Casey Qadir's Hubly Drill: A Leap Forward in Neurosurgery | EP 24
Description
In this episode of UNinvested, Sahil sits down with Casey Qadir, co-founder of Hubley Surgical. Casey shares her journey from being an undergrad at Northwestern University to founding a startup that aims to revolutionize neurosurgery with a battery-powered cranial drill. She discusses the challenges and triumphs of building a medical device company, the importance of perseverance, and her unique approach to balancing work and personal development.
What we explore:
Casey's background and the inception of Hubley Surgical at Northwestern University
The interdisciplinary class that sparked the idea for a cranial drill
Collaboration with professionals as an undergrad and earning their respect
Transition from a class project to a startup, including patent filing and early funding
The decision to go full-time and join the Alchemist Accelerator
Challenges of balancing a full-time job and a budding startup
Raising initial funding and overcoming investor rejections
Iterative product development and the importance of user feedback
Navigating the FDA approval process and maintaining product safety
Expanding the vision of Hubley Surgical beyond the initial product
The value of passion and perseverance in entrepreneurship
Casey's routine of pursuing a part-time master's in applied math to stay intellectually stimulated
Where to find Uninvested:
Website: https://www.uninvested.org/
In this episode, we cover:
[00:00:00] Introduction and welcome to Casey Qadir
[00:00:07] Casey's background and the start of Hubley Surgical
[00:00:17] The interdisciplinary class at Northwestern and the initial idea
[00:00:37] Working with professionals as an undergrad
[00:01:02] Filing the first patent and getting early funding
[00:02:33] Transition to full-time and joining the Alchemist Accelerator
[00:03:44] Balancing a full-time job and a startup
[00:05:02] Early challenges and decision-making
[00:06:00] Iterative product development and the importance of 3D printing
[00:06:56] Raising a friends and family round and managing resources
[00:08:44] Navigating investor rejections and refining the product
[00:11:01] The importance of FDA approval and maintaining product safety
[00:12:33] Overcoming low points and staying committed
[00:13:44] Expanding the vision of Hubley Surgical
[00:19:56] Casey's routine of pursuing a part-time master's in applied math
[00:21:07] Closing remarks and thank you
[00:00:00] Sahil: Welcome Casey. How are you doing?
So I'd really love to just learn a little bit more about you, you know, for our audience. Hubley is a startup you're working on. If you could tell us the story of getting there.
[00:00:09] Casey: I started Hubly Surgical alongside, a team of students at Northwestern. I was in this class. It was a, like a cross listed business school, med school, engineering, law school class called NUvention Medical.
It's at Northwestern. And the whole purpose of the class was to teach you by doing how to start a fledgling medical technology startup. And I teamed up with some students, one who was a neurosurgeon, another guy who was a, electrical engineer, who is now a law student focusing on IEP. Together, we came up with this idea of a, a cranial And the reason that's important is because the neurosurgeon on the team, he was a neurosurgeon getting his MBA at night, he was the one who said that he uses a hand crank drill to drill holes into patient's skulls every single day.
And this is the most common neurosurgical procedure. It's an emergency, so it's done in the ICU typically. This neurosurgeon, Dr. Amit Ayer, said, you know, he uses a hand cranked drill every single day, and he said, you know, basically he was like, there's got to be a better way. And we came up with a drill that's battery powered and stops automatically when it breaks the skull.
[00:01:17] Sahil: Sounds like you've worked with a lot of professionals while you're an undergrad student at Northwestern. How did you get them to take you serious? Not to say in an insulting manner, but you are an undergrad and they are. Someone with an md,
[00:01:27] Casey: no offense taken in all honesty, when I first started the class, I was really worried about my ability to team up with people because I was, I was the only undergrad in the class.
The class actually was not for undergrads, so I was like, you know, way less qualified than, pretty much everyone else in the class. So I, you know, went to the front of the class at the beginning of a couple of lectures and said. Hey, if anyone wants to work with me, here's some ideas that I have. And they were all neurotech related.
After one of these like idea pitching sessions, Amit, the neurosurgeon came up to me and said, Hey, I like your ideas. I'm a neurosurgeon. You seem to be interested in that. So. Let's work together.
[00:02:07] Sahil: So it was really just like your passion for neurosurgery, which convinced him to work with you.
[00:02:11] Casey: Pretty much, yep.
[00:02:13] Sahil: So is he still on your team today?
[00:02:14] Casey: He's a full-time neurosurgeon, but I still work with him and he's immensely helpful, obviously providing that expertise.
[00:02:19] Sahil: You start with this class project, you eventually, you get to this drill idea, but then how do you make that reality?
[00:02:26] Casey: You don't need to decide to go full time right away, but at the very beginning when we started graduated from the class.
It was a matter of talking to the professors and they said, Hey, I think that you're actually onto something here. The immediate next step is to file a patent and start trying to get some money. So we did that. We filed our first provisional patent, in November of 2018. so about six months after we had finished the course, right when we filed that first patent, we felt, that our IP was protected enough.
To start writing grant applications and applying to pitch competitions. Won some early funding, which paid for that patent prosecution, and then allowed us to incorporate as a company. And then I would say that the biggest Leap of faith was right after that period. Now the next step was if we're actually going to do this, we're going to need some significant money in order to actually build the product and then do FDA testing.
That's going to take, you know, at least a million dollars upwards. To get that FDA clearance. The only ways to get that kind of money are either through government grants, like NIH or NSF grants, or through investments. The only way to get investor funding is if you have a full time CEO. That was the period where I graduated in June of 2019, worked full time at, as a software engineer for about six months.
And in that six month period, I applied for startup accelerators, which we got into an accelerator called Alchemist in the Bay Area. And I put my job on. Like December 3rd, 2019 moved to San Francisco on December 4th of 2019. And then the accelerator started on December 5th.
[00:03:57] Sahil: So a few follow up questions with that one, like you said, your IP was protected cause you had this provisional patent, but like, were you ever worried about another competitor, you know, doing something completely different, solving the exact issue and beating you to mark?
[00:04:09] Casey: I know it's a good question. It didn't really worry me. Cause I guess I figured it was something that I had no, you know, control over, like I was constantly attending these conferences, talking to some strategics, you know, some of the big players in the space and getting kind of that positive reinforcement that we were working on a real need and what I was, what we were doing was important.
And so I figured that I was, you know, we were doing the diligence. That we had available to us to see what else is out there, who else is working on this. And if something came up out of nowhere, then, you know, all we can do is work faster and saying, I should go full time on this company as soon as, like, as soon as I can, I, instead of working for, working as a software engineer for like two years first.
[00:04:50] Sahil: Yeah. So talking about that, you did end up taking a job. You had some sort of safety net. You didn't want to go all in. Right away. What was your rationale for that?
[00:04:58] Casey: Actually, I got offered the job like a year in advance. It was before we had filed our first patent. It was before we even really started applying for pitch competition.
So I accepted the job in, I guess, September, October, whenever I got the offer, and as the company started to become more and more legitimate and it looked like something that was, could be something, I did have that decision to make when I graduated in June of, do I, you know, like, do I just go straight into it or should I do this job?
The nice part of. Of working in a full time job for like six months is that I had enough savings that I said, okay, I can go full time on this company for like at least three months and totally pay for myself and not need any other fucking thing.
[00:05:36] Sahil: Take me through those six months though, when you're at your job, how are you still trying to manage a startup, which at the time I believe it was just you and Amit.
[00:05:43] Casey: Yeah, so I, it was nice. I had permission for my job to like have this as a side hustle. I was working for a bank as a software engineer. So like a medical device cranial drill was like way out of the realm of what I was working on there. I mean, it was just nights and weekends. It was kind of all I, all I worked on in my free time.
And it just got to the point where, you know, by the, by the time I applied to startup accelerators and like, maybe like September, October, like only like a few four ish months into my job, I felt like I absolutely had more than 40 hours per week of work that I could be doing on my startup. You know what I mean?
Like, I was like, I know exactly how I would be spending my time every day if I went full time. And that was part of a signal to me where I said, okay, it makes sense to go full time on this. I know what I need to do, how I would structure my day. There are things that I don't have time to do right now because of my job.
So it kind of like built up in the beginning, I would say I was working on it, maybe like I don't know, maybe like 20 hours a week right when I graduated and it just like steadily there got there more and more work came up like my to do list just lengthened.
[00:06:46] Sahil: What did you wish you could do but you couldn't because of your job?
[00:06:49] Casey: Definitely a lot of product development. The iterative process of testing in the workshop and then trying again 3D printing new things and then. Being able to pull the, pull the new 3D prints right out of the printer instead of like if 3D printer becomes ready in the middle of the day when I'm at my job that I have to wait until night to get it.
That kind of thing was definitely very time consuming, or rather, I don't know, also definitely was taking calls. I wanted to chat with as many neurosurgeon users as possible, to get their feedback on what I was working on and then also to have them in person try out the product. And since I was constrained on, kind of this nine to five, it was like I was also very constrained.
Like, I was constrained not only by these people's schedules, like neurosurgeon schedules, which are insane, but then on top of that, by my own schedule.
[00:07:34] Sahil: So when you leave to go to this accelerator, it lasts for, I'm assuming, three months, like most accelerators. How did you leverage the extra funding you got, and how much runway did that give you?
[00:07:43] Casey: Well, it ended up being a lot of runway, because we made it last. So the accelerator was supposed to be from December to May. So December 2019 and May of 2020. but then in mid March, it went completely virtual. And I had been planning to raise our first capital round in May of 2020 at the end of the accelerator.
So when the world kind of shut down in mid March for the pandemic, I decided to delay that fundraise until the end of the year. We did manage to raise a very small, like I want to say 300, 000, like I'll call it a friends and family round because it was primarily like individual angels, people in the network.
so that was really helpful. So I guess the 330, 000 basically ended up lasting us like a year.
[00:08:25] Sahil: When you go into this angel round, a lot of people are always like, Oh, I reached into my network, you know, I reached into angels. But really take me through that because early on, these people are giving you money when you essentially don't even have like a real product or anything yet.
What is like your mindset going into those conversations? Do you feel an additive pressure, especially if it is friends and family rather than venture capitalists or someone?
[00:08:45] Casey: That first round that you raise is the hardest. Everyone probably tells you that. But like the first million dollars that I, that we raised is genuinely by far the hardest money that we've ever raised.
Every round since then has been like a walk in the park in comparison. But yeah, it's really hard because the beginning, you're right. You're just selling people on an idea and your passion. In general, you know, you don't want to take money from anyone who the relationship would be ruined if everything goes bottoms up.
That's where the accelerator comes in. Where through the accelerator you're working with people as mentors, really closely for like this three to six month period. And so the kind of ideas that is that of that is that they're getting to know you really, really well. and so that's why they can say, Hey, I've worked with her for X number of months and I believe in her passion.
I believe that. She has the grit and know how, whatever else that she needs to get this venture done.
[00:09:41] Sahil: So when you're, when you're raising so early, I know, you know, angels tend to take more equity. How do you weigh that against trying to bootstrap? You know, in your case, it's probably very, very hard to bootstrap a medical device, but at the same time, you can be giving your company weigh in some regards for what is going to be your lowest valuation.
[00:09:55] Casey: I feel that we bootstrapped as much as we possibly could have. And I, and I get, I feel like we bootstrapped from. The time that we took the class, the class started in September of 2017 until, honestly, until like early 2021 when we started raising significant money. And what I mean by that is like, everything that we could possibly do on our own, or like do cheaply when it comes to like customer discovery.
I have this one example where, there was a neurosurgery conference in Phoenix. I really wanted to go, but I did not. I didn't want to spend the money or I didn't have the money to, like, pay for the conference attendancy or for the hotel. So I bought flights and my best friend from high school's grandma lived in Phoenix.
So I stayed with her. I'd never met her before, but I was like, Hey friend, can I stay with your grandma? And they were like, sure. So I stayed with this grandma. And. I attended the whole conference. That conference, I, I just went up to a ton of, I went, I went to all these different sessions of people who I wanted to talk to, and I would like run up to them after their panel or whatever and I would say, Hi, I'm Casey, I'm a, you know, I'm working on this thing, I'd love your input, whatever, and I did that.
Ended up getting like, maybe like 30, like 15 minute conversations out of us at his conference.
[00:11:14] Sahil: That's a lot of grit, especially for being by yourself doing these user research and you only have one co founder. At what point did you bring on someone else to the team?
[00:11:21] Casey: My, CTO Tyler joined on March 1st, 2020, and he basically worked like halftime for almost a year, maybe like, yeah, until 2021, where he was, he quit his full time job.
but then I didn't, we didn't have the money to pay. I mean, I wasn't making a salary. I didn't have the money to pay him.
Where did you, where'd you meet Tyler? Cause nowadays what's in supply is ideas. What's not in supply is a CTO.
I actually met him through the very small world that is Chicagoland MedTech.
But my professor of the class. that this company was founded out of. His name is Mark Fisher, and he's a medical device engineer. He was like the engineering professor for the class, but he's primarily an engineer. I think what happened, so I put up a LinkedIn post, which is a crazy thing to do for a co founder, like a LinkedIn job application.
And Tyler, and a lot of people applied for it. He was flagged as someone who people really liked working with and who had the perfect background.
[00:12:15] Sahil: It seems that early on, you like, you had a lot of doctors on board, but you obviously still have to go through like the whole FDA testing approval process. So how do you really maintain faith and conviction that it will pass?
So, because one failure could derail your whole startup, what you're working towards, even if you have doctors on board who say, I love this. There's still not the people that are signing off that they can use it.
[00:12:36] Casey: Of course. I mean, FDA clearance is the name of the game. So my head of quality, Julie Byers is amazing.
So I totally credit basically the whole FDA clearance to her. It's definitely a very long process. That's why it takes so much time to make sure that every step of the manufacturing process and then obviously of the actual like device, like testing works. But yeah, I guess I don't necessarily Think of it as, you know, it could have been one thing and then we failed.
It would have been like, if we didn't pass any given test during the testing, then we would have gone back and made the right changes and then tested again. Once you pass all the testing, then you go to the FDA, and then you just sit back and wait and see if they ask for more testing. And again, if they do ask for more testing, you just go back, you do the testing, you know, you pass, and then you keep going.
And again, it's like, if you don't pass, then it's like, it's a, thank God you, they asked for the testing, because you want to make sure you're putting out a good result. Product that has no safety issues.
[00:13:30] Sahil: You've been going at this startup since 2018. So what I want to know is really what were your lowest moment?
It's a tumultuous process and you will have a lot of low points. So kind of what were your lowest points in this six year, you know, five and a half year process?
[00:13:43] Casey: The lowest point was fall of 2020, which as, as I mentioned earlier, we had originally planned to raise our round in May of 2020. And then I, I postponed it to like September, October, or yeah, I said, I postponed the race to September.
cause I figured like six months after everything shut down because of COVID, like maybe people would, you know, the market started to bounce back a little bit and investors were a little less afraid of doing some risky investments. So, so yeah, when I tried to raise again in September of 2020, I always say this, but, I had 44, no, I had, let me see.
I had exactly 50. investor meetings scheduled. And it was like, I had gotten these meetings from primarily from Alchemist, from my accelerator. And it was like through this network that I had scheduled 50 meetings. And investor number three said yes. Investor number six said yes. And then I got 44 no's in a row.
And at that point I had just like run out of people to have meetings with. Typically if you get more yeses than that, The people who say yes, introduce you to their networks and you get more investors. And that's how, that's how I can grow beyond the 50. But in this case, since I had gotten a total of 48 no's totally exhausted my network, so, and it wasn't growing.
So that was rough because that was right around when, you know, I had been. Telling my CTO Tyler that we were going to hire him full time as soon as we've raised this round. And then I just totally failed to raise the rounds and it sucked. And I get at this point, it was like, I wasn't making any money. I didn't have money to pay Tyler.
We had, we had been surviving off of like really tiny grants that I got here and there, like little pitch competitions and stuff like that. So, you know, I went back to the 48 people who said no. And I asked them, why did they say no? And I think it's important to note that when they first said no, I asked them and they all said, you're too early.
It's too risky. You know, COVID, whatever. And I went back to them after I had exhausted my network and was like, shoot, what do I do? I went back to them and I said, okay, now I need to actually give me a reason that I can control, not just I'm too early or it's COVID. But is there clearly you, you might have invested.
That's why you took the initial meeting with me. What can I do? What could I have done? What can be different about the company? Beyond just we're too early. That would make this a compelling investment for you. And I got really great advice, which was that our cost of goods to make our product was too high.
They said, I think your COGS are too high in this pandemic market, you know, health care, health care costs need to be low, you know, people, the hospitals are, are having trouble with their budgets and you cannot be raising the, like, your COGS are too high, it means your price is going to be too high, it means so I took that advice to heart and Tyler, my CTO, and I, but probably mostly him, really just completely Like reinvented the Hubly drill.
Like we had built the drill, we had our MVP, and we went back to the drawing board and said, we need to reinvent this so that it's cheaper to make, or less expensive to make. And he did, and it took him, he was like a powerhouse, it took him like two months. And then I went back to those investors and I said, hey, I listened to you, I took your advice, here's our new cogs and here's what our new price point can be.
And then a bunch of them invested. It worked.
[00:16:49] Sahil: So when you were at your low point, did you consider just walking away, maybe going back to your previous job, or was it always, I'm never going to give up? I mean, you basically exhausted all options, so why didn't you walk away?
[00:16:58] Casey: I never considered walking away because I'd already taken that 300, 000 of angel funding.
And so I knew that I needed to bite the nail to make this company happen, and I still genuinely was very, very passionate and still am about the actual mission of the company, which is patient safety. So I think that that's kind of what it boils down to, and that's why those angels early on are investing in a passionate founder, because you have to be actually passionate about the mission to, to not walk away when it gets hard.
So those, that was, those were the two things, but no, I never considered walking away, because. I feel like there's always more options. There's, there's more options because I didn't have actual employees yet. So I didn't need to pay myself. I could just couch serve my CTO. I felt really sorry for him.
Obviously that I kept telling him that, Oh, we're going to race this round. I'm going to hire you full time. It's going to be great. But he also didn't walk away because he also had faith in the mission and faith in both of our abilities to figure it out. But anyway, so we didn't have, we didn't have like a payroll that we were missing.
It was just the two founders who founders know that they're taking on this risk when they found a company. So. So that made it easier, I think, to just say, okay, we have no money or, you know, we have like, what, 10, 000 in the bank or whatever it was. I don't remember. In all honesty, I don't remember exactly how low our bank account got, but you know, however much money we had, it was like, this is what we can, we have to spend on product development.
And that's going to be the most important thing is making as much progress as possible. It would have taken many more grant rejections and investor rejections. Before I would have considered giving up.
[00:18:28] Sahil: So now that you've usually raised 3 million and throughout this whole process, has the vision changed at all or like your approach?
[00:18:36] Casey: I think really the only change is that in the very, very beginning, when this was a class project, and probably again, those early days when I was first starting out first going full time, I was really focused on this one procedure with the hand crank drill. And I realized. After that are we as a team realized and customers, you know, like users have helped us realize to all of the other possibilities for this technology.
So the vision has definitely expanded and continues to expand over time as we, we ourselves think of new avenues for using the technology. So again, we're, we're an auto stop and grill. So it's a matter of thinking of what other medical procedures. would benefit from an auto stop. And as I said, a lot of times, like now that we're FDA cleared, we have paying customers, our customers will come to us and say, Hey, I think it'd be really useful to have this in X, Y, Z procedure.
And then we're like, that's great. Let's, let's talk more about it and see how we can make that happen and what the regulatory process is for that. So the vision has expanded from being pretty laser focused to making medical drilling safe across across a whole bunch of settings and a whole, across a whole bunch of procedures.
And we're starting off with the handrail.
[00:19:47] Sahil: Well, I'm glad the vision is expanded. I can definitely see it. There's definitely value in all sorts of procedures, but I want to ask you just one final question that I ask every interview. And has there been any routine that you've kept throughout the years?
[00:19:59] Casey: The one thing that I've done to keep myself sane is this is super nerdy, but I have actually been doing a part time one class at a time nights and weekends, masters in applied math for like the last three years.
So as I said, it's one class at a time, and it's totally virtual, like nights and weekends, but I've, I've really, I'm actually almost done with it. I've done it for over three years now, and this is now, this semester is my final class, and I don't know what I'm going to do with myself after. But it's been really nice because doing math proofs is not a part of my brain that I am ever using with respect to my company.
I do use my brain all the time, and I feel very intellectually challenged and fulfilled, but like math proofs specifically is not part of it. So. It's kind of fun to just like be able to like sign off my emails at one point in the night and say, I'm just going to do my math homework now. As I said, super nerdy, but it's something that I really liked doing.
And I'm actually doing that, that part time math masters with my dad and we don't live in the same state, but he and I have taken a lot of like classes at the same time, which is kind of fun. We can like work on our homework together and stuff.
[00:21:01] Sahil: Well, I would definitely call a class a routine. Thank you so much.
And with that, this has been Uninvested. I'm Sahil.
[00:21:07] Casey: I'm Casey.
[00:21:08] Sahil: And this is UNinvested. This is a personal video, any views or opinions represented in this video are personal and do not represent those of people, institutions, or organizations we may or may not be associated with in a professional or personal capacity.
The views expressed are for entertainment purposes only and not to be misinterpreted as actionable or investment advice.
