Dr. Adam Power, co-founder and Chief Medical Officer at Front Line Medical Technologies, shares his fascinating journey from a background in vascular surgery to developing COBRA-OS, a groundbreaking device for hemorrhage control. He discusses the challenges and milestones in bringing this life-saving technology to market, the impact of the device in trauma and emergency care, and innovative future applications, including its unexpected use in non-traumatic cardiac arrest.

Guest links: https://frontlinemedtech.com/

Charity supported: Canadian Cancer Society

Interested in being a guest on the show or have feedback to share? Email us at [email protected].

PRODUCTION CREDITS
Host & Editor: Lindsey Dinneen
Producer: Velentium Medical

EPISODE TRANSCRIPT
Episode 064 - Dr. Adam Power

[00:00:00] Lindsey Dinneen: Hi, I'm Lindsey and I'm talking with MedTech industry leaders on how they change lives for a better world.

[00:00:09] Diane Bouis: The inventions and technologies are fascinating and so are the people who work with them.

[00:00:15] Frank Jaskulke: There was a period of time where I realized, fundamentally, my job was to go hang out with really smart people that are saving lives and then do work that would help them save more lives.

[00:00:28] Diane Bouis: I got into the business to save lives and it is incredibly motivating to work with people who are in that same business, saving or improving lives.

[00:00:38] Duane Mancini: What better industry than where I get to wake up every day and just save people's lives.

[00:00:42] Lindsey Dinneen: These are extraordinary people doing extraordinary work, and this is The Leading Difference.

Hello, and welcome back to another episode of The Leading Difference podcast. I'm your host, Lindsey, and today I'm excited to introduce you to my guest, Dr. Adam Power. Dr. Power is a leader in innovative medical devices for trauma and emergency care that is committed to lowering the barriers and bleeding control and resuscitation. Dr. Power was instrumental in the development of COBRA-OS, drawing on his unique clinical viewpoint and expertise to ensure utmost patient safety and assist with the company's global expansion. In addition to his current role as co-founder and Chief Medical Officer at Front Line Medical Technologies Incorporated, Dr. Adam Power is a vascular surgeon in the division of vascular surgery at Western University, which he joined in the fall of 2012, and he is involved in all aspects of academics and clinical care.

Also, Front Line was just named the 2025 Medical Device Technology Company of the Year, so I definitely wanted to highlight that too.

All right. Well, thank you so much for being here today, Adam. I'm so delighted to speak with you.

[00:01:55] Dr. Adam Power: Yes, it's a pleasure to be here. Thank you.

[00:01:57] Lindsey Dinneen: Of course. Well, I'd love if you would start by sharing a little bit about yourself, your background, and what led you to what you're doing today.

[00:02:05] Dr. Adam Power: Sure, I'd love to. So I'm a Canadian. I grew up on the east coast of Canada and was always interested in science and math and those types of things. I think, importantly, I grew up with an identical twin brother as well. So we really didn't know what we wanted to do with our lives, and ultimately we're good in science and math and ended up in medicine. And then both of us, when we got into medicine, we weren't sure exactly what we wanted to do in medicine, and ultimately both of us became surgeons. He became a urology surgeon, and I became a vascular surgeon, where we joke that we're both plumbers. I deal with the red stuff and he's the yellow stuff.

But I did my initial medical school out on the east coast of Canada and then I did my general surgery training, which also involved trauma training, and then did a Master's of Bioscience Enterprise, which was basically biotech business from the University of Cambridge in the UK. When I finished my general surgery training, I continued on and did vascular surgery training at Mayo Clinic down in the US, and since that time after graduating from there, I've been at Western University in London, Ontario, Canada, for the past 13 years practicing as a vascular surgeon and an academic vascular surgeon.

But when I was here at Western, I was always interested in innovation. I filed my first patent as a resident way back when, and have filed many over the years. But ultimately, if I was ever gonna see anything that came outta my head and was actually used in a patient or I could actually use in a patient, I figured I'd have to do it. I knew that I couldn't do it by myself. And so, I was very fortunate to meet my co-founder Dr. Asha Parekh. She's a PhD, biomedical engineer, extremely smart jack of all trades, and we teamed up now about eight years ago.

We met here at Western, teamed up and really took an idea right out of our heads and patented it and raised money for it, prototyped it, brought it all through the regulatory steps to approvals, built a quality system and ultimately got it out onto the market in Canada, US, Europe, now Australia, and more to come. So the commercialization piece is what we've been focusing on over the past three years. And it's been really fun, but very exhausting but very rewarding as well. I think I'll stop there because I've been blathering on, but...

[00:04:39] Lindsey Dinneen: No, it's fantastic. I really appreciate it. Plus, it's really fun to hear about your trajectory and so, okay, so you've teased us a little bit about this company of yours and this innovation of yours. Can you now share a little bit more about that and the development of it over time?

[00:04:55] Dr. Adam Power: Yes, of course. Well, I mean, thing that we recognized early on is, and I'll just explain how I normally explain it, is if you have bleeding, it's a hemorrhage control device. And so if you have bleeding in your extremities, then you can often either put pressure on it or you can put a tourniquet on it. The problem when you have internal bleeding in the torso is that you can't actually put direct pressure on it, and there's no tourniquet that necessarily works for intraabdominal, intrathoracic bleeding.

And when people bleed to death before coming to hospital, I mean, they're bleeding in these areas. You can empty almost your entire blood volume into your chest or into your abdomen. And this does account for a significant number of fatalities in all environments, basically in the trauma environment. That's military, that's pre-hospital, that's any time that that people are bleeding from internal organs.

And so, because this is such a problem, the old fashioned way to fix it is to open up someone's chest and put a clamp on the aorta. So what does that do? Is it basically above the clamp, keeps blood flowing. The remaining blood in the body keeps blood flowing to the brain and the heart, keep you alive. And then below the clamp, it stops sort of the hemorrhaging from the spleen or the liver or whatever. So there's two things going on. One above the clamp and two below the clamp.

But opening up somebody's chest in, you know, side of the road or in the emergency department really is impossible. You need highly skilled people like vascular surgeons like myself to be able to do this. And even if we were at the side of the road, we don't have the resources available to keep a patient alive.

So there is this idea that we could do this minimally invasively, sort of accomplish this through minimally invasive means. And this, the idea of doing REBOA, which is an acronym-- Resuscitative Endovascular Balloon Occlusion of the Aorta-- came into being. This was probably 15, 20 years ago now. It wasn't necessarily a new idea. It had been done since the Korean War. There was somebody actually put a balloon up into someone's aorta to stop bleeding, but it came back again and was starting to be used a little bit more because.

And so really the idea is to, through the femoral artery in your groin where you can feel a pulse, you introduce initially a sheath, which is your access point, and then you place the device up through the sheath, up into the aorta and inflate a balloon in the aorta. So instead of an external clamp, it's an internal balloon clamp that keeps blood flowing above the balloon and stops the blood flowing from below the balloon.

Initially these devices were as big as my baby finger, like they were massive. And so if you put them in and you took it out, there was a big hole in the artery, had to cut down on the artery and repair the artery. But as it got more and more advanced and technology advanced, they become smaller and smaller.

So that's really where we came in. The initial devices were 12 French, about the size of my baby finger. And then it advanced to Seven French and all of a sudden Seven French-- and these are diameter, French sizes are basically diameter-- and so when it went from 12 to seven French, now we could start doing it through the skin without actually cutting down on the artery. But that Seven French size was still very large and you're putting this in the hands of people that don't do this all the time. And so, we had the idea to bring it down even further now to Four French. And so this is essentially the size of an IV.

And so you put a tiny little IV in somebody's femoral artery. And lots of different people can do that. And then you advance the device up in, inflate the balloon and you can magically occlude the aorta. In our first study that we did, the first inhuman study, we averaged about just over a minute to occlude someone's aorta, which was really fast to be able to get that amount of control that quickly. So that, that was really been the advancement is to decrease the access size, make this whole procedure simpler so that so that we can essentially save more lives.

[00:09:08] Lindsey Dinneen: Okay, so thank you so much for sharing a little bit about that. Can you tell me about the beginnings of this innovation and how you brought it to market? Because it's really wonderful to hear all the success, and I'm so excited to hear that it's spreading, you have presence all over the place now. But you know, that's not an easy pathway. And I'm curious if you could walk us through a little bit about that decision to go, "You know what? We have a solution to a known problem, we can make this happen." And then how did you actually go about doing that?

[00:09:42] Dr. Adam Power: Yeah. I think, I mean, I make it sound fairly straightforward, like a nice story, but it certainly was not that. I mean, we were very lucky I would say, that we had a lot of great advisors and mentors that we figured that we try not to fail early, fail fast. We wanted to make this one as successful as possible. So before we made any decision, we often would consult our mentors. And I'm a surgeon. I like to shoot first, ask questions later. My partner is not. And so I think we, we strike an excellent balance between not just the engineering and clinical side of things, but also from driving a business forward, getting all the information, but helping to get decisions made and moving forward.

You know, starting out, we really had to choose the right sort of fit for what we wanted to pursue. We like to say it checked all the boxes. It checked all the boxes as far as even where we are. We're in Canada, we're not in a tech triangle where there's tons of funding opportunities. We knew we would be limited from a funding perspective, so we couldn't choose something that necessarily required a hundred million dollars to start up. So, you know, we had this device that we knew that we could fundraise for it. And then once it was fundraised, it was simple enough that we could get it manufactured.

We chose to go the OEM route for the original equipment manufacturer, so we didn't have to build a manufacturing facilities ourselves. And then really from there, and building a quality system in the regulatory, we did work with a lot of consultants, that was both positive and negative experience. We had great consultants. We had not so great consultants. But really what our our goal was, is to learn the process ourselves. And so there's always manuals for things, even from the FDA perspective. They give out great documentation about what is supposed to go into an FDA application. And we dug into that.

We really tried to understand. We did not trust anyone. That's one of my rules in surgery is, "don't trust anyone, not even myself." So we really didn't trust our consultants, and we tried to double check and triple check everything so that we didn't make mistakes. And of course, we did make mistakes and had to go back to the drawing board a few times. But as much as we wanted to get this out there, we really did wanna learn the process and know the process because ultimately we're the ones that are responsible to the patients in the end, and we needed to make sure that we had a handle on each and every step of the way. We, of course, because of that, were maybe not as quick as we could have been but in other places we became more efficient because, as we learned the process, getting feedback back and doing it right the first time, it really made a difference. So.

[00:12:39] Lindsey Dinneen: Yeah, absolutely. Of course. Yeah, and I appreciate you going into a little bit more of the nitty gritty details 'cause it is so fun to hear the success stories, but of course, as you go along, there's that pathway to success. And it's helpful to understand that yeah, it's gonna be potentially a long road, sometimes windy, sometimes weird, but at the same time that it is possible. So as you look to the future with your company, what are you thinking of in terms of the future? Are you going to continue down this pathway and continue with iterations of this device? Are you thinking of new devices to introduce as well? Or, what are your thoughts for the future?

[00:13:18] Dr. Adam Power: Yeah. And I have to be very careful what I say here, obviously. I can share generically what our thoughts are. We love this. Ultimately there was no better feeling than to use-- I mean, I've used my device to save a patient. And, you know, I would say that Asha, who's my co-founder, she cares. I'm a physician, but she cares about the patients just as much as I do, as does everyone in our company, which is really quite rewarding.

But the future, what does the future hold? We really want this to get to everywhere. Yes, we're in lots of different countries ,have commercialized really all around the globe, but we really wanna go deeper into a lot of these geographies and really help as many people as possible. We realize that we can't do it on our own and are gonna need help. And so that's, we're in a growth phase right now of our company and we're looking for strategic collaboration. We're looking for those opportunities to deepen our ties and in all the different geographies.

That being said, we are inventors and of course we have an idea every day about what we could improve on. But as far as the pipeline goes for our company, we are focusing on some very specific up and coming applications that we hope to have in the next couple of years. And I also wanna say that, I talked about trauma and bleeding, but the more exciting side of aortic occlusion has really been the applications. And you'd think, okay, it makes sense for trauma to be able to stop blood flow and stop bleeding.

But some of our recent successes have been through postpartum hemorrhage. And there is this really, terrible condition called placenta accreta, where the placenta grows into the uterus and when you deliver the baby either by C-section or by delivery, and then the placenta attempts to be delivered, it tears, and you can have torrential bleeding. And, and so our device is being used in these women who are pregnant when inflicted with this condition and helping to decrease blood transfusions, helping to save a mother's life. So that's been really amazing.

And then next on the horizon is strangely there's, it's not even a bleeding application. We've done some research and there's research going on globally about using aortic, minimally invasive aortic occlusion for non-traumatic cardiac arrest. And so if, which is really, again, it's like, "Oh my gosh, does this thing do everything? It might make your supper tonight if you're not careful." So it, so what happens there is that if somebody drops dead basically in front of you, and you start CPR, if you start pushing on their chest and pushing on their heart, you're pushing blood to the whole body. And the way you get someone back to life is if you can get the heart muscle oxygenated again.

So if you put an aortic occlusion balloon up close to the heart, every time you push, you're directing blood right into the coronary arteries and right into the brain as well. And so what we're seeing is that there's increased return of spontaneous circulation rates when you do this with CPR. And there are different trials around the world that if this shows that there's an increase in survival or in better neurological survival, this will be the first time that we've really changed the script on cardiac arrest since advanced cardiac life support came out many years ago.

So this, again, is very exciting for a simple device to be able to make that much impact in all these different areas. So, you know, we have a lot to focus on right now, even growing into the future because some of these, like cardiac arrest, are quite early on. So we don't wanna lose sight of this great original product, but we do think all the time about different pipeline ideas that could help other patients.

[00:17:18] Lindsey Dinneen: Yeah, but, and to your point, even the amazing other use cases for this incredible device, like you said-- maybe it's gonna make us dinner next-- but the idea being that, who knows? I mean, there's so much more to discover even now, which makes me excited just to think about how many more use cases you could have for it and how many more people you could save.

So, speaking of that, are there any stories that kind of stand out to you, moments that you've had where, you know, either through your day job, so to speak, being a vascular surgeon, but also being the co-founder of this company that really sort of affirmed to you that, "You know what? I am in the right place at the right time, in the right industry." Just those moments that really stick with you.

[00:18:05] Dr. Adam Power: Yeah, I mean, it obviously all stems back to the patient and what patients are impacted. And I remember, the first time that the device was used at our hospital, one of the radiologists called me in and said, " We need to use one of these balloon occlusion devices for a patient that's been in an accident." And so I went in and I said, "I actually have the device that my partner and I created. We can use this for the patient." And so we started using it for the lady that was involved in a very serious accident, had a pelvic fracture, and she was a Jane Doe at that particular time. She was anonymous. And anyway, we noticed that she had actually had some vascular surgery done based on her angiograms, and I leaned over and I-- so she was sedated, but she was awake-- I said, "Have you had vascular surgery? Who's your vascular surgeon?" And she said, "It's Dr. Power. He's such a nice man." And so I was actually helping one of my patients. That was pretty crazy.

[00:19:04] Lindsey Dinneen: Oh.

[00:19:05] Dr. Adam Power: Also from my hospital, when I heard one of my junior residents was able to save someone's life. So, you know, junior residents are often good, but they're not trained surgeons. And so to have a simplistic device that one of my residents could actually place and help someone, that's pretty amazing too. There's also been times where like even the postpartum hemorrhage, we hear the first cases in the States of saving mother and baby. That's pretty incredible. Or that we donated some devices to the Ukraine conflict as well, and we heard that it saved some soldiers' lives as well. And there's different military groups that, that use our device and save soldiers.

So it's all back to the patient. And hearing those success stories and hearing about somebody alive because of this particular device, because of all this effort that we've put in. I mean, it's really makes it worthwhile. It sounds kind of corny, but as a surgeon, I can help one person at a time, but as somebody involved in industry and medical device industry, I don't even have to be there. You know, this device can help long after I'm gone. The tricky part of it, being the Chief Medical Officer is, I usually only have to worry about my patients. Now I have to worry about everybody worldwide and the device being used. That was a little hard to wrap my head around initially, but yeah.

[00:20:28] Lindsey Dinneen: Yeah, of course. But the ripple, the ripples, the impact that you get to have because of this device and because of your diligence getting it to market, because it isn't an easy path, and that's incredible. So thank you for doing the work that you're doing. That's not easy and it's very appreciated. This is incredible. So, yeah. So, okay. When you were growing up, let's say 8-year-old, Adam-- you know, you're having a good time doing whatever you like to do-- could you possibly have pictured yourself where you are now?

[00:21:08] Dr. Adam Power: No, I don't think so. I mean, I, I. I came from a very small, like, small upbringing and, you know, in my family I had absolutely lovely family members, but they really, apart from my aunt, they weren't overly educated. And so I really didn't know what it took to be successful in life, really. I had work ethic from my parents, that's for sure. And so that's what they bred into me. And all I knew is that I was gonna work as hard as I could, and I figured that as long as I keep working-- and I was lucky to have some brains as well-- then I figured things would fall into place.

They honestly haven't fallen into place exactly how I pictured them as I grew older and what it would look like. But I'm certainly thankful for where I am right now, and what is the next five years or 10 years gonna look like? I have no idea. And I guess I just don't even picture it. I have goals, but I also know that those goals change depending on circumstances. And you need, as I'm growing into middle age-- I think I'm beyond middle age now-- I'm thinking about midlife crisis and things like that. I get into philosophy and there's like telic and atelic things and so, it's sounds, again, it's about the path and the journey.

It's not about the ultimate goal because, having reached a lot of these successes, that good feeling lasts for maybe a day or half a day. And you think you know, I spent all these years coming with the, with our device, getting our device to market and getting FDA approval and like, oh my gosh, like, you'd think, I'd feel so great about that. And it did. It felt great, but you wake up the next day and you gotta keep going. So you have to enjoy the journey and that's really what it's the wisdom that comes with age is trying to enjoy the journey as much as possible and not focus too much beyond that.

[00:23:09] Lindsey Dinneen: Yeah. Yeah, and I think that's really good advice too, in that it is because the daily life isn't usually all the celebration and successes. I mean, that does happen and those are good moments, but because the vast majority of our life is spent on the journey component of it, and going through those peaks and valleys, it is important to find something you love and feel that you can make an impact in. So I'm so thankful that this is what you've chosen to do.

So pivoting the conversation a little bit just for fun, imagine that you're to be offered a million dollars to teach a masterclass on anything you want. Could be within your industry, but it doesn't have to be. What would you choose to teach?

[00:23:55] Dr. Adam Power: And would that mean that I was an expert in it?

[00:23:58] Lindsey Dinneen: Well, certainly if you're getting paid a million dollars, somebody has decided you aren't an expert at it. How about that?

[00:24:05] Dr. Adam Power: Okay. Well. Can I pretend like I'm an expert in it? There's something that I really love, but I'm not I'm probably not an expert in it. It would be, I would teach a masterclass in DJing. Isn't that strange? I know it's so random.

[00:24:21] Lindsey Dinneen: Oh my goodness! Tell me more!

[00:24:23] Dr. Adam Power: Well, I mean, I love music. I've, I grew up playing lots of sports and never was involved in music. And, and I've always appreciated music and art, but I was never able to do it. And, you know, growing up I did love sort of all types of music and then even electronic music and it just somehow talked to me. So I started DJing electronic music basically when I was around med school and have always loved it now, and when I was over in England, I DJ'ed on the campus radio and also DJ'd in a club.

It was really fun and it sounds pretty silly to be talking about this when I have these other things that are on the go. But honestly, being able to share space with other human beings these days, and actually having a good time and having it not be stressful and having it be only, you know, everybody's wishing others to have a good time. There's not many people that go out sort of dancing into electronic music that are thinking bad things about other people. Really they're just out for a good time. And so being able to steer that whole music and scene is pretty awesome. And I do love it. And I don't DJ as much as I used to, but I still do different events, usually Christmas parties for the operating room. I'll do the typically wedding sort of DJ, but then they always, 'cause they know me, they let me do an hour long electronic set, which is like hardcore electronic. But then I go back to the regular stuff. But I would want to teach a masterclass in DJing.

[00:25:56] Lindsey Dinneen: That is awesome. How exciting. Oh my gosh, I love that. And I think you're right. Music brings us together and it's a wonderful way to, to share a little bit of joy.

[00:26:07] Dr. Adam Power: Yeah.

[00:26:08] Lindsey Dinneen: Yeah. Okay. And then how do you wish to be remembered after you leave this world?

[00:26:15] Dr. Adam Power: I, so number one is I don't, again, with my midlife crisis, I've actually been trying to eliminate my ego as much as possible. And so when people talk about legacy, it actually gives me the hives these days to be quite honest, because I don't like that because I think you're focused a lot on yourself. In my opinion, a lot of legacy is all about you. The way that I would wanna be remembered, though, is truly that I was kind and compassionate to everyone that I met, and that I stood for something, and that I left the world a better place.

[00:26:57] Lindsey Dinneen: Yeah, those are wonderful things to want to be remembered for, absolutely. And then final question, what is one thing that makes you smile every time you see or think about it?

[00:27:09] Dr. Adam Power: My kids. My son Kai and my daughter Saoirse. They are the light of my life. And I, you would think that with how busy I am ,you know, those things would deprioritize, but they truly are the one thing in my life that makes me smile when I get up in the morning.

[00:27:30] Lindsey Dinneen: Oh, that's wonderful. Well, that is absolutely incredible. I loved getting to meet you and speak with you a little bit today. Thank you so much for sharing about your journey. Thank you for sharing about your incredible device and your bits of wisdom along the way. The idea of we've gotta enjoy the experience, the path, the journey. And I just really appreciate you spending some time with us. So thank you for everything you're doing to change lives for a better world.

[00:27:59] Dr. Adam Power: Oh, well, thank you for giving me the opportunity to speak with you. It was absolutely lovely chatting with you today.

[00:28:05] Lindsey Dinneen: Wonderful. Well, thank you again so much. Thank you also to listeners who are tuning in, and if you're as inspired as I am, I would love it if you would share this episode with a colleague or two and we'll catch you next time.

[00:28:20] Ben Trombold: The Leading Difference is brought to you by Velentium. Velentium is a full-service CDMO with 100% in-house capability to design, develop, and manufacture medical devices from class two wearables to class three active implantable medical devices. Velentium specializes in active implantables, leads, programmers, and accessories across a wide range of indications, such as neuromodulation, deep brain stimulation, cardiac management, and diabetes management. Velentium's core competencies include electrical, firmware, and mechanical design, mobile apps, embedded cybersecurity, human factors and usability, automated test systems, systems engineering, and contract manufacturing. Velentium works with clients worldwide, from startups seeking funding to established Fortune 100 companies. Visit velentium.com to explore your next step in medical device development.