From Combat Medic Hero to Entrepreneur: Dr. Andrew Napier's Startup Journey

He knew nothing about being an entrepreneur. But after serving on the frontlines in Afghanistan, this decorated U.S. military veteran realized a lot of the advanced surgical techniques he witnessed as a combat medic weren't available to the general public. In this episode, Dr. Andrew Napier shares how his service inspired him to start IntuBlade and create a video laryngoscope with patented lens-cleaning technology. Plus, hear his advice on how to bring clinicians and entrepreneurs together in order to move healthcare forward.

Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts. And keep up with us on LinkedIn, Twitter, and Medium at @InflectHealth, and on the web at InflectHealth.com.

Transcript

[00:00:00] Lindsay Kriger: Hey everyone. This is Lindsay Kriger, director at Inflect Health, the innovation hub of Vituity where we strive to be a catalyst for better care. I'm thrilled to be hosting "For Startups, By Physicians" where we share insights and guidance to healthcare startups and technologists looking to create the future of health.

[00:00:18] Lindsay Kriger: As a physician-founded firm, we have connections with clinicians and intimate knowledge of what they need and how they work. We will be interviewing our executives, frontline providers, and industry leaders to help your business be effective and scale. Thanks for joining and let's get going.

[00:00:41] Lindsay Kriger: Today I am joined by Dr. Andrew Napier, the founder and CEO of IntuBlade, a video laryngoscope medical device company with patented lens-cleaning technology that performs rapid intubations. The incorporation of spray technology in the device makes it unique compared to similar [00:01:00] market products. 

[00:01:01] Lindsay Kriger: Dr. Napier is also a Vituity emergency medicine physician who was awarded the Purple Heart as a combat medic during his time in service. Andrew, welcome to the podcast and I'm so excited to have you on. Thanks for joining. 

[00:01:15] Dr. Andrew Napier: Hi Lindsay. Thank you so much for having me. 

[00:01:18] Lindsay Kriger: We have so much to talk about today. I can't wait to hear a little bit more about your background. So if you actually don't mind just starting from the beginning, not the beginning of time, but after graduating from medical school and residency, what took you down this path into military service and how that led to your journey as an entrepreneur? 

[00:01:37] Dr. Andrew Napier: Of course. Yeah. Going back one click further. I actually joined the Army right out of high school. I was a fourth generation army in my family, so father, grandfather, great-grandfather. I was the next up. I got the opportunity to serve. I jumped right on it. Some of the services that were being offered did come with different benefits, different perks. Some of that was having access to education, higher education. A GI bill was really becoming [00:02:00] at that time more. So joining up, I, as soon as I got through, I went through about a year or so of training I went through as a combat medic, as you had said. And right after that I was home for maybe a couple of months before I got deployed over to Afghanistan. 

[00:02:13] Dr. Andrew Napier: I actually volunteered to deploy. I went to southeastern Afghanistan in 2008, 2009. There. I served with a 201st Engineer Battalion. We were attached with the 101st Airborne Division and we served out of FOB Orgun-E. And I was served with the forward surgical team at that. 

[00:02:28] Dr. Andrew Napier: My time in service was interesting. I got to see a lot of facets of the medical industries. Coming from training, we had EMS and there was things that were provided to us during our military training, our combat medic training. But actually seeing that on ground was very interesting because you saw that change between what was on the textbook versus what was actually happening in real life. There's an ideal way that patients present when you go through treatment pathways, how things are supposed to work, and then you see how things actually play out in real.

[00:02:55] Dr. Andrew Napier: During my time there, I got to be the first assist to more than a few different operations, [00:03:00] amputations. There was a lot of things that we were seeing. There was a very large array of injury patterns I was being exposed to at the age of 20. Some of that as well, we got taught with more advanced surgical techniques.

[00:03:09] Dr. Andrew Napier: At that age we were doing surgical airways. I got very familiar with airways, and during that period of time, we were issued a video laryngoscope during that time. I got to see that be used. It was really cool because at the time we were still using " analog devices," something that you would have to physically look down yourself and see versus something that had a camera attached to it.

[00:03:29] Dr. Andrew Napier: So the novel idea at the time was being implemented for the first time on a grand scale. Something that I saw immediately off the bat was that whenever that camera would go into someone's mouth — blood, vomit, spit — would go onto the camera lens itself and that would obscure the view. It made that device useless. You would've to take the thing out because the geometry was hyper-angulated, so you couldn't see the anatomy correctly. You'd have to take the device out, clean it off manually, and then reinsert that. 

[00:03:55] Dr. Andrew Napier: Now this was 2008, I thought at the time I was 20 and I was like, to, someone definitely is gonna come along and [00:04:00] fix this. This won't be a problem. I came back home went right back to under. All through summers, winters, I was a full-time student. I got out in three years and went right into medical school. Now I was still doing some internships during my time as an undergraduate and was still seeing the same thing in both the operating room and also in the emergency departments.

[00:04:17] Dr. Andrew Napier: I kept thinking, someone, this has gotta be different. Someone's gonna come along and fix this. This continued though, and throughout medical school continue to see the same thing. It just was part and parcel, people just accepted it for how it was. It just seemed so silly to see that because you would see those delays in innovations.

[00:04:31] Dr. Andrew Napier: At that point, that's when I decided, I was like, "Hey, I can mock this up." So I started drawing things out. There were some, my other ideas I was tinkering with from my time in war and different medical devices that I was thinking about, but this was the one that was really in the forefront of my mind because it just seemed to happen so often.

[00:04:45] Dr. Andrew Napier: Then enter into residency, that's when I started doing more trials with the device, started testing it out on my own, like airway mannequins that I was purchasing off of Ebay. And really tinkering this thing and really trying to think about it. Nothing about business. I had no idea. 

[00:04:58] Lindsay Kriger: Let me stop you there. That was [00:05:00] actually gonna be my next question was, so we hear, and especially in the medical field, you hear a lot of stories like, my dad was a doctor, my mom was a doctor. I became a doctor. So you started the story similar, right? You're fourth generation military service and that is what leads you down this path.

[00:05:16] Dr. Andrew Napier: Yeah. 

[00:05:16] Lindsay Kriger: What about entrepreneurs? I imagine that most folks coming out of military backgrounds are. Scrappy. Like you've seen horrible things, but you're really hungry to make change. Did you have entrepreneurs in your family? What did they do after military? How did you go down this path? Because traditionally, physicians as a cohort aren't usually the most risky, and starting new businesses are definitely risky. So tell me a little bit about how you got that niche to do that. 

[00:05:44] Dr. Andrew Napier: Yeah. So my grandfather was a big tinker and he's the one that really instilled that in me early and coming up in, in southeastern Kentucky. And he didn't have a lot of access to things, not a lot of access to education, and especially technology was not a big thing.

[00:05:57] Dr. Andrew Napier: My grandfather worked for NCR and he [00:06:00] worked on the engineering side of the house, so he was assembling things like remote controls back in the 80s for a tv, which was like cutting edge technology there. And he was helping me put together computers in elementary school. So I was assembling those things, learning to tinker early on. 

[00:06:13] Dr. Andrew Napier: My father works in the labor field, so he's able to do a lot. He works in education, but he's just a master of many things. He puts together houses, he beat out all kinds of work, works with his hands, and that's something I grew up around.

[00:06:24] Dr. Andrew Napier: But in the service, we talked about it, the ingenuity that comes with being in combat, something breaks, there's not someone that's there to say " simulation off." You have to understand and go forward. If a window breaks, you're crafting one, you're coming up with one. But that got instilled in us early. 

[00:06:38] Lindsay Kriger: That makes so much sense and super inspiring, and you can see how the fields of emergency medicine, innovation, and entrepreneurship collide.

[00:06:47] Lindsay Kriger: Okay, so let's go back forward. So you're mocking these things up with, mannequins off eBay. What happens next? 

[00:06:54] Dr. Andrew Napier: Yeah, so piecing those things together, I knew that once it, I started, we went through nine different iterations and I got [00:07:00] something that was down that was just money. I could clean off Vaseline up of a camera lens, and I was like, this is crazy. Because if I go into this simulated environment, very easy for me as I to get this clear view. Again, I knew nothing about business. That's something I never really thought about. Tinkering being a skilled laborer, a labor bee, if you will, and that's something in my whole life. I went in as an enlisted soldier, and the same thing as I could see that the parallels with being a physician on the front lines with Covid and things.

[00:07:22] Dr. Andrew Napier: At that point, I didn't really know what to do. I was able to leverage my network through the Tillman Military Scholarship. I had knew a another Tillman military scholar that had a lot of experience in business backgrounds. He ran a lot of companies on the business side of things and I gave him a call and one thing led to another, and then we formed a company.

[00:07:41] Lindsay Kriger: I love that. And how long were you guys forming a company? Just together until we met, until Inflect, and Rick and Andrew met you guys? 

[00:07:52] Dr. Andrew Napier: Dave and I early on, I give him credit because he'd saved this before it was dead in the water. I was ready to turn this over and ready to bring on partners and just give [00:08:00] away part of the company, and this should make things work.

[00:08:02] Dr. Andrew Napier: Dave stopped me and was like, "Hey, don't. Please." That really helped out. He knew how to do this from the internal side. So we worked together. We did not give up any part of the company. So those first few years, we were still learning. Dave did not have any experience into the medical device industry, but a lot of what he had from the government contracting side translated over.

[00:08:19] Dr. Andrew Napier: So we were able to build our company from the ground up, work a lot with IP. So right from the get-go, when Dave and I first met, that's what we were working for. So we actually filed for a patent shortly after meeting. 

[00:08:31] Lindsay Kriger: The podcast is called "For Startups, By Physicians", but I'm gonna flip it around. For physicians, like what is the advice to other physicians when you're trying to go through this startup process when especially everyone thinks they have the next greatest idea.

[00:08:44] Lindsay Kriger: What was that patent process like? 

[00:08:46] Dr. Andrew Napier: It's not the idea, in and of itself. My father always talks about a time where he thought he was gonna be a millionaire, of coming up with an idea of having like marketing stars to people and that was the big thing in the nineties that came out and then people named it and he was like, oh, that was my idea. It's lost. I'm like, dad, [00:09:00] there's a lot of, there's a lot of steps because you think about something that you start out with and even with a great idea, there's so many ways that you can just kill it right from the beginning. 

[00:09:07] Dr. Andrew Napier: As a physician and someone that's speaking to other physicians who I've spoken to, I have been able to mentor a couple along the way as well, is really focus on your strengths. You know that market better than anybody else. What was crazy to me, especially being within Vituity and seeing the things that we get issued within that emergency department, seeing things that it was issued overseas, there's a big disconnect with those who are pedaling these devices that are saying, "Hey, this is the next great thing since sliced bread."

[00:09:32] Dr. Andrew Napier: As a clinician, you're just like, no, this has no relevance here. So know your strengths, stick by them. Be confident in yourself. 

[00:09:40] Lindsay Kriger: No, that's such a great point, and I think that's what drives so many of us at Inflect, is just wanting there to be actual technology that's useful to the front lines, whether it's in an emergency department, in an operating room, or in Afghanistan. All these places are full of people that are doing [00:10:00] practical things, so we need to design technology and innovation that meets people where they're at, meets us at the moment where we can say we can't pause, like you said, and reset the device think to keep working through it. So that's awesome. 

[00:10:12] Lindsay Kriger: Okay, so you guys, you get this patent and now what is the journey with the product and how have you been using it and seeing it adaptation?

[00:10:19] Dr. Andrew Napier: It took a couple years for us to get our first issued patent. From then we were off to the races, so to speak. I could speak out about the device. Everything was shrouded the secrecy until then, but we were able to do a preclinical study. We published those results in the American Journal of Emergency Medicine back in 2021, but we conducted that study a year prior to its publication.

[00:10:38] Dr. Andrew Napier: At that point of getting that and understanding and seeing the value in what we had, we really wanted to start building and from very early on, the monetary value you have as a company, what you're worth is your intellectual property. At the end of the day, that's what you have and that's what you can stand by.

[00:10:53] Dr. Andrew Napier: So we were trying to go back to the books, try to make sure that we have the right intellectual property lawyers and people to guide us in [00:11:00] those next decisions because again, these took years for things to be issued. We have things that are still pending now, things that we're still waiting for to come back on.

[00:11:07] Dr. Andrew Napier: That was very important. Very crucial early on is to really lay that solid foundation of, one, having a good team and for two, understanding what you have, your intellectual property. 

[00:11:16] Lindsay Kriger: Sounds like you have an amazing co-founder that you trust. Most people probably say number one. Do you guys have any other employees or anybody else working with you or it's just you two right now and that's the team. 

[00:11:26] Dr. Andrew Napier: We have a team that we've reached out to and partnered up with over these past around six months or so. Now we had some folks that have been subcontracted out for certain things here and there, engineering work, and also with a few other things helping go along the way. But right now we do have a core team. We have engineering that's involved, quality management. We've got around 10 people right now that we have employed under our umbrella. 

[00:11:47] Lindsay Kriger: Oh, that's super. That's really growing and that's exciting. Tell me a little bit about the actual device. So what's it been like going from idea to patent to touching something tangible like you said, " can I imagine intubating someone [00:12:00] with this device?" Would it work? How's that been? 

[00:12:03] Dr. Andrew Napier: I was able to save a picture and I had sent over to an engineer early on, and it was on the back of an overdue bill when I was in residency and I was trying to sketch out and I just grabbed something because I had a hard time. I didn't understand how to do CAD drawings. I didn't understand how to do those things. I knew how to put my ideas onto paper, and I knew that having those instructions were important. It's nice to look back on that and they bring back so many good memories at the time. 

[00:12:26] Dr. Andrew Napier: At the time, it wasn't good. Very stressful. But having an app and seeing how easy that was to communicate that idea, to put that in, have something in a three-dimensional model, just completely change the game to see, I can tinker with things. I can put things in a virtual environment and see how those things would perform under pressure. Now, with the advent of 3D printing and having that so accessible, I was able to take that and to print things off rapidly.

[00:12:47] Dr. Andrew Napier: We're talking within three to five business days, I've got in my hands, I've got my very first prototype. It made that rapid prototyping and getting it to the next product so much easier. I went through over nine different beta [00:13:00] tests, so I would be like, "Hey, if I want this, can I adjust that? Can I adjust this?" each time.

[00:13:04] Dr. Andrew Napier: And it was a total makeover, and you would never see it for, one, from on paper, but for two, in a virtual environment, it's not until you have your hands on to have a physical device. It was very cool. I still remember that feeling of seeing that box on my doorstep coming home just exhausted from the hospital and ripping that thing open and getting started and just having that whole rush of energy and getting that going again, every single time.

[00:13:24] Dr. Andrew Napier: It's invigorating and it's very nice to see that to come out from paper rather to have something physical in hand. 

[00:13:30] Lindsay Kriger: Have you used one of your own devices intubating someone? 

[00:13:34] Dr. Andrew Napier: Not on a live person. At this point, we are in a pre-market phase. We have submitted our 513(g) for our pre-market notifications with the FDA, but right now we're not approved for human use and we have sent these things off to multiple sites for simulation environment, so on, on these advanced airways, on mannequins.

[00:13:52] Lindsay Kriger: That'll be part two of the podcast in a year or two. There's so much continuing magical education in these virtual environments and in prototype [00:14:00] labs and SIM labs. How do you think that a device like this could be incorporated or enhance or change how training is done either on the field or in a residency program or whatnot?

[00:14:12] Dr. Andrew Napier: The thing that I do wanna highlight as you say that too, and bringing that up about that environment and going back to what we had discussed about physicians and being aware of things, be aware of the environment that you're introducing this technology. 

[00:14:23] Dr. Andrew Napier: In med school, there was a thing that was going on with some physicians who had used a lab that was sponsored by the university. They had 3D printed something. It became this huge litigious thing, and where they weren't able to use the device, they ended up killing it instead. So just be aware of what you're doing because that will stifle progress. 

[00:14:39] Dr. Andrew Napier: These rapid prototypings are very easy, and I was seeing that done in my own residency. So we had some things that were being talked about or being discussed about advanced airways, surgical airways, things that on pediatric devices, things that we could tinker with in having these different attachments to certain devices. So we're having that done just real time. So we'd think about it and you could go hop online and have that printed and [00:15:00] bring that back into the training environment. I think it's very cool. 

[00:15:02] Dr. Andrew Napier: I saw in 2008 the very first high fidelity simulation mannequins that they bled out. I was able to apply tourniquets properly because that's what we saw from the Vietnam War about the inappropriate use of not having the tourniquets used appropriately. Then actually in combat, so actually putting on a tourniquet on someone that was injured myself, and you understand this isn't a game, this is not easy to do and this is something that you could really screw up. So you start talking about someone bleeding and someone that you're seeing die in front of your eyes. It changes the game. Having that high fidelity I think is extremely important. We're gonna have a whole new wave of innovation. 

[00:15:35] Lindsay Kriger: I love the opportunity to train people in an environment. You're learning, but you're also learning and understanding the implications. Of course, I can't personally imagine how scary it would be in real life, but knowing that we can help people with training and expertise and really giving them the confidence when they go out, whether it's in the hospital or in the battlefield, and understand, I am trained and I do have the confidence [00:16:00] to save someone's life. 

[00:16:00] Lindsay Kriger: You mentioned all the opportunities for innovation in the health space, in the healthcare field, in the hospital, in an acute trauma setting, if I am a startup and I am an entrepreneur and I am a tech junkie and I wanna help, how do we bring these worlds together? 

[00:16:18] Lindsay Kriger: What do we bring the clinicians that are not entrepreneurial like you, but passionate about making it better? How do we bring them together with entrepreneurs who can do rapid prototyping, who can create devices? How do we bring those two worlds together to really change and forward our field? 

[00:16:36] Dr. Andrew Napier: That's a great question, and I know that there's been quite a few companies that have, I've sought to do that with, not clinicians of course, but also for the general public, the incubators, the accelerators, there's some shortcomings in some of those areas.

[00:16:48] Dr. Andrew Napier: And going back to what I had mentioned previously just about as a physician to know what you're bringing to the table, that's been my biggest challenge at times, is to be able to speak to someone in an express and to say, this is what [00:17:00] works and here's what happens, and here's how this goes. A lot of those accelerators will be tailored around more potential ideas, things that haven't been shown, things that are great ideas. And of course that those need to have those, them not putting the down by any means. But I think that bringing that together, trying to bridge those gaps is something that, that I've sought out to do myself and something that I spend a lot of time to discuss with other physicians as well, and really trying to foster that environment of trust.

[00:17:24] Dr. Andrew Napier: And I think that's paramount because of a lot of physicians as well. There's a lot of mistrust in some of these systems. Covid did not make that any better. Having that trust is very beneficial moving forward because with that, we know our heart's in the right place. I want to help people, I want to help individuals.

[00:17:39] Dr. Andrew Napier: And I do sometimes worry, I worry about with when we partner up, when we discuss this with other people, and going along the way, discussing with VCs and discussing with investors, because I don't necessarily think that probably the bad thing. My mission is people, I'm people-centered and I want patients to have better outcomes.

[00:17:54] Dr. Andrew Napier: And sometimes those things don't align. And I think that having a company, having somebody that [00:18:00] makes that the forefront of what they're doing, what they're projecting, it's very important because that's gonna be a magnet. It's gonna be a magnet to people just like me. 

[00:18:07] Lindsay Kriger: I can't agree more, and it's why I've been with Vituity and Inflect for over 10 years and why we see this tremendous support and success with partnering technology and healthcare together. Our hearts are in the right place and how we get there is gonna be a journey, but we're all in it for the right reason. 

[00:18:25] Dr. Andrew Napier: 100%. 

[00:18:25] Lindsay Kriger: Dr. Andrew Napier, thank you so much for joining the podcast today and looking forward to seeing the device really come to life and transform clinical care.

[00:18:34] Lindsay Kriger: Thank you so much. 

[00:18:34] Dr. Andrew Napier: Thank you so much, Lindsay. 

[00:18:37] Lindsay Kriger: Thanks for joining us, and again, I'm Lindsay Kriger, director at Inflect Health. Here at inflect, the future of medicine care and health delivery is not just right for disruption. It's increasingly personalized, accessible, and human. Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts.

[00:18:57] Lindsay Kriger: And keep up with us on LinkedIn, Twitter, and [00:19:00] Medium at @InflectHealth, and on the web at InflectHealth.com.