Theranos Faces Growing Number of Lawsuits Over Blood Tests | Hacker News Reader

Theranos Faces Growing Number of Lawsuits Over Blood Tests

bloomberg.com

84 pointsucha87 comments

Some of you may remember this article and these comments:

https://news.ycombinator.com/item?id=10252183

When I read this, I immediately thought it was a red flag. So far, I have never heard of a founder/employee who successfully executes without sleeping or idolizing a mythical version of Steve jobs.

I have a feeling that this is a clear pattern. Founders who claim not to need to sleep / date / etc. have major problems with their business.

As with all self-reported claims, take it with a grain of salt.

Among my own entrepreneurial friends, I often notice a difference between self-reported hours worked and actual hours worked. I also notice a strong under-representation of hours slept, as if not getting enough sleep is the key to becoming an ubermensch.

These aren't even dishonest people. I think there's just a lot of peer pressure in tech to brag about how much you work.

This. I can produce code for 4-5 hours a day, and my dumb face generally fills up a large percentage of the ticketing system's "done" column.

Sure, there are emergency situations when a 14 hour shift is needed, but keep that up for long, and you and your project will suffer the consequences (found that out the hard way just recently).

Has anyone here worked at a place where developers truly spend a 10 hours a day coding at full productivity? More likely they're lying to themselves: either they spend an inordinate amount of time at the water-cooler, or they're so slogged down can't remember what being productive feels like anymore.

I also find that most days, by the time I've sat down to write a feature, I've already fleshed out how I'm going to implement it. A lot of the "work" happens in the shower, or while doing groceries, or while biking around the city. Then once a day I turn on my computer, bang out my solutions, do some code reviews, and turn that ungodly glowing screen right the hell back off.

Not that it means spending the rest of the day idle... not working oneself to oblivion means time and energy left over for learning new things, doing math puzzles, playing with interesting technologies, reading, or simply relaxing and letting one's brain have some defrag time while staring at the ceiling.

Many of the most useful patterns I've used to solve tough problems I only learned because I was playing with subjects wholly unrelated to my work. I can't imagine this not being true for everyone.

I believe G.H Hardy said in "A Mathematician's Apology" that any more than 4 hours of mathematics a day was counterproductive.

(As with everything: YMMV. But for me this holds true.)

The self-reported lack of sleep is a pretty good indicator that the ceo/worker is focused on the wrong thing. Self reporting is probably a stronger signal than actually knowing how much they sleep!

How about just the quack factoid that veganism lets you function on less sleep?

That's almost /r/shittyaskscience level.

Well, maybe temporary because you are not processing heavy food. But long term that lack of b12 will have way more detrimental health and mental effects.

It's also pretty common in startup and executive culture to lie about how many hours you work. It's a machismo thing. In reality people rarely actually work 80+ hours. Even if they are physically present that much they are not really working (in a productive / effective sense) for more then 50-60 hours of that time.

Research has repeatedly shown that for most people productivity begins to decline after 40 hours a week and to tank after 50. Results can vary a bit from individual to individual and for different types of work. Knowledge work is usually worse in the sense that deep "flow state" focus can usually be sustained for even less time than this. Humans seem to be "burstable" in the sense that short duration crunch times can be done but they require rest afterwords to return to peak performance.

> Founders who claim not to need to sleep / date / etc. have major problems with their business.

Who else is on this list besides Elizabeth Holmes? Also, don't most founders have problems with their business?

Elon Musk doesn't sleep much, if I remember right he said about 4 hours per night once.

To contrast that, Linus Torvalds has said many times over the years that he gets at least 9 hours of sleep everyday (http://www.linuxscrew.com/2011/07/15/linus-torvalds-the-fact...).

Me personally, I do NOT feel well if I haven't had a solid uninterrupted 8 hours of sleep.

I'm close to the same. I can function on 7, but any less than that and I'm a basketcase, and really do honestly need 8 a day. I feel like people think it's a virtue or something if they can get 4 hrs of sleep and not fall down from exhaustion, but in reality it's so unhealthy.

I feel like different people have different sleep requirements. Although veganism changing those requirements is likely a quack factoid. Veganism! The meth of diets!

Einstein, in contrast, was said to regularly sleep 10 hours per night (unless he was working on a difficult problem, then it was 11).

As much as I admire SpaceX and am cheering them on, I can't help but wonder if they would have had two rockets blow up were it not for their fabled workaholic culture.

He said he averages 6 hours of sleep per night: https://www.quora.com/How-does-Elon-Musk-thrive-on-little-sl...

What's an early grave worth?

I'm sure he and a lot of other people would rather accomplish certain things in their life even if it means dying an early death, as opposed to living a long life that doesn't satisfy them.

I realize that it's not always that cleanly zero sum, and yes, it's definitely possible to live a life that is both full and long, but in the case of Musk and perhaps others who put their heart and soul in their companies (especially during the early period), it's not so clearcut.

I really think the underlying problem is that she was a pretty young woman and this prevented her from getting the kind of reality check she should have gotten much earlier. I am a woman and I find that men either won't really engage me at all or they want to, I don't know, be nice? Be encouraging?

I know it is always challenging to get good constructive feedback, but I think charming, pretty women more often than others either get no feedback or get gushed at. I have a tendency to get treated by people like I am their best friend or something and it often weirds me out and fairly often leads to uncomfortable and problematic situations. I have spent a lot of years trying to find a solution to this.

I am kind of glad to see this company being reigned in, but I find it sad to watch what happens with Ms. Holmes, who probably believed and probably still believes the hype about herself. I think she still is failing to get the memo she needs to get and it is kind of tragic. She was essentially a child when she started this. Her elders and so-called advisors -- all brilliant men, it seems -- should have pulled her up short a long, long time ago. Instead, she is being dragged through this bloody mess.

It's a hard thing to watch, in part because I am so glad to see this vaporware company called on its BS, but at the same time I am generally inclined to be compassionate and I just feel someone -- probably many someone's -- failed in their duty (edit: To Ms. Holmes, a young kid with a dream) long ago and for a long time. It should have never gone this far.

I don't know - I can agree that the "pretty young woman" effect may have gotten the ball rolling down this path, but saying it's the "underlying problem" kind of minimizes the agency she had in creating this situation, which was already enormous many years ago, before it was too late. And some men, like the late Ian Gibbons, did try to engage her with legitimate feedback. I think the bigger underlying problem was her managerial style - demanding utter secrecy so as to maintain her own omniscience. I don't know why it works so well for Apple, but it seems like the silo-ing of Theranos prevented any kind of intra-organizational regulation, so business pushed ahead full steam even as the product failed to materialize.

That is an excellent comment (I upvoted it), but I feel like saying it may have gotten the ball rolling but is not the underlying problem is -- semantics? Once the ball is rolling, it tends to keep rolling that way. Once you have the likes of Henry Kissinger making you feel like you are Wile E. Coyote, Super Genius, why on earth would you listen to some lesser known punk telling you "You think you're all that, but you're not!"?

You sound unfamiliar with Ian Gibbons' role in the situation. He was Therano's chief scientist for 8 years. It's hard to envision how Holmes could have ignored his concerns simply because the rest of her echo chamber was positive, short of God herself fêting Holmes.

For more info on Ian: http://www.vanityfair.com/news/2016/09/elizabeth-holmes-ther...

It's hard to envision how Holmes could have ignored his concerns

Yet, it appears that she successfully did exactly that: Ignored his concerns. And your article says so, from the very top:

In a searing investigation into the once lauded biotech start-up Theranos, Nick Bilton discovers that its precocious founder defied medical experts—even her own chief scientist—about the veracity of its now discredited blood-testing technology.

The quote is irrelevant, we certainly know she didn't listen to concerns! :)

The thread you started is about the thesis that she was in an echo chamber of positive thinking due to her being "pretty", and I'm specifically addressing your attempt to defend it by noting that once Kissinger made Holmes feel like Wile E. Coyote, she wouldn't listen to some punk.

All the reporting indicates Kissinger wasn't involved, and that she ignored even her chief scientist's grave concerns. It wasn't just "some punk", and she wasn't getting a pass from everyone because she was pretty.

Having been alternatingly over-praised and ripped apart by people I look up to, that's where the parents suggestion of agency comes in for me, to be able to step back and look at your situation analytically, to not believe your own hype, to have a clear enough understanding of the task "her life was built for" (taken from another quote elsewhere) to question once in a while if there is any meat to the opposition. These are all components of professional/adult responsibility; and with great power etc etc. (implied is the typical transitive money==power of our society)

The thrust of this ramble; I do hold her to have a great deal of personal responsibility, and differentiate very little between any participants who had sufficient knowledge and did nothing.

It's much more likely that she was a well-connected, upper-crust WASP with lots of connections. When you have Kissinger, Bill Frist, and George P. Shulz as advisors, and a few VCs already on board (who it turned out were family friends), other investors and media tend to just assume everyone else has done the due diligence.

From second-hand experience, women (young and pretty or otherwise) have absolutely no trouble getting their ideas shot down, or getting dismissed in general as unserious.

From second-hand experience, young pretty women have absolutely no trouble getting their ideas shot down.

Getting your ideas shot down is not at all the same as getting good constructive feedback that helps you orient properly. It is actually pretty easy to chalk that kind of thing up to jealousy and hatefulness (and, thus, ignore it). "Haters gonna hate" and all that.

I did consider further editing my original comment to clarify that detail. I have gotten plenty of negativity in my life, even quite ugly stuff. That is extremely different from someone who actually wants me to succeed telling me why my project will not fly and that I need to address those things in order to have any hope of succeeding.

My adult sons can be counted on to give me that kind of constructive feedback. So far, I have mostly failed to get it from other men and it is mostly men who have the kind of knowledge I am interested in accessing.

<it is mostly men who have the kind of knowledge I am interested in accessing.

As a female, I actually find this kind of offensive. There are plenty of intelligent, capable women working in tech, if that is the field to which you are referring, as well as business, healthcare, etc.

You are entitled to your feelings. It is a factual statement. I am not going to retract it nor apologize for it.

> charming, pretty women more often than others either get no feedback or get gushed at

Having watched her speak, she is neither.

> Instead, she is being dragged through this bloody mess

I am at a loss in this sentence. In a world where immigrant children drown at sea, we are supposed to think she s actually a victim?

I don't think the reason she didn't get her reality check was her looks, but her family wealth and connections. She got plenty of feedback since WSJ started reporting about her. Her response was even more secrecy pretending there is no elephant in the room.

I am a chronically ill homeless woman who was molested and raped as a child. I find your comment rather offensive for a great many reasons. Children drowning at sea is not relevant to the topic and most people I talk to online do not genuinely care about my suffering. So this appeal strikes me as a rather nasty means to be dismissive of me. I was not suggesting anyone else was obligated to have compassion for her and I am quite confident your supposed compassion for real suffering will fail to in any way benefit me.

Making arguments for and against things is one of the joys of discourse. There is nothing in my comment (even remotely) referring to you. Instead you are the one basically blaming me of being a bigot. I might be wrong, but you also seem to be seeking an apology. If you feel you need to "benefit yourself", please seek the help of your local welfare authorities.

I commented on how I personally feel. You are attacking that. It is a form of personal attack. And thank you for proving my point that your comment about children drowning is just a nasty rhetorical device.

I am defending myself against you basically call me offensive. I said nothing about yourself. It is not a form of personal attack just because you name it so.

Causality is a tricky thing (see Pearlmutter et.al); often people jump on the most socially-salacious (Latin salire ~ "leaping") explanation, after the fact, probably because it is at that moment, the best available instrument for change.

She's dragging herself through the mess at this point.

It's not unusual for founders to raise large amounts (at least eight figures, say), ignore all criticism, and fail spectacularly years later in ways that make you wonder what the hell they were thinking. What's unusual in her case is her Trump-like ability to hold frame and act like nothing is wrong or ever was wrong, regardless of pesky "facts."

As an aside -- another interesting manifestation of this Trump-like behavior, and this is the clearest case that I have seen, are the multiple times when Hillary literally seizes on camera and plays it off as if it never happened.

As a male co-founder I once asked an advisor for connections with "cynical product people" in order to illicit negative feedback of my company's product. I felt like the positive feedback loop in SF was that bad (for everyone).

I think a lot of different things are in play here. Part of it I think was just a culture that wanted a female Steve Jobs character, that opportunity was there and she took it. She also got a lot of credit coming out of Stanford, hell she even hosted one of those seminar courses at Stanford.

So her gender is not a factor. It is not because she is a charismatic woman. It is just because she is a female Steve Jobs.

I don't disagree that attractive women can sometimes be disproportionately encouraged simply because of their looks but is there a reason to believe this to be the case with Holmes other than the fact that she is attractive and successful?

It is my opinion, informed by my personal experiences (edit: and by reading multiple articles about the company and its melt down). I haven't presented it as the conclusion of some study. I don't know where you can find a study of comparable situations. I don't know of any other so-called decacorns, much less ones going down in flames to this degree. So it is essentially impossible to have some kind of meaningful large scale study.

That doesn't prevent me from having opinions. I have studied things like social psychology, so it is not an uninformed opinion. But your question sort of makes me think of when I talk to men on HN who fail to see any sexism here when there does not appear to be a single woman on the leaderboard.

(That always makes me feel like "okay, if that isn't obvious on the face of it, not sure there is any point in wasting any breathe here.")

>> But your question sort of makes me think of when I talk to men on HN who fail to see any sexism here when there does not appear to be a single woman on the leaderboard

I am relatively new on this site, where is the leaderboard? How do you know whoever are on it currently doesn't include any woman? The threads that I have read so far since I have been here, except for some of the comments, I hardly check who posted the comment let alone know whether it's a man or a woman.

It is inherently hard to tell here. I appear to be the highest ranked woman here and I am thousands short of the leaderboard. I actively researched it and blogged about it. Check my profile for links.

Click on Lists at the bottom of the page and then click on Leaders.

Thanks, had never seen the Links at the bottom of the page before.

:-)

I wonder if some of the people downvoting this would explain why, as I don't see anything clearly objectionable about it and the personal opinions expressed certainly seem relevant to the topic.

So simply disagreeing with you is sexism now? I am a PoC, so should I take that people disagreeing with me are racist?

I said no such thing.

If Theranos succeeded then everyone would be singing paeans to Ms. Holmes but now she has failed it must be the fault of advisors and because she was not 'pulled up short' earlier? How you can ignore her borderline criminal behavior?

Also let's not the play the 'young kid' card. Zuck, Bill Gates all started their companies at a similar age.

Yes they did. And they succeeded. Perhaps part of the reason is that they are male and they got more of the right kind of feedback because of it.

Great point of view into what sometimes causes this problem. As a male who works with plenty of female engineers, I've never considered that (but I also give them the same treatment in code reviews as any other engineer).

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From what I have read, she spent like a decade "building" this company before making any effort to release a product. She dropped out of Stanford and has been hailed as a genius while failing to launch and when she did finally launch, this is the result.

Meanwhile, she has apparently been backed for a very, very long time by such luminaries as Henry Kissinger and former US senator and presidential candidate Sam Nunn: https://www.theranos.com/leadership/counselors

So, some pretty girl had former serious VIPs on the world stage patting her on the head and saying "You go, girl!" while she had no product. And we wonder why it became such a huge mess. She was like 19 or 20 when she dreamed this up. I don't know how long she has had their backing, but that is heady stuff for almost anyone, of any age. If she had it in her early twenties, good luck reigning in her insane ego and getting her to see reality.

Her reality is that she can get the backing of people like that. Many people are very "la la la, not listening -- don't confuse me with the facts, my mind is made up." If they can get social proof that they are awesome, it gets far, far worse. And being backed by people like that is very strong social proof.

So, in my opinion, they had an obligation to also put the brakes on and demand real proof while patting her on the head and fueling the growth of her enormous ego. Is it any wonder she has such an enormous ego given those experiences?

You're probably right. But ideally, why should someone like Kissinger, who isn't a science guy would be strong social proof in this context, instead of the scientific community, or scientific advisors with expertise in diagnostics ?

Social proof and scientific proof work completely differently. If this had been driven by science, it wouldn't be the mess it is.

Companies fail and egos get inflated all the time. I'm not sure what substantiates her being an attractive woman as the salient point, especially when the attractiveness advantage (and resulting gigantic egos) exists for both sexes.

Give me a list of companies headed by attractive young men that have been hailed as Decacorns (worth $10 billion) while producing zero products for an entire decade and being lauded in big name publications for years which are now also going down in flames that rival the burning of Rome. Given that only 17% (or less) of CEO's are women, you should have zero problem coming up with at least five such names off the top of your head if there is no gender bias involved in this situation.

Oh, let's make it easier: List me 5 or more unicorns ($1 billion valuation) headed by a guy going down in horrendous flames and all over the media. The men don't have to be particularly good looking or charming either.

But in this case, it wasn't about tweeting if one's plant need watering. These were medical products, and people, usually the crowd that needs them, were making big life decisions based on the results.

The gender of the founder isn't as relevant as the size of the sh* hitting the fan when things go wrong.

I'm reminded of the cargo cult mentality.

Just because you act like Steve Jobs and have the same fashion sense and sense of secrecy, doesn't mean you can build another Apple.

It almost feels as though she was more focused on her image as an important CEO and a female pioneering a role in tech than, you know, actually building the tech and company itself.

Agreed — if you read the great Vanity Fair article [1] about Theranos, one thing that becomes apparent is that Holmes's public statements were classic sales hubris; she was publicly announcing rollouts of technology that didn't work yet, and her scientists were learning about the plans after the fact. It's possible that she genuinely believed her own hype — her surprised reaction to the FDA shutting them down seems to indicate this.

[1] http://www.vanityfair.com/news/2016/09/elizabeth-holmes-ther...

Investors seemed to reward the veneer of success more than looking at the fundamentals.

It's interesting that in the midst of all this, Holmes is carving out time to host a Hillary fundraiser[1].

I almost wonder if we'll see the government/military magically acquire her company at a pre-scandal valuation in a couple of months.

---

[1] http://www.recode.net/2016/3/14/11586966/theranos-ceo-elizab...

>I almost wonder if we'll see the government/military magically acquire her company at a pre-scandal valuation in a couple of months.

no chance. They already tried to sell the tech to DOD in 2012 and that failed spectacularly in the best style of "Pentagon Wars".

https://www.washingtonpost.com/news/wonk/wp/2015/12/02/inter...

As i see it it was the beginning of the end as it seems to me that it was the only real business plan they had and it failing forced them to pivot to try to produce at least something for consumer market. Btw, the 4 star Marines general they have on the board is the one who was using his position back then to push the deal through.

Not going to happen. Bureaucrats aren't CEOs, they can't just unilaterally spend billions of dollars. The money would have to be appropriated by Congress, and the chance of Congress doing that in the current environment is about 0%. Whoever sponsored the bill would get raked over the coals for years.

Didn't DoE give a loan to a solar startup?

How exactly is that interesting, or relevant?

It's not, but it's election season and certain voters like to wax-vitriol about opposing candidates.

I have no inside knowledge but at this point it doesn't seem that Theranos has any real assets outside of whatever hard assets and cash they've still got from their funding?

At what point do you just throw in the towel, declare bankruptcy and try to make your creditors and investors as whole as possible.

The buzzards are circling on this one.

Dockets:

http://www.plainsite.org/profiles/theranos-inc/

http://www.plainsite.org/dockets/304bu4iy6/arizona-district-...

tl;dr: Patients and investors are pissed, and so they're suing for fraud.

Is there a real chance she might be criminally charged, and end up in prison?

Are other medical startups having troubles because the science is inherently hard or is it really because Theranos did some "mistakes" ?

Here is naive question: The problem Theranos is solving can't be that difficult, you just need to take smaller amounts of blood and automate testing. Is anyone else doing this? Seems very promising area. I see that Theranos is facing crazy obstacles to make things work, not 100% sure why can't they produce something instead of nothing.

Statistics stops you. Blood testing is all about statistics. You measure a certain number of things in the blood test, which gives you an idea of how much of the thing you're looking for is in the blood.

Some of these things (bacteria, virus, etc) only needs to be in the blood in very low concentrations to be harmful, and to get a good reading you need a larger sample.

Most software companies have a Theranos-like business model, ship broken stuff on purpose for profit.

It worked great until someone thought it was a great idea to do it with technology used to provide medical treatment to human beings.

"Move fast and break things" works well until one of those "things" is grandma.

It's also unwise when your concept probably isn't even theoretically possible.

You can definitely bite off more than you can chew with software, but most problems are actually solvable.

> It's also unwise when your concept probably isn't even theoretically possible.

If the concept is easier and cheaper blood tests, I think we can solve that.

If the concept is testing with a given volume of arbitrary blood, you've dug yourself your own grave.

I'm not familiar with medicine; was this not known in the field ?

Surely a student from Stanford, who I hear was also doing research at NUS, should have had access to enough advisers who could've averred that to her (before the company took off) ?

A lot of her professors in Stanford told her that her vision is not possible. Of course she didn't listen to them.

>> easier and cheaper blood tests,

Cheaper isn't enough to drive enough demand against the competition, because of insurance.

So they got pushed towards easier, i.e. no pain finger prick, which was their downfall.

How companies see themselves:

Disruptive next-gen mobile VR social network startup powered by serverless machine learning and blockchains implemented by engineers/adept hikers fed exclusively with gluten free organic kale/tofu/quinoa salads and kombucha.

What they really are:

Death march ran by Steve Jobs' cultists/buzzword collectors solving problems that nobody has in a way they don't really understand implemented by overworked depressed people that drink themselves into oblivion to cope with technical debt.

I think they are not the only ones who provide broken medical technology. It sks but that is how most businesses work. Overpromising and underdelivering. But the ones that get attacked get attacked because they made too many enemies. In some regards they are actually the ones who tried the most to actually change something, thereby commiting themselves too much to attack.

And when most software companies break things people don't die or get misdiagnosed and then die! This is very different.

https://youtu.be/aRrDsbUdY_k?t=5m23s

http://www.theverge.com/2012/9/20/3363914/wrong-turn-apple-i...

http://www.dailytech.com/Lockheeds+F22+Raptor+Gets+Zapped+by...

https://en.wikipedia.org/wiki/USS_Yorktown_(CG-48)

https://en.wikipedia.org/wiki/Mars_Climate_Orbiter

The first one isn't a product that can be sold but rather a systemic failure.

The rest of them didn't kill anyone.

iOS 6 Maps was definitely a pretty big mistake, but Google Maps was available the majority of the time it was broken. I guess I can let you have that one, since it was pretty appallingly bad and because not everyone knew you could download the actually good Maps app.

The next two examples were unfortunate mistakes where a tiny bug caused a massive failure, and these things happen sometimes. They didn't ship a broken product, just a product with a worse-than-expected bug. I feel like that's understandable when your target platform is a damned jet airplane or ship, and your underlying platform is some complicated 35 "Intel i960" mess running Ada[1] or 27 Pentium Pro computers all running Windows NT 4.0.[2] I'm not sure what you expected.

And yes, the loss of the Mars Orbiter was awful, and yes the error was noticed by two different people who said something about it.[3] I think this might be the most applicable scenario to your point, where a broken product was shipped broken on purpose because of stupid time pressure.

Two of five isn't too bad, but it hardly shows a pattern of shipping broken stuff for profit. Sometimes people want profit, but many times people make mistakes.

1: http://www.militaryaerospace.com/articles/print/volume-12/is..., https://en.wikipedia.org/wiki/Intel_i960

2: https://en.wikipedia.org/wiki/USS_Yorktown_(CG-48)#Smart_shi...

3: https://en.wikipedia.org/wiki/Mars_Climate_Orbiter#Cause_of_...

You can have a bad traffic accident if your maps app tells you to enter a street with opposing traffic.

Now, true. Mars Climate Observer didn't kill anyone. But to build that equipment the government had put money away from health and education, which saves people and prevents violence, and that indirectly kills people. It's not a closed system.

Even in the software world, at least the product "basically" works. In this case even the basic product didnt work.

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