Doctor, serial entrepreneur, finds better ways to help patients

Dr. Tim Fischell is many things. He is an interventional cardiologist and Medical Director of the Department of Cardiovascular Research at Borgess Medical Center, a professor of medicine at Michigan State University, and he is what many in the business world refer to as a "serial entrepreneur."

But looking at his resume does not even tell half the story. He is something else that is hard to define. His colleagues say it is a never-ending drive to improve things, to build something better when he is frustrated with the current state of medical technology.

"He's incredibly bright," says Dr. Steven Almany, director of medical innovation and an interventional cardiologist at Beaumont Hospital in Royal Oak. "The guy has a passion for looking at things and looking for a better way to do it. I think that's a rare trait."

That's why Almany's venture capital fund, BioStar Ventures based in Petoskey, has invested about three-quarters of a million dollars in Fischell's latest venture, Ablative Solutions Inc., which promises to provide relief to the millions of people worldwide who suffer from hypertension.

The company, which has attracted $3.2 million in private investment so far, is based on an idea that Fischell had just a few short months ago, in October 2011. To go from idea to investment in that short amount of time is just about unheard of for medical startups, says Almany. But to understand why BioStar would have such confidence in Fischell's ideas, we need to take a look at his background and reputation.

First a word about the Fischell family. His father, Dr. Robert Fischell, is the co-inventor of the implantable pacemaker, of the insulin pump, the implantable defibrillator and a host of other pioneering innovations in medical technology. Tim Fischell's older brother, Dr. David Fischell, is CEO of New Jersey-based Angel Medical Systems, which markets an implantable heart-attack detector. Tim Fischell has been involved in about 10 startups, his family between 12 and 15, Tim Fischell estimates. He is an inventor and co-inventor on more than 70 patented devices.

So, what is it about this family? Innovation is part of the family culture, Fischell says.

"The hallmark of an inventor is rather than seeing a problem and saying, 'that's a problem,' you see a problem and you go, 'there has got to be a better way,'" Fischell says.

And that is exactly what happened back in 2009 when Fischell founded the Kalamazoo-based company Ostial Solutions, which was recently sold to Merit Medical Systems for an undisclosed amount. Ostial Solutions was born out of Fischell's personal frustration as an interventional cardiologist. Fischell estimates that he has performed between 4,000 and 5,000 stents since his career began in 1986.

But about eight years ago, he had a very bad day. He had three cases in a row where he had to put the stent in the ostium, or the opening, of the right coronary artery. Fischell explains it's a very challenging procedure for even the most-experienced surgeon to figure out exactly where the opening of the right coronary artery is relative to the aortic wall. You have to get the edge of the stent lined up almost precisely, with the margin of error at less than half a millimeter.

Essentially, he says, it is impossible to get it right more than half the time. "I don't care how good you are," he says. "I don't care if you've done 10,000 stents. You are going to miss by more than 1 millimeter" more than 54 percent of the time. In three cases in a row, he missed the ostium and had put the stent in too far.

And that's where the Fischell family drive kicked in. Fischell developed the Ostial Pro, a relatively simple-to-use device that helps prevent the catheter from going into the artery. The device contains four tiny "legs," the tips of which are gold-plated so surgeons can easily see them. The legs pop open like a lunar lander and prevent the guiding catheter from going into the aorta. Using contrast agents to see the gold "feet," doctor can line it up perfectly, Fischell says. With the Ostial Pro, he says, you're plus or minus .1 millimeter, which means "you never miss."

Merit Medical Systems apparently agreed and bought the company in February.

Ablative Solutions, his latest startup, was also born from frustration with current methods, and Fischell is pretty excited about its prospects. A hot topic in medicine right now is what is known as renal denervation. A company called Ardian discovered that if you cut the sympathetic nerves from the brain to the kidney, blood pressure drops 20 to 30 points. Probably about 90 percent of hypertension is caused by the kidney releasing norepinephrine from the sympathetic nerves. Cut the nerves to prevent the release, and "you essentially cure 90 percent of high blood pressure," Fischell says.

Ardian found a solution with a device that goes into the renal artery. The problem is that it causes excruciating pain and requires a morphine drip.

So, Fischell says, he's created a better mousetrap. He invented a catheter that, in a 30-minute procedure, will painlessly knock out the nerves and does not damage the renal artery.

"We think we will be one of the leading, if not the leading, renal denervation devices in the world in another year or two," Fischell says.

Almany agrees that the device has potential and his VC firm invested on the strength of the invention and on the strength of Fischell's reputation for successful innovation. "The market for this, as you can imagine, is mind-boggling," Almany says, when you think of how many people suffer from hypertension. In China alone, there are more people with hypertension than the United States has people, he says.

"We've known Tim for a long time, tremendously respect all the accomplishments that he's had in the field," Almany says. "The guy just does not stop."

As for Fischell, he remains in Kalamazoo for family reasons and because there is a history of medical innovation in the community. Before he moved to Southwest Michigan 14 years ago, he was at Vanderbilt University in Nashville, where he says it was considered bad form to be in the medical profession and innovate at the same time. "Somehow, if you were an innovator, inventor, entrepreneur, you're somehow an evil person," Fischell says.

He found Kalamazoo more welcoming, in the same way the Strykers and the Upjohns did.

So, while Fischell is still betting on Southwest Michigan, investors are betting on Fischell.

"A lot of people bet on the horse, but sometimes you're smarter just to bet on the jockey," Almany says. "With Tim driving the horse, I like that."

Howard Lovy is a freelance writer who specializes in technology and innovation. He can be reached by email.

Photos: Erik Holladay