Episode 365

#366: Cardiac Arrest: Five Heart-Stopping Years as a CEO on the Feds Hit-List

In this episode of the Global Medical Device Podcast, host Etienne Nichols engages with Howard Root, former CEO of Vascular Solutions and author of "Cardiac Arrest: Five Heart-Stopping Years as a CEO on the Fed’s Hit List," and Mark Duval, President and CEO of DuVal & Associates.

The episode delves into the harrowing experiences of navigating severe legal battles over off-label promotions, highlighting crucial insights into maintaining innovation while managing legal risks in the MedTech field. Additionally, Mark DuVal, a noted regulatory attorney, provides his expertise on the responsible corporate officer doctrine and its implications for industry executives.

Key Timestamps:

  • [00:00:15] - Introduction by Etienne Nichols.
  • [00:01:30] - Howard Root's background and the origins of Vascular Solutions.
  • [00:05:00] - Mark DuVal introduces Howard Root, detailing his legal battles.
  • [00:10:00] - Howard Root discusses the intricacies of his federal indictment and the subsequent trial.
  • [00:30:00] - Discussion on corporate responsibility and regulatory implications in the MedTech industry.
  • [00:50:00] - Audience Q&A session with Howard Root and Mark DuVal.
  • [01:10:00] - Closing remarks and takeaways.


  • Howard Root: "We're not imposing rules at the bare legal minimum...we want to have a gray area. It’s why you drive 55 in a 60 zone."
  • Mark DuVal: "Always be truthful, fairly balanced, and not misleading when discussing device applications."


Latest MedTech Trends:

  1. Increased scrutiny on off-label promotions highlights the need for clear regulatory strategies.
  2. Growing legal precedents emphasize the importance of corporate responsibility at all levels of operation.
  3. The role of ethical practices in sustaining innovation within the MedTech industry.

Practical Tips for MedTech Professionals:

  1. Ensure thorough understanding and compliance with FDA guidelines and local regulations.
  2. Implement robust training and compliance programs for all staff, particularly in sales and marketing.
  3. Engage experienced legal counsel to navigate complex regulatory landscapes.

Future Predictions in MedTech:

  1. Enhanced regulatory frameworks to better define and manage off-label use.
  2. Greater use of AI and data analytics to monitor compliance and ethical practices.
  3. Increased advocacy for legislative changes to protect innovators from aggressive legal challenges.


MedTech 101:

Explaining terms like 'off-label use', which refers to the use of medical devices for indications not specifically approved by the FDA. While legally permissible under certain conditions, it requires careful communication and documentation to ensure compliance and mitigate legal risks.

Audience Interaction:

Poll Question: "Do you believe current regulations fairly balance innovation with patient safety in MedTech?"

Call to Action:

We encourage you to leave feedback on the episode and suggestions for future topics via email at podcast@greenlight.guru

Reviews on iTunes are also greatly appreciated!


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About the Podcast

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Global Medical Device Podcast powered by Greenlight Guru
The Global Medical Device Podcast, powered by Greenlight Guru, is where today's brightest minds in the medical device industry go to get their most useful and actionable insider knowledge, direct from some of the world's leading medical device experts ...

About your host

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Etienne Nichols

Mechanical Engineer, Medical Device Guru, and host of the Global Medical Device Podcast