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About the Guest:

Elsa Chi Abruzzo, RAC, FRAPS
CEO & President of Anuncia Medical

Elsa Chi Abruzzo is a medical device executive, entrepreneur, and founding member of Anuncia, Inc., Alcyone Therapeutics, Arthromeda, Inc., and Cygnus Regulatory. Elsa has a 30+ year successful product development, operations, regulatory, quality, and clinical track record in med tech Industries. Her experience includes leadership positions at Baxter, Cordis JNJ, CryoLife, Percutaneous Valve Technologies, AtriCure, InnerPulse, Merlin MD, Sapheon, and PTS Diagnostics. Elsa earned a BS in engineering from the University of Miami in Coral Gables, FL, and is regulatory affairs certified and a Regulatory Affairs Professional Society Fellow, recognized for her leadership in Regulatory and Quality by MDDI.

About the Episode:

This week on Entrepreneur Rx, John interviews Elsa Chi Abruzzo, CEO & President of Anuncia Medical, about her company’s recent product, the ReFlow Ventricular System. This device acts as a shunt component that allows Hydrocephalus patients to flush their cerebral spinal fluid at home and release pressure safely and keep their catheters from becoming occluded.

Hydrocephalus patients have problems reabsorbing CSF which can increase intracranial pressure and cause many different issues, so they typically get a catheter that drains it from behind their neck to their abdomen for it to reabsorb. These catheters tend to get occluded after time and lead to revision surgeries. Elsa talks about how the ReFlow Ventricular System can improve the lives of these shunt patients and provide great advice for medical device entrepreneurs looking to develop and scale their own solutions.

Listen to this episode and learn about this disruptive, no-brainer innovation!

Entrepreneur Rx Episode 70:

Entrepreneur RX_Elsa Chi Abruzzo: Audio automatically transcribed by Sonix

Entrepreneur RX_Elsa Chi Abruzzo: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt: Hello everybody, and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt: Hey everybody! Welcome back to another episode of Entrepreneur Rx, where we explore and dissect the great founders in health and medtech that I have access to. Today, I'm really excited to talk to you, Elsa Abruzzo. Elsa and I got connected a while ago because we made an investment in her company, Anuncia, which is groundbreaking, and she'll have, I'm sure she'll want to tell us about this. Also, welcome.

Elsa Chi Abruzzo: Thank you, John. Glad to be here.

John Shufeldt: Thanks, well, this will be really cool. So, I mean, you've got a crazy diverse background, and so give people some context of how this all started for you.

Elsa Chi Abruzzo: Great, so my background is in engineering. So I basically started in medical devices in 1988. I know, I started when I was 12. Growing up in Miami, that's where I started working, and did manufacturing operations, saw a lot of different areas of the medical device world and manufacturing world, and kind of ended up in regulatory and clinical because it gave me a really good perspective about all areas of the medical device world, because everything goes into a submission, right? Everything goes into a clinical trial, and you really get to see what you're doing. I'm not a doctor like you are, but it's great to be able to be in the clinic and see what your products are doing and have that perspective, which was really important for me. And that sort of led to my own regulatory business, and it led to working with a lot of startups, and I just fell in love with startups and continued that. And somehow, I ended up being a CEO, that hardest job I have ever had, and I'm a mother of four boys.

John Shufeldt: Wow, well, it's interesting because what you just said is about as telling as I've ever heard it described. I'm a mother of four boys, and the speed of CEO is the hardest job I've ever had.

Elsa Chi Abruzzo: And the boys are ages 13 to 31.

John Shufeldt: Those of you out there who want to know what being a startup founder CEO is like, I think she just summed it up in one sentence. That was, I'm going to repeat that, that's a great sentence. It's interesting, being in regulatory to me would be like, I want to shoot myself because it's so nuanced-based, And then what it's led to is, it's literally the perfect springboard. I mean, that was kind of genius. I would not have thought of that.

Elsa Chi Abruzzo: It's interesting because, at least from my regulatory business and then later working for startups, if you have a niche area that you know, and this goes for any area, right, any entrepreneur, any consultant, if you have something that you've developed expertise in that you know how to do well and it attracts companies to you, and then it just became, I just became a connector, right, because of it. So somebody would come to me because they needed to get something through the FDA or ... and everybody else they had gone to said, no, you can't do it this way, or it's going to take you this many years. And I said, well, okay, let's look at it. Let's, maybe we can. And having the engineering background and the other aspects of it, they said, well, we can get through this, we can do this. And then you have this person come to you and go, oh, I know this person, and here's a manufacturing person that I know, oh, I know this other person, and here's a clinical person that I know, and it just builds your network. And I think if you love what you do and you're good at what you do, it just works.

John Shufeldt: That's, I mean, that's once again, great perspective. But it's really interesting because it is the gateway into looking at these companies because it's doing your regulatory consulting business, you really had to get in the weeds with these folks. And I can imagine a lot of the folks that were in the same business, always called the attorneys the Office of No. There's a friend of mine who's a great attorney, he does healthcare stuff, and I was harassing him that he was the officer No when I'd go to him with these ideas, he'd be like, no, you can't do that. I'm like, well, no, I'm pretty sure I want to, and I think I can. I know you can. This was back in the early MeMD days with, before telemedicine was a thing he told me unequivocally, you can't do that. And so I would suspect, a lot of people going to these FDA experts are being told, no, that'll never work, FDA will never do that. But your perspective of no, I think we can figure out a way to get this done, that had to be refreshing for people.

Elsa Chi Abruzzo: Yeah, I think so. And look, I've had my share of no's from the FDA, too, right? And even when I worked at AtriCure, right, we, FDA had gotten it into their minds that a certain device couldn't go 510K route for a particular reason, and I knew that wasn't right. I mean, I knew that wasn't really fair, and I think that they were misunderstanding it. And we went through the process, we went through a supervisory review. We brought clinicians that really understood this device and this area of medicine, and we went to the FDA, and it goes, here's why, you know, you're wrong, FDA. I mean, most of the time they're right, don't get me wrong. I think they're very good at what they do, believe it or not. I mean, you would think that somebody in my area would fear the FDA and maybe not like them, but that's absolutely not true. But we went to them, and they were receptive, right? And sometimes it's about rethinking things, looking at things a different way, and also persistence, right? A lot of stuff that you see out there didn't just get there overnight, it took a lot of going back. In fact, I think that CEO at the time at AtriCure called me the little engine that could, because I just kept going up the hill and, you know, chugging along, but that's sometimes what it takes.

John Shufeldt: Would you say, as far as being the CEO, entrepreneurial, that is the best quality someone can have is just resilience or persistence?

Elsa Chi Abruzzo: Absolutely. The co-founder, because this company was spun out of a, not a large company, but another company that had been founded in 2011, and I've known that, my co-founder and the CEO essentially for about 25 years now. And I loved him as a friend, and sometimes I didn't like him so much as a CEO, and now I totally get him, and I completely understand some of the things he did and why he did them and sometimes why he was stressed and all that. And one of the things that he expressed to me, when he gave me the opportunity to say, hey, do you, you know, want to stop being a VP of regulatory and clinical and whatever and want to run this company? And I go, yes, because I love the operations part of it. But, you know, you're going to be fundraising. Oh, yes, I'm, sure, how hard can that be? That is so hard. And if you don't have a thick skin, if you're not willing to get a lot of no's, if you're not willing to have people criticize you, then you shouldn't be in this, because that's what you're going to hear 90% of the time. But man, that 10% of the time where they'll tell you, hey, you did fantastic, and man, I'm going to give you this money, and that's what you live for, right? And so it's kind of like sales in a way, right? You also have to know what that other party wants, right, and how to make that a win for both parties, right? So it's been a long haul, too, maybe I'm going on two-plus years now, two and a half years. ... venture startup, right? And I can tell you, it's dog years. I feel like I've been doing this now for like 10 or 20 years.

John Shufeldt: It's funny, I literally think, that's how I feel about you. I literally think we've known each other for a decade, and I know it's probably been 18 months or two years. Why don't we talk about the product that you guys have? Because when I saw it, this to me was, now, this would be a no pun intended, as people, once they hear about it, this is a no-brainer. If someone who's taking care of these patients, this is like, oh, thank God someone's finally doing this because it needs to be done. Explain the product.

Elsa Chi Abruzzo: Yeah, so Anuncia's product, main platform, right, because we have quite a few other products in the pipeline, but our main product that we're about to launch in March is called the ReFlow Ventricular System, and this particular one is a Gen2, it's a mini. And what it does is it's a component of a Hydrocephalus shunt, and basically, for those who may not be aware of Hydrocephalus, it's when you have cerebral spinal fluid that bathes the, these cavities called ventricles in your brain and around your brain and your spinal cord. But you make more of it than you need per day, and so if you have issues where it can't be reabsorbed or there's no connections, you need to somehow get rid of it, or your intracranial pressure increases, and it can cause all sorts of issues, right? Pain, cognitive issues, and you need surgery to resolve those because it can cause death. So what they do is they drill a hole in your head, they stick a catheter, they put this flow-regulating valve, and then they go ahead and tunnel a catheter behind that from your neck to your abdomen so that excess CSF from your brain can be shunted to your abdomen and reabsorbed. And so these catheters become occluded, in fact, 50% of them in two years, 80% of them in five years, and they lead to revision surgeries, which are horrible for these patients, right? The quality of, terrible, they don't want to live away from a hospital, each of these costs $40,000. So what our device does is it lets the patients, under the direction of the neurosurgeon or their caregivers, be able to press it at home and flush it and keep their catheters open. Such a simple idea. It came out of originally of an IP that we licensed from Boston Children's, and it's evolved since then because back then it was just for, hey, if you had symptoms of an occlusion, which is like pain and nausea and whatnot, imbalance, you would press it and buy yourself time not to have emergency revision surgery. But I guess necessity is the mother of invention, some of these wonderful neurosurgeons said, hey, I have these really high-risk patients, and this happened to be kiddos, although Hydrocephalus, anybody can get it at any age for a variety of reasons, right? And why am I going to let them get occluded? And so he trained these caregivers to do this to these kiddos that had multiple revision surgeries before ReFlow. And now some of these patients are out for years, and they haven't had only one revision surgery versus like 13 for this particular cohort. So it could be very game-changing for these patients, and that's what attracted me really to want to be the CEO here, the, to be able to change the world, and to me is just, kind of one of those bucket list things that you have to do, right?

John Shufeldt: Totally. So, for those people who aren't used to ... of CSF issues or shunts, any time you have a shunt and you get a headache, the first thing that crosses your mind is, Oh my God, my shunt is occluded because the presenting symptoms are initially always headache, and they didn't get lethargy, trouble walking, incontinence, and so they get a headache, and they're in the emergency department, and we're always like, Oh God, another shunt patient, because they're very frequent. And then you've got to call neurosurgery, and they tap the shunt, and you do a CT scan on them, and you expose them to radiation that's probably not needed. And there's a percentage of them that are clogged, but there's a vast percentage of them that aren't, but they have a headache, so they were told, hey, if you have a headache go into the emergency department. So with what you're doing is like, so when I heard, I'm like, oh, thank God, because this will change the lives of all these people. If they can push the button and their headache goes away, or push the button, it doesn't go away, they can say, okay, it's probably not for my shunt because my shunt flushes, so I must just have a headache.

Elsa Chi Abruzzo: Yeah, no, and that's true. And a lot of these people don't know, a lot of the children that have Hydrocephalus that go and become young adults, and some of them have had, I know one person in the Hydrocephalus website, this young lady, 21 years old, has had over 140 surgeries.

John Shufeldt: Crazy.

Elsa Chi Abruzzo: That, to me, you know, to me, that's just crazy. And I sometimes tell the story, too, when we're talking to some of the clinicians and whatnot, one of my friends, the marketing consultant that I used to know back at Cordis and Cordis neurovascular, and this is to show you how many people actually have Hydrocephalus, and you probably know somebody who has that, and you're not aware, right, or a friend of a friend. But this particular patient, his name is Jimmy, was 14 years old, had had 12 revision surgeries by then, had such cognitive impairment that he was having a birthday party with magicians and seven-year-olds because that was his cognitive age, and he didn't want to go back to the hospital because he was in and out all the time, and he didn't tell his mom he was having symptoms, and he passed that night in his sleep because he didn't want to go back to the hospital. I mean, that still gives me goosebumps, and it just, and had he had the ReFlow, it wouldn't have mattered because his mom would have been flushing him no matter what, in the morning and at night. Now, when our data are nascent, we have great data, but it's limited data, and so we do want to run clinical trials to really cement this potentially as a standard of care that you do prophylactic flushing, right? And the other piece of it is a lot of folks don't know that you can get this from stroke, from, in kids, intraventricular hemorrhages, from being ..., yeah, tumors, from traumatic brain injuries, and actually some of these patients probably need this more because they have blood and proteins in their cerebral spinal fluid that would clog up the catheters even more than just the tissue that's floating in the CSF. So it's, to me, it's such a privilege, honestly, to be able to do this. My husband is a doc, he sometimes, you know, has these like cases that he's working on, and it just seems so, so daunting what you guys do, to be honest, but especially if you deal with children and the elderly because they're just such vulnerable populations. But I kind of feel great that I'm able to do my part too, to help you guys treat these patients. It's really very meaningful.

John Shufeldt: Well, the cool thing is, what you're doing is, we all treat patients one at a time, so to speak, the nice thing about a lot of entrepreneurial efforts is you're really changing the lives of a population. I think I probably told you this, there's a Medvale case I was involved in Kansas, and it was a young girl, history of seizure disorder, with a shunt, went to four emergency departments in these rural towns, and basically, on the second to last one, they did a CAT scan on her, and it was red late, and they said she had Hydrocephalus or shunt was clogged, and she ultimately passed away. And I remember thinking as I was reading this, I'm like, oh my God, if this kid would have had a ReFlow shunt in, wouldn't she still be alive? And you change one of those lives, game-changing.

Elsa Chi Abruzzo: Absolutely, and I wanted to bring a little bit of awareness, John, to this growing patient population that people maybe don't realize exists, called Abnormal Pressure Hydrocephalus that affects the elderly. Typically, these patients are underdiagnosed now because their symptoms mimic that of Alzheimer's, dementia, Parkinson's, because they have issues, imbalance.

John Shufeldt: They have incontinence, they're sleepy, their cognitive impairments, yeah, you bet.

Elsa Chi Abruzzo: Yeah, and they're older, and so they basically get misdiagnosed for that. But in these patients, if you put a shunt in, and I've known, actually, people that I've worked with that have had parents that have been shunted, their symptoms resolve pretty reasonably within six months in some cases. And there's a large trial, one of our centers that we were getting ReFlown to, but there's a large trial that is called PENS, P E N S, and there's multiple, the multicenter study, but it's gotten NIH funding to look at that, right, to look at these patients and to shunt them, and that could be, there's 20 million of these patients worldwide.

John Shufeldt: This is, really? Yeah, no idea.

Elsa Chi Abruzzo: Yeah, they say that there's about 700 to 1 million of these patients in the US right now. And what happens is the way you would diagnose this is to image the brain, if their ventricles are enlarged, and they don't have the other signs like atrophy of the cortex, and it's most likely PH.

John Shufeldt: Yeah, yeah, it's happened, they've got abnormal pressure, and then almost by definition, they have it. So yeah, where I work is, we see a lot of these patients, and it's, and they're often very subtle, like you said. So changing them for the rare ones that can have, that aren't Parkinson's and aren't Alzheimer's, you're like, Oh my God, this person can actually be treated, it's pretty refreshing to think that you can fix that. Let's change subjects a little bit. Just talk about your kind of entrepreneurial roots. What advice do you have for folks who are kind of starting their entrepreneurial journey? I had a physician yesterday who was a pediatric intensivist, and he's like, Hey, I want to do something more, and I'm not quite sure how to dip my toe in the water to this to get involved. What advice do you have for them?

Elsa Chi Abruzzo: Yeah, that's really interesting because I actually gave a like a little lecture to the W.P. Carey Business Executive MBA class here at Arizona State University last fall, and there were a lot of those. There were actually physicians getting their MBAs, and engineers, you know, getting their MBAs because they do have that entrepreneurial spirit, right? And so I think, first of all, they need to, if it's something that's patentable, they need to find a good attorney, right? But, you know, there's a lot of resources, not just here in Phoenix and Scottsdale, but just everywhere that you can tap into, right? There are accelerators and incubators and the such, and they do help these entrepreneurs with, you know, finding the attorney, finding the regulatory experts, the manufacturing, those kind of things. And there are a lot of those resources, right, if you look for them in just about every area. One of the first things that, you know, that I did when I was starting this, because we were a company in Massachusetts and we brought it down to Scottsdale, was I was one of the Total Capital Network Female Founders. And they helped you pitch, and they helped you set up your business plan, and they helped you find your IP and how to set up your board and those kind of things because there's so many pieces of it, right? The other thing is, depending on your industry, I'm sure there's association groups, and they can put you in contact with folks and talking to other entrepreneurs, I think is really important, because there's so many aspects of it, and it can be really daunting, but you sort of almost need to just start, right? Because if you keep thinking, I need this, I need that, and whatever, it just, it's never going to really materialize. And you almost need to kind of just start and kind of jump into that fire and get it going, and then things will come along, right? It's kind of the way. But I think if you have that spirit, don't be afraid to meet somebody, get a mentor, a great mentor, somebody that you admire. I've been so fortunate to have them. So I think that's some of the advice I can give. I don't know. How did you jump into it?

John Shufeldt: Eyes Wide Shut. It was sort of the same way. It's like, I've got this idea, I don't know what I'm doing, I'm going to go for it, and just dove in. And I think a lot of physicians, and probably a lot of engineers and a lot of folks that do this are so used to having all their ducks in a row, and everything fleshed out, and everything just lined up perfectly that, like you said, it's never going to happen. And if you think it's, if you think you're there, it's probably even worse because you won't be there. And so I think that's good advice as far as just taking that first step. And it's going to be like, you have four boys, and it's the hardest thing you've done. It's going to be painful as hell sometimes, but oh so worth it. What do you say to people who say, I want to do this, but I don't really have the next, the new thing, I don't have the next great idea?

Elsa Chi Abruzzo: It's very interesting. So I was working with a banker one time that, and she gave me this slide that talks about, it talks about these completely disruptive innovations, right, versus incrementally disruptive innovations, like the next best of a thing that already exists versus a new complete thing.

John Shufeldt: The 0 to 1, this is Peter Thiel, 0 to 1 versus 1 to N.

Elsa Chi Abruzzo: Yeah, and those things, they improve lives, and they can be very profitable, and they can be very attractive to investors and the such, it just depends what it is. I wouldn't give up, and then from those things, right, spur other things. So our initial product, the ReFlow made something that was already there, worked, right, and in itself, even though it's part of a standard of care makes, is very disruptive, right? Because it can change these patients' lives. And the same thing, but now we have all these other products that we're working on that are truly, maybe very disruptive, right, and maybe very brand new, but you start off, right, somewhere, right? And a lot of these, especially the doctors and the engineers, it, I think that people may think that I've heard the expression, if you have a hammer, everything's a nail, right?

John Shufeldt: I say it all the time.

Elsa Chi Abruzzo: Yeah, right? So but the, I think that the difference here is that a lot of the docs, a lot of these engineers, a lot of these new entrepreneurs are really trying to solve a problem that exists rather than coming up with a solution and then trying to figure out what problems it can resolve, and that's the difference. Even if you have something that is incrementally disruptive, as long as it's something that solves a problem for you, I think you can make it work because then you believe in it, and other people probably need it too.

John Shufeldt: Totally. Yeah, it's funny, we just had a discussion about an hour ago about. There's a lot of folks out there who have great solutions for problems that don't exist, so they're a solution in search of a problem, those are always tough. You know, sometimes you land upon the aha moment of, Oh my God, this really does fit this mold, maybe we have to tweak it a little bit. But the flip side of that is what a lot of physicians have, and is, I see this problem, someone has to think through this. So the shunt you guys are working on, why don't you explain to me, literally no-brainer, I was like, why hasn't someone thought of this before? This is so obvious and so easy, and I know none of it's obvious or easy, but it was like just when you hear about it, you're like, Oh God, of course, this is a great idea. Why didn't somebody think of this before?

Elsa Chi Abruzzo: Yeah, well, I can't take credit for the invention, obviously. I mean, it came from Boston Children's, and it was neurosurgeons who ... these issues, right? And that's where some of the best ideas come from. But it's not just in medicine, right? It's in everything, whether it's the next best gadget. Sometimes I go on a, I get these emails from Grommet, right, and they have all these entrepreneurs and they kind of, you know, let you go to their own websites and stuff, but they kind of highlight these products, and there's some really innovative people out there, really genius. And it was like, wow, why didn't I think of that? And yeah, right? So.

John Shufeldt: Yeah, some total aha moments where you're like, Oh my God, this is so obvious. And I'll introduce you to somebody tonight who has one of those products that fits very in line with what you're doing, so I'm really excited to get you two together.

Elsa Chi Abruzzo: Oh, that's fantastic.

John Shufeldt: But the same sort of thing, it was, she described this, what she was doing, and it was like, Oh my God, this is such a no-brainer. And it has to do with neurosurgery, but her and her neurosurgical partner invented this thing, and it's literally genius. And again, it fits very well with what you're doing. But it is amazing the ingenuity out there and what the solutions they come up with for problems that have been around for a long time and no one's thought to solve them or no one's been successful, so hats off to you.

Elsa Chi Abruzzo: Thank you.

John Shufeldt: How hard has it been to fundraise?

Elsa Chi Abruzzo: I don't know if you've noticed, but the economy hasn't been great.

John Shufeldt: So I've noticed.

Elsa Chi Abruzzo: So, but so I think it's even more difficult. I've been very fortunate because I have a great board and great mentors, and they know a lot of folks and initial investors that really believe in what we're doing and need to have that kind of foundation really to grow, but yeah, it's been a little difficult. It's been now, and it also depends how much you're raising, right? So it's interesting because last year or the last 18 months to two years, it's been a biotech, software, medtech, those were the things that they were trying to fund, not medical devices, not your bread and butter lifesaving treatments, but that implants and things like that. And fittingly enough, I think the tide has turned a little bit. It's really gone back to, the IPO, and SPAC markets are kind of a little wonky right now, and so these big biotechs are having trouble, or startup biotechs having trouble getting funded. And there's so much competition with a lot of the fintech, the softwares that do scheduling or ERP or whatnot, because there's, and so people are going back to things that the IP is stronger that you have to have manufacturing prowess to get it through, and so I think it's there's a resurgence of that, the stuff that you had to work a little harder, maybe, and it wasn't a moonshot 20x right away kind of a deal. But I think, and eventually, I think it'll stabilize, and I think that you'll get all of it getting funded as the economy picks up. But it's been difficult, it's been difficult fundraising, here especially, because I think that in Phoenix and in Arizona, there's yet not that kind of critical mass of venture capital and private equity that there are maybe in other states. And I hear that from AZ Bio, and I hear that from other places. And thank God for VCs like yours, Accelerant, and, coming in here and understanding that sometimes you need local support to also get that international, that national and international support from other VCs and health systems and whatnot. So, it's been a little daunting because of that as well. I am hopeful that also there will be additional funding for women founders and underserved groups, hispanic, I'm Cuban, actually, and it could be a little tougher. I think mostly perspective and having the right mentors. Now, I've been fortunate that I have those mentors and I've had those resources, but so many women, people of color, don't have those resources, and I think we need to do a much better job here, especially, but just in general.

John Shufeldt: Yeah, it's funny, I've noticed. I mean, I started Accelerant now about a year ago, and there has been almost a sea change in the Phoenix market for angels and VCs coming into it. I think we are the next hub. It's been, obviously Silicon Valley, New York, Chicago, Austin, Salt Lake, I think Phoenix is next. And so, I know there's a there's definitely a buzz out there about what's coming into the valley.

Elsa Chi Abruzzo: Yeah, our life sciences community is certainly not as large yet as, of course, Boston and Bay Area, and the Twin Cities, and even Texas now has a lot of biotechs popping up there and all that, but we do have these other great industries, right, the semiconductor industry and software and things like that. And I think that, hey, even if we attract them because of that, and then we can expand these other kinds of more nascent industries that are struggling a little bit, but, you know, if they hit critical mass, then we'll definitely make this area.

John Shufeldt: I mean, the nice part is, too, we have the great Mayo Clinic, ASU, U...A, GCU, and NIU, great ... and institutions to help really catalyze us. So I'm bullish on the Valley for really becoming a health tech hub, so.

Elsa Chi Abruzzo: ... this morning because our company is part of the Skysong Innovation Center, that is, and they have many innovation centers as part of the Arizona State University, but this one is in Scottsdale, right? So the city of Scottsdale was there, and there were, they brought some of the local companies that are in Skysong to talk to this panel of real estate scout for new companies and events and things like that. And so I was there, and one of my fellow CEOs who, great story, came from India and went to ASU, got his business degree, Nikhil Vivek Karpathy, was there, and somebody completely different that he worked for, a company that has about 4000 people, about 50 here, and they do civil engineering and stuff like that. And it's really interesting how we are definitely growing in so many different areas, right? And how this particular, there's so many untapped resources. So just for those entrepreneurs that want to come to Phoenix, and hey, I'm always recruiting, right? Because I think that as you build critical mass, you're going to bring in those VCs, you're going to bring in all that capital, you're going to bring in more diversity, everything's going to happen, right? As you reach that point, is that, when I was moving the company here from Lowell, Massachusetts, Greater Phoenix Economic Council, city of Scottsdale, ASU, AZ Bio, I mean, they were taking me places and showing me where I could house that, where were the contract manufacturers, where I could get interns and hire new people. It was just amazing. And so for those entrepreneurs, tap into some of those resources that the government level, at the city and local level, because they want you to start a business.

John Shufeldt: Oh yeah, yeah, and it's funny, I never did that. I would have been smart if I had. But yeah, that was the, that's the first thing you did that was incredibly prescient of you because it also just puts you right in the ecosystem, really, day one. I mean, I think I've heard, I heard of you right when you landed almost, so it worked out perfectly well.

Elsa Chi Abruzzo: And the other part is what you're doing, right? Give back, right? If you're going to stay relevant and you need to build your community, and you need to stay, so, for example, I'm, I tell somebody that I'm sort of in my Yes Phase, right? A lot of people think they're very busy and they don't want to go, and like one of those folks, for example, one of your partners, Chris Hughes, I see him at every event. I know that man. I don't know how he has time to participate in all the things he does, but he just gives back to all these students and younger entrepreneurs and whatnot. And I'm in that phase where I feel like I've been so fortunate to have all these great mentors and people that looked out for me and were there along the way that, I think you need to do the same.

John Shufeldt: Yeah, pay for it.

Elsa Chi Abruzzo: Yeah, and if they ask me, come talk here, come do this, come do, I just can't say no right now because it's just so important what we're doing. So I commend you, I commend your partners because, yeah.

John Shufeldt: Yeah, we got a great team. Well, so where can people find out more about you and Anuncia?

Elsa Chi Abruzzo: Yeah, so you can go to AnunciaMedical.com. You can look me up specifically on LinkedIn if you want. I will be more than happy to talk to anybody and give them advice, my two cents, and then just leave you with the fact that, hey, always keep learning, right? I love your little signature that Stay Humble line. Always stay humble. Always keep learning. You never know who you're going to meet from whatever walk of life and whatever situation that's going to change your life and it's going to impress the heck out of you, and I'm just a true believer in that.

John Shufeldt: Totally, everybody can teach you something. So, yeah, I completely agree. Well, Elsa, this has been amazing. Thank you so much. I'll see you in a few hours. I'm excited about that. Y'all, thanks for listening. This has been another really amazing episode of Entrepreneur Rx, and we will have all of this in the show notes as well as ways to contact Elsa. So thanks for listening, have a wonderful day, and also, I'll see you soon.

Elsa Chi Abruzzo: Thank you. Bye bye.

John Shufeldt: Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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Key Take-Aways:

  • Investments in the MedTech space are trending toward products with strong IP with manufacturing prowess.
  • Phoenix, Arizona, is slowly becoming a venture capital and private equity hub.
  • Entrepreneurs need to have thick skin, as they will face rejection and criticism repeatedly.
  • There are many local accelerators and incubators that will connect entrepreneurs with mentorship or other resources they might need.
  • Disruptive innovations can also happen incrementally.
  • It’s completely okay to come up with an idea and then figure out what problems it can resolve, and as long as it solves a problem, it can work out.


  • Connect with and follow Elsa Chi Abruzzo on LinkedIn.
  • Follow Anuncia Medical on LinkedIn.
  • Visit the Anuncia Medical Website!


  • To find out how to start a business and help secure your future, go to JohnShufeldtMD.com