I live in the world of early-stage Orthopedic companies. I worked inside Orthopedic startups and today I provide recruiting for many of the most promising startups.
I respect startup leaders. They put it all on the line. Building a startup is hard work and the odds are against them. Statistically, most Ortho startups do not reach a successful outcome - an exit, an IPO or a profitable longterm business.
I have seen 7 specific reasons why startups burn out.
#1 Lack of Execution- The team fails to execute the business within the time frame and within the cash on hand. The team must knock off key milestones at a fast-enough rate to drive valuation.
#2 Faulty Regulatory assumptions - The regulatory pathway assumptions at the start of the company take a turn for the worse. Regulatory = time + money, and you need a lot of both to get through it. Usually this is a class II that turns into a class III or turns into the need for years of clinical data. The average cash needed to complete a class III PM/IDE is about $100M and 10 years.
#3 Wrong Management at the wrong stage - As a startup moves from concept, to working prototypes, to verification testing, to regulatory fili...
