Neurotechnology Perspectives: Casey Grage and Hubly Surgical
As part of our entrepreneur series, the Brain Startup Blog team interviewed Casey Grage, the cofounder of Hubly.
Casey Grage, CEO of Hubly Inc. www.hublysurgical.com
A bit about Hubly: Hubly is saving lives through modernizing the antiquated $150B bedside surgery market. We’re beginning with the most common neurosurgery, the bedside ventriculostomy, a procedure that involves creating a hole within a cerebral ventricle for drainage. Improper failed ventriculostomy can lead to stroke, hemorrhage, brain infection, and even death. Unfortunately, ventriculostomies fail up to 50% of the time. This is, in part, because the procedure relies on a free-hand, hand-crank drill without any features for guidance or stability. Hubly aims to modernize bedside neurosurgery through the introduction of a novel IP protected drilling system that includes plunge protection and guidance, reducing human suffering and financial burden in this procedure’s $8B market.
Biography / Founding Story:
Casey published a full-length novel at the age of 10 before spearheading a successful decade-long campaign to install solar panels in her school district.
While building Hubly as a Northwestern University student, she completed two majors as well as hundreds of hours of health and health tech volunteer work. She graduated in just three years, turning down a Columbia graduate degree program and 6-figure salary to pursue Hubly full time.
She has acquired years of experience in neuroscience research, software development, public speaking, and bioengineering, and has held roles at NASA, JP Morgan, and several research labs. Her vigor and breadth of skill reflect a determination and passion for neurosurgical innovation. Casey is a neuroengineer — soon, she’ll be the one who revolutionized bedside neurosurgery.
See the interview below!
1. How did your journey as an entrepreneur begin?
Since the age of maybe 9 or 10, my life plan had been to get my PhD in neuroscience and start some kind of neurotechnology startup. I thought that to found a company, what I held as the pinnacle of success and innovation, I needed the maximum level of education and experience. This career trajectory has remained nearly unchanged — I’ve just mixed up the order a bit.
I was an undergraduate student at Northwestern University, studying neuroscience and global health, when I overheard two students talking about a class called NUvention Medical. I visited the website and saw it was a course cross-listed across the medical, law, business, and engineering schools. It is structured in the Stanford Biodesign model in which students form groups representing those four disciplines. Then, they identify a clinical need, validate the market, and produce a solution. Some NUvention teams had even continued beyond the course to create companies. The class was for graduate students only and based on application. What the hell. I applied.
That summer, I received a call from the founder of the Farley Center for Entrepreneurship and Innovation. “We’ve never taken an undergrad before,” he said. “But we found your application intriguing. We want to give you a shot.”
My team converged on our passions for neurology, and that’s the very team I run this company with today. When we began, I never imagined I could found a real company out of it, much less become the CEO. It sounds cheesy, but in all honesty, one thing just led to another and a school project became what will be my life’s passion for the next decade.
Our team was awesome and worked really well together. Our discovered clinical need was genuinely dire. Our solution was immensely clever. Above all, I realized I didn’t need a PhD to create a company. I had the skills and resources and drive to do it now. I love research and still plan to pursue a PhD eventually. But right now, people are dying every day our product is not on the market. There’s not exactly time to waste!
2. Why were you specifically interested in neuroscience?
All the neuroscientists and neurologists I know get into it through one or more of three avenues: science and technology, philosophy, or humanitarianism. When I was a child, I originally loved neuroscience for its scientific implications. Later, learning about philosophical concepts such as the mind-body problem only reinforced my interest in the subject. Equally important as my pure fascination with the field is that neurotechnology yields results which tangibly benefit people in my lifetime. This prerequisite is something I have increasingly realized I need in my career to feel fulfilled and impassioned about my work.
3. What problem did you identify that prompted you to start your company?
My co-founder Amit is Chief Neurosurgery Resident at Northwestern Hospital. When we were identifying clinical needs in NUvention Medical, Amit suggested we do something about the ventriculostomy.
We quickly learned the ventriculostomy is the most common neurosurgical procedure, used to treat traumatic brain injury, intracranial hemorrhage, hydrocephalus, and cancers of the nervous system. It fails up to 50% of the time it is performed with failure meaning stroke, hemorrhage, brain infection, or death. This is because the procedure today relies on a free-hand, hand-crank drill without any features for guidance or stability. As the most common neurosurgery, the ventriculostomy is often performed by junior residents, general surgeons, and trauma clinics. The absolute dearth of safety mechanisms and frequency of the procedure in non-expert settings lead to this obscenely high failure rate.
Moreover, we learned the ventriculostomy is not unique. Like many surgical procedures, it is performed at the bedside, or outside of an operating room. The archaism of its free-hand, hand-crank drill is what the field of bedside surgery looks like. Hundreds of thousands of people die each year due to this antiquity — not to mention, bedside surgery presents about a $150B market annually.
We started Hubly because bedside surgery has to be modernized, and we’re the perfect team to do it. Our first product is a drilling system to replace the ventriculostomy’s hand-crank drill. Our patent-pending technology includes plunge protection, guidance, and features for ease of use to reduce that insane 50% failure rate and save lives and improve the quality of life for millions over just the course of a few years.
4. In 10 years, what do you think the neurotech space will look like?
Startups are the future of neurotechnology! I know you’re thinking ‘of course the neurotechnology entrepreneur has to say that,’ but this belief is why I became an neurotech founder. I was listening to the UCSF Health Technology podcast episode in which the creator of Stanford Biodesign, Josh Makower, discusses how innovation dies once startups undergo an acquisition. With so much overhead and extensive shareholders, big companies often lose patient focus and get too comfortable in their ways. Smaller companies are better able to adapt and take the necessary risks to innovate tech. Startups also allow for a repositioning of the addressed clinical need toward the actual needs of the market. We founded Hubly because large companies today ignore the bedside surgery market. Integra is making money off the hand-crank drill, so why change? The reason is hundreds of thousands of people needlessly die each year as a result of this antiquity. And if that’s not enough for you, there’s real capital to be gained as soon as someone takes the chance.
To create a future of neurotechnology startups, we need: 1) more pre-accelerator resources for medtech entrepreneurship, and 2) a shift in how VCs address medtech ventures.
On the first action item: large companies skew toward one privileged demographic who disproportionately align focus toward the needs of that same demographic. I know quite personally how Silicon Valley infamously brews radical prejudice, but startups, more so than large companies, give neglected communities a chance to enact change in the medical innovation space. We could not have gotten to where we are today, or even have created Hubly, without the help of so many resources available to us: NUvention Medical, Northwestern’s incubator The Garage, and Chicago’s Startup Boost pre-accelerator, just to name a few. The future of neurotechnology will rely on there being more resources for medical startup creation, and specifically more resources in rural areas and for underserved populations, so they can bring their needs to the forefront.
On the second need: venture capital firms today are focused on finding the next unicorn — the next billion dollar company. They’re willing to fund 30 companies with multi-billion dollar serviceable available markets in hopes just one will succeed. Neurotechnology companies often aren’t like that. The markets are smaller. VCs have to change their power-ball strategy to create space for these specialized medical technology ventures (Greater Colorado VC has some great articles about alternatives to power-ball). Medtech startups still make hundreds of millions of dollars, and they radically transform people’s lives in ways TikTok never will.
