By Jon Caroulis
They first met as adversaries – in deep water. J. C. Lopez and Alex Sotolongo were playing against each other in a high-school water polo match in Miami. They became friendly and later competed together at national-level water polo matches, then went their separate ways to college. Both hoped to become doctors. The two reconnected when they were accepted into the Perelman School of Medicine. Now, as 4th-year students, they have teamed up to conceptualize something that could, as one experienced medical developer said, “improve efficiency in a commonly performed surgery.”
Their experience has been akin to pursuing their medical education while at the same time studying for another professional degree. Lopez and Sotolongo have had to educate themselves on the long and sometimes difficult process of procuring a patent, obtaining financing, writing proposals for grants, and finding partners and mentors. But both of them credit their time as water polo players with providing a foundation that gave them the mental and even physical power to keep at it.
And it all started with a drawing on a napkin.
Sotolongo was at a dinner party with his wife, Beatrice. At the time, he was on a surgical rotation taking care of patients suffering from vascular disease. The patients were treated with state-of-the-art therapies, and the surgeons, Sotolongo says, were “highly trained and extraordinarily skilled.” Still, he notes, “there were often devastating complications.”
“I thought to myself, there has to be a better way, our patients deserve more.” For months, he pondered how the surgeries could be improved.
Then, at the dinner party, “an idea popped into my head, seemingly out of thin air.”
Fortunately for him, Beatrice is the CEO of a start-up company and has served as a sounding board for his frequent ideas.
“I pitched the idea to her, and to my surprise she responded with something along the lines of ‘This, surprisingly, isn’t crazy.’ That’s when I knew we were on to something, and I scribbled some rough sketches on a napkin.”
To move his idea from the napkin to the surgical suite, he reached out his water polo buddy. They had reconnected at Penn Preview, the second-look weekend for School of Medicine students. They communicated through Facebook when they saw they had both been admitted to the Perelman School.
Lopez and Sotolongo have a base at Plexus, where they can test their ideas.
Lopez had worked for Penn’s Center for Technology Transfer, which was then incorporated into the Penn Center for Innovation (PCI) when that was formed. He was part of the program during the transition and had 18 months of experience with technology transfer and market analysis in all. He picks up the story: “He reached out to me about his idea and wanted some input about the intellectual property around it.” Using the skills he had developed, Lopez was able to determine that Sotolongo’s idea could amount to a viable product with respect to patent protection and financial opportunity.
As Lopez recalls, they started chatting about the idea together in December 2015 and then came across a momentous e-mail announcement from PCI. It concerned a competition, called DevelUPmed, to develop new medical devices. “We both thought, ‘What the hell, let’s give this competition a shot and see what can come of it.’ So, we submitted the idea.” They were selected as the only student-run team out of the three finalists in the competition, which received more than 50 submissions across Penn Medicine and the University.
Michael Dishowitz, Ph.D., is a portfolio manager for PCI’s new ventures program and director of DevelUPmed. The latter, he says, partnered with 20 investors, entrepreneurs, and industry experts to identify devices with the most promising commercial potential. “J. C. and Alex’s invention was at the top of the list in part because they proposed a novel solution that would simplify and shorten vascular anastomotic procedures” – usually surgical procedures joining two tubular structures like blood vessels.
Each team had mentors who advised them on forming a company through Penn’s UPstart or UPadvisors programs. They also participated in the “customer-discovery” program run by Penn I-Corps, created by the National Science Foundation to increase the impact of research it has funded. In addition, Dishowitz points out, the teams were advised by experts on intellectual property, FDA regulatory affairs, and health-care reimbursement. Each team in DevelUPmed also received $10,000 for prototyping its project.
Sotolongo puts it bluntly: “Without the resources and guidance that the PCI has provided to us, none of this would be possible.”
Forming a Company, Pursuing a Patent
Sotolongo and Lopez have now formed their own company, Angiio. All grants they’ve received for the project have been awarded to the company. They are the only full-time employees, and they had help from two interns over the summer. One is a Penn undergraduate engineering student and the other a first-year Penn medical student.
“We’re now at the stage where we are finalizing our initial prototype as well as developing our overall business case for the product,” Lopez adds.
At the end of September, they and the other finalists made their formal “pitches” to a panel of judges. The team whose prototype was selected received $50,000 from the Ben Franklin Technology Partners of Southeastern Pennsylvania. Although theirs was not selected, Dishowitz says that Lopez and Sotolongo “are very talented individuals, and their company has the potential to really improve medical care.” He points out that the reviewers in the earlier competition were blinded to the identity of the applicants, “so it’s certainly impressive that their idea stood out.”
Their device would use magnetic forces in vascular surgery to improve the way arteries and veins are connected by speeding up the connection process and reducing complications. As Lopez explains, the magnet will help deploy sutures that then allow the surgeon to tie the arteries together in a faster way than currently offered techniques. According to the Angiio website: “Current solutions require hand-sewing grafts to vessels and are regularly complicated by leakage from suture holes as well as decreased oxygenation to the brain, kidneys, and bowels due to prolonged surgical times.” Lopez adds, “We are in the process of submitting our provisional patent and continuing to develop our initial proof-concept prototype.”
But there is a complication, the two partners point out. In the process of submitting their provisional patent, they cannot publicly describe the mechanism in greater detail. “If we did,” Lopez says, “it would constitute what is called a ‘public disclosure’ and essentially eliminate our ability to patent the device if the crucial aspects of it are made public prior to submission.”
The device, now named Vesicon, will be 6 to 10 millimeters long, small enough to fit into various arteries. In theory, they say, a surgeon will insert their invention using another tool they’re developing that will serve as a “guide stick.” Lopez and Sotolongo haven’t yet figured out what material will be used to construct the magnet.
“We’ve begun testing our deployment mechanism with a makeshift electromagnet, made out of microwave parts, just to understand the physics behind the idea,” Lopez says. “As we continue to refine our product, we plan on testing it on vessels to ensure we can deploy the device through a vessel wall.”
Pooling Their Talents
It’s been eight years since Lopez and Sotolongo first met as adversaries in that Miami pool.
“Although my main goal was to always beat his team, I knew right away that I respected Alex as a goalie in water polo,” Lopez says. “I always came into those games with a strategy on how to score on him and knew I would have to bring my A-game whenever we played each other.”
Sotolongo calls Lopez “one of the fiercest competitors I faced in my athletic career, and what was most impressive about him was that he would be the first one to come over and joke around with the opposing squad, regardless of the outcome. As I have come to know him in medical school, I can still see that intense, competitive spirit permeating through all of his endeavors.” What most impresses him, he continues, “is his vision, diligence, and practicality. I can say with a high degree of confidence that we wouldn’t be anywhere close to where we are if it wasn’t for the skills and qualities he brings to the table.”
For his part, Lopez cites Sotolongo’s intellect and his ability to understand a problem.
“I think we have been quite complementary partners, with Alex focusing on the hard science and myself focusing on the other aspects of the business, such as legal issues, financing, fundraising, regulatory, and reimbursement.”
Sotolongo says he applied to Penn because of the resources available to students in addition to the superb clinical education it offered. According to Lopez, he applied for similar reasons – as well as for the opportunity to complete the dual-degree program with the Wharton School. He started his studies there this fall. The experience of developing a product, he says, “has solidified my conviction to pursue a dual M.D.-M.B.A. degree. I have learned just how complex taking a simple idea such as ours from point A to Z can be.”
In addition, he appreciates the work he did at the Penn Center for Innovation office, which he says “taught me the basics of intellectual property and just how important it is to commercializing an idea.” He also learned the importance of reaching out to people to get their advice and solicit their help in making additional them help make further connections. In this regard, he adds, the Penn Med Alumni network “has been invaluable.”
Through the alumni network, Lopez and Sotolongo connected with Pitou Devgon, M.D., G.M.E. ’08, M.B.A. ’10, who did his residency in internal medicine at Penn, then earned an M.B.A. degree from Wharton in health care management. Devgon now has a start-up company, Velano Vascular, which he co-founded with another Wharton alumnus, Eric Stone, M.B.A. ’07.
“I always enjoy helping entrepreneurs in the Penn community, especially when they are passionately trying to innovate,” Devgon says. “When I first saw their concept, it seemed highly compelling.” Although he, too, can’t provide specifics, he says, “It could improve efficiency in a commonly performed surgery.”
Devgon has worked primarily with Lopez on the strategy front, especially around the F.D.A. approval process and market development. “People don’t know how much blood, sweat, and tears go into developing even the simplest medical device. Putting together the right interdisciplinary team and raising money takes a huge amount of time,” Devgon says, “but that’s what lays the foundation for great technologies to be developed.”
At the Pennovation building, Lopez and Sotolongo, representing Angiio, made their formal pitch to a panel of judges and mingled with other DevelUPmed finalists.
The Path to Medicine
Although they are now immersed in the business of medicine and technology, Lopez and Sotolongo were on different paths to becoming physicians.
“My interest in becoming a doctor started in my high-school chemistry class,” Lopez recalls. “It was then I realized I absolutely loved chemistry and more specifically biochemistry. After thinking about it, I knew the only career for me was to become a doctor.” At Stanford University, he majored in biology, with a minor in chemistry.
Sotolongo majored in biochemistry at George Washington University, where he worked with Ferid Murad, M.D., Ph.D., the recipient of the Nobel Prize in Physiology or Medicine in 1998. Sotolongo spent two years working in Murad’s laboratory. He also had the opportunity to be a co-author on several papers with Murad.
“For about as long as I can remember, I have known I wanted to be a physician,” Sotolongo says. “Since beginning medical school at Penn, the reasons for wanting to enter medicine have become clearer.” The most important factor: having the opportunity to interact with faculty members at Perelman and witnessing at first hand the impact they have on the lives of their patients and, more broadly, on our understanding of disease and on the practice of medicine. His goal is to become a cardiothoracic surgeon.
Lopez and Sotolongo might be budding entrepreneurs, but they never overlook the fact that they’re still students. Working on their project, says Lopez, “has definitely required a lot of extra effort on both our parts, but it has been an incredible learning experience. We have learned an incredible amount of practical, real-world skills in the past eight months from attempting to develop this device, and I know this has shaped how I view problems and solutions moving forward.”
Sotolongo admits that combining his classwork and working on their project is not easy, “but it’s what I came here to do.” He emphasizes that Penn “is extremely supportive of medical students’ pursuit of experiences in the basic and clinical sciences, as well as a host of other endeavors.”
It has been a long journey since Sotolongo and Lopez first encountered each other in a pool. But what started there, they agree, has been an important part of their lives.
“More than anything else, my involvement in athletics taught me the simple lesson that there is no substitute for relentless dedication to a singular goal,” Sotolongo says. “The most important lesson, however, is that it takes more than an individual effort to accomplish anything of extraordinary significance or importance.”
Lopez, too, believes his athletic career has shaped his work ethic. “Playing water polo taught me exactly how much hard work goes in to a single success,” he says. “More importantly, it taught me that there are many failures before one can achieve a great outcome.” That background has prepared him well for entrepreneurship, “which requires an extraordinary amount of dedication in the face of much adversity.”