sal Daher: Complementarity of skills, shared vision, shared ethical approach to things is extremely important, and the ability to work together. I have interviewed Ed Roberts who is in some ways the founder of the study of entrepreneurship at the Sloan School. I also interviewed his doctoral student, Chuck Eesley, who is a professor of entrepreneurship at Stanford University. Both of them said basically the most strongly supported finding in the study of entrepreneurship in all the studies of entrepreneurship that have been done is the fact that having a co-founder increases the chances of success for an enterprise, for a startup.
The second person on the job and the third one, third hand at the tiller, on the oars, it really is tremendously powerful. Makes life easier, it's a less lonely experience, you have a lot more resources, better vetting of decisions. There are downsides. There are times when you get a dysfunctional co-founder and all that stuff. If you're founding this after decades working in an industry and you know someone pretty well, you can scout that out.
Dom Messerli: I agree with you 100%. I went through the experience myself. I agree 100%, having a good co-founder is essential. It makes a lot of things a lot easier, even the fundraising you appear as a team. It makes a monster difference. I'm very blessed and lucky now partnering up with John Williams. We're going lockstep. He's on the sales side. I'm on the R&D product development side. Certainly, I understand sales but not like he does. It's a great complement and it makes a huge difference. For sure, if I could go back in time, I would focus more on making sure a good co-founder is there and go lockstep and move forward. It's a very important point.
Sal Daher: This is tremendous. Now, did you have a model for entrepreneurship in your family? What made you think about starting a company instead of just looking for another job?
Dom Messerli: It was not in our family. No one in our family has been an entrepreneur. I don't know why I was always intrigued by it. Even when I was getting my engineering degree, I started a small, tiny, little business then just on the side and was making small cables to connect our calculators to the computer. Made those. Something small I did then. Just the fact that leaving the comfort of Switzerland and going out to the United States where I thought I'll learn a lot, there are some great opportunities. I think I always then as I went through my career, I saw the opportunities of what could happen, but I had such a fantastic job at Synthes.
Every few years I had a chance to grow, learn something new.
Sal Daher: Synthes was probably an entrepreneurial organization, right?
Dom Messerli: It was, yes.
Sal Daher: How old was it when it was sold?
Dom Messerli: When it was sold, I think actually it was close to 25 or 30 years.
Sal Daher: A young organization, so it was a startup in a way.
Dom Messerli: Yes.
Sal Daher: This is a tremendous conversation. As we think of wrapping up this really, really fun chat, is there anything else that occurs to you that you'd like to communicate to this audience of angel investors, of founders, people who are thinking of starting companies? Any parting thoughts that you have?
Dom Messerli: Yes. First of all, again, thank you for having me and asking the questions and letting me speak from my heart.
Sal Daher: Well, I'm grateful to you for bringing such a really delightful, wonderful story.
Dom Messerli: What's important, I think if anyone is interested to become an entrepreneur, it's not the fact of, "Look, I would like to be an entrepreneur." It's more like if you see something that really interests you, that you're really passionate about it, I think going after that is important. I think in my case, it was that as well early, I have to say, I actually fell into it. When I was looking for an opportunity in the United States, and I share these brief stories, that after looking for a long time to just find a job, I was going to take any job, I didn't care, I’ll work at McDonald's, it doesn't matter. I want one year. I want to learn the language. I want to learn the culture.
After looking for a long, long time, eventually, I was actually presented with almost at the same time two opportunities. One of them was with McDonnell Douglas. At that time, Switzerland was in the process of buying the F-18 fighter jets from the United States. The other opportunity was coming along with the medical device company Synthes. I was a young engineer. I didn't know much, didn't have a lot of experience, but I made a fundamental decision at the time. This might sound very silly. It was like, "Okay, I could work for building the fighter jets." From an engineering perspective probably fantastic.
Sal Daher: Very cool, right?
“...I feel we can have a positive impact with these patients with osteoporosis and the spinal fractures. That drives me.”
Dom Messerli: Very cool, but overall, in my head, it was like, "The purpose of the fighter jets is to kill people." Very simplistically thinking. Then, on the other hand, I was like, "Well, a medical device company. That is to help people." I didn't know much about it. I chose to go the route of helping people. Now, being an entrepreneur, I was driven by, I really believe that with our solution, we can make a difference. That's why I was doing it. That's why I still do it today because I feel we can have a positive impact with these patients with osteoporosis and the spinal fractures. That drives me. You mentioned earlier, said, "Well, maybe at some point you make a lot of money." That's not really the main driving factor.
Sal Daher: No. That's somewhere in the back of your mind.
Dom Messerli: I think that would be great.
Sal Daher: You're going to have a nice house in the Bernese Highlands, grandkids running around. That dream.
Dom Messerli: People tell me, "Dom, then are you going to go out and buy a bigger, huge sailboat?" "Look, I have a 23-foot small sailboat. Maybe what I'll do, I'll buy new sails. Be a bit faster when we're racing on Wednesday nights." I think for entrepreneurs, I think it's important to follow what they believe in. I think that's important. You said, there's a lot of angel investors listening to this. I think the angel investors, they should invest also in the things they believe in.
I think with what happened with River Valley Investors, and then John Williams, he invested in the company because he believed in the mission. He believed in the mission so much that he actually now is an employee of the company as well. I think that's where things then work out. I think that's what's important.
Sal Daher: That is really very, very sound advice. That's what angel investing is. It's not about the money. It's about rolling up your sleeves and helping and making a difference in something that is going to make the world a better place. Dom Messerli, founder of Lenoss Medical, I thank you very much for being on the Angel Invest Boston podcast.
Dom Messerli: Thank you so much, Sal. It was a pleasure to be here.
Sal Daher: This is the Angel Invest Boston podcast. Thanks for listening. I'm Sal Daher.
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I'm glad you were able to join us. Our engineer is Raul Rosa. Our theme was composed by John McKusick. Our graphic design is by Katharine Woodman-Maynard. Our host is coached by Grace Daher.