Headwinds

I have watched many orthopedic companies create self-imposed difficulties for their business... or headwinds. They obviously don't create headwinds on purpose.
It got me thinking.

How do Orthopedic device companies accidentally create these headwinds?
Well, they just do these things.

Create an implant system with lots of permanent instrument trays that have to be cared for and shipped around the world (eg: all major total joint manufacturers).
Raise a lot of money and hire too many people before the business can support the payroll (eg: Conformis)
Loose control of their cash flow with st...