A year ago (the November 2020 edition), the Strategy Toolkit paid homage to Plato’s observation regarding one of the driving forces of innovation, i.e. necessity or customer need, in contrasting how the great powers the US and China were responding to the covid pandemic.  Serendipitously, I recently spent some time with the San Francisco-based roboticist and entrepreneur Anders Nancke-Krogh.  What he shared with me was a fascinating example of just what Plato meant.  Below is my interview with him.  I believe you will also find the story fascinating. Feel free to follow up with him directly if interested in learning more.

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TST) What was the context (or starting conditions) when you had the idea for Plover Ventilator (i.e. the original Plover startup situation)?

ANK) At the start of 2020, I was an advisor to Plover Wash, a robotics startup based in Portland Oregon with the goal of designing a robot to wash cars.  Not just today’s typical automated carwash experience, of course, something much more sophisticated.  Our machine uses lidar to scan the car completely and to use the data to guide the washing apparatus optimally and sustainably.

Our team, eight people in total, comprised mechanical engineering, vision engineering, software QA and testing, etc.  I knew them well, what they could and could not do.  They had reached out to me based on my robotics expertise, and I was commuting back and forth from San Francisco.

In early March, I had just returned from the latest trip to Portland when the covid-19 lockdown hit:  Monday March 16th, I remember it well.  In the midst of adjusting our work to the lockdown rules at each end, I read all day long whatever I could find about the pandemic.  People were dying and doctors didn’t know why exactly;  there were emergencies everywhere, a shortage of respiratory supportive infrastructure, whether it be ventilators or experienced operators or oxygen supplies.  Worst case scenario projections forecast that we would run out of ventilators soon, on current trends.  And there was no end in sight.  I turned to my spouse Nina, a serial entrepreneur with deep startup operations experience, and asked, “How hard would it be to create a ventilator?  How long would it take?”

TST) How did you come up with the idea for Plover Ventilator (alone? with others?) and initially implement it?

ANK) Nina and I spent the entire next day researching ventilators and the efforts around the world to jumpstart the design and production of new, inexpensive models.  Teams were doing it in Italy and Spain, places hard hit early on by the pandemic.  Some were open source, some closed.  None of these initiatives had any idea when they would have a functional ventilator ready for production, nor did they know what volume they might be able to manufacture at.

We predicted that the large machine vendors like Ford, and other mechanical manufacturing companies doing e.g. air conditioning units, might be able to retool their production lines and manufacture existing ventilators. However we predicted it would take at least 3 months before a single device left the manufacturing floor, during which there was a critical gap to fill.

We found an MIT POC design from 2 years ago, drawings of which included a big valve mask (BVM), the part that pushes the air into the patient, typically manually operated, but provisionally automated by the MIT team.  We turned to each other and realised we could automate this function more effectively by adding sensors, alarms and other monitors – all controlled with the addition of a small microcomputer, a DC motor, a power supply, etc.  The team at Plover had the skills.  If we stopped all the work on the car wash robot, dedicated everyone to the ventilator, it would take about 2 weeks to create a prototype.  By this time we could set up our own assemblyline and assemble the first models ourselves.  We could even rally volunteers to help out.  We were excited by the discovery.

Nina set realistic production targets (50 units week one, 150 units week two, ramping up to 1000 units per month) to guide our sourcing.  And we projected that we’d only need to do this for 3 months, by which time the major players in the market would have brought needed capacity online.  We drew up draft initial plans, with goals and milestones, and brought them to the Plover team.

After Wednesday morning’s standup meeting, we presented our idea to the Plover founding duo.  We anticipated being told no but, to our surprise, they listened, did their own quick due diligence, and in less than 24 hours gave the green light.  In their words, “This is the right thing to do.  It is our human obligation.  Even if we save only one life, it will be worth it.”

It was not that simple, of course.  We needed to bring the existing shareholder investors onboard next.  To protect them from any product liability (ventilators are medtech and car wash robots are not), we proposed creating two new entities:  Plover Ventilator Inc (own / develop the IP, build the ventilators) and Plover Ventilator Org (a non-profit that raised additional capital, bought the ventilators and gave them away to hospitals).  PV Inc in effect built up debt from Plover Wash by using their resources.  PV Org could buy upfront (estimated COGS of $1K, sale price of $2K), and I reached out to families and friends angels, raising over $60K in under a few hours.  We were off and running.

Remember that this was the most extreme moment of the pandemic lockdown, with no end in sight.  Plover had a large facility for the car wash robotics work and no one could be onsite.  The Plover team was available and, in fact, working on PV Inc. reduced the pressure from the board to cut wages, a step many startups were being forced to take.  On Thursday morning, the founders presented it to the rest of the team, who enthusiastically agreed.

So we spent the first 5 days pulling together documents, requirements, planning, and working directly with physicians and nurse practitioners in Portland, San Francisco, and Idaho.  We ran everything on Google Docs.  Plover’s COO & co-founder, an amazing networker, found and reached out to Lonny Ashworth, a professor of respiratory care from Boise State University, who was already making progress on his own design (based on his earlier work for the SARS epidemic) and who was looking for a partner like PV Inc.  He endorsed us, “lighting the fire”, even shipping to us gratis a $60K mechanical lung large scale testing machine (from another company on whose board he sat). 

TST) What lessons did you learn from the experience?

ANK) Our positive lessons, what we did well, were two-fold.  First, we set clear goals, end-to-end, from the very beginning, so that every team member understood the details of the pivot, what we going to deliver, when, and to whom.  And why.  We used the production targets every day.  We were running quickly and had to make adjustments on the fly.  Second, we held daily sprint meetings, not just in the mornings, but twice a day (at the start and the end).  The second meeting reviewed where we had landed after another marathon 12 hour work day, helping us to prepare for the next day by “mulling over” ideas that night.  “It felt like fabric”, in that nothing was allowed to slide, no one became frustrated, we were just working.

Our negative lessons, what we wish we did better, focused on the financial side.  We should have taken the precious time to discuss the financials and financial risks with everyone more often, to avoid ending the pivot without disagreement.  We didn’t do it in the interest of not impeding the pace of R&D, at a time when we felt that the delay of a few hours was critical.  We told ourselves that we could sort it all out later.  Because, after 3 weeks, the media began to report that the ventilator shortage crisis was not turning out to be as urgent as first reported.  We completed our prototype on time and actually manufactured two units (one for Professor Ashworth, one for Plover), and decided to stand down the effort.  The pivot back to Plover did not go as smoothly as the pivot to PV Inc, for the reasons highlighted above.

Extra: another Substack author to check out

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