Envoy Esteem Activation

My post of January 4 discussed the anticipation of activation of the Envoy Esteem implant.  It seems that hearing with one ear has become progressively worse over the past seven plus weeks so activation cannot come too soon.

I am familiar with the facility near the Tampa Airport where this will occur and head out at 8 AM for the 9:30 AM appointment with Allison, the Envoy Esteem technician.  An easy drive over the Sunshine Skyway Bridge and a beautiful morning.  It always feels better in Florida when there is cold and snow up north and they had a good dusting over the weekend.

We arrived early and Allison was set up and ready to go.

I have been on an Envoy Esteem Patient Facebook group for some time and the experiences of the other patient activations prepared me for the process and the sounds I would hear.  The peer support has been both enlightening and uplifting.

Would it turn on?  Would it have feedback?  Zap, beep and bingo – sound!  As expected, my voice was strange at first as well as a number of sounds I had not heard for some time.  Some audiogram tests were done to set the sound below optimum level as the levels are to be increased by increment over the next few weeks as I learn to hear again.  No feedback issues occurred.  Everything worked well.

We did some sound level instruction on the personal programmer and the process went efficiently and exactly as expected.

Judy and I  then went shopping  next door at the International Mall.  We went to the Apple Store as I am now addicted to my IPAD2.  I offered to buy Judy some $30,000 ear rings at Tiffany’s since this would make our ear costs even but she declined (if you believe that one, I have some Florida properties to offer you).  We had a light lunch and I experienced the expected chewing sounds but actually heard the server for a change.

Driving back, I could listen to talk radio.  This has been difficult since road sounds are so loud with hearing aids that I cannot get enough volume to hear over the highway noise if I have a passenger (volume is no problem if I am driving alone but the car vibrates due to the level of sound I set it at).   I listened to Envoy Esteem’s #1 benefactor of advertising revenue talk about the Florida Primary this week. I am not a happy camper with Republican choices so I will write in Gov. Mitch Daniels as my little protest and encourage others to do so.  Nonetheless, off to a big Republican event tonight, a short rally with Newt tomorrow and more political events this week.  At least I will hear what they are saying.

The follow up appointment for adjustment will be in early April and I will keep copious notes of my hearing experiences but so far, so good.

Envoy Medical, Story of American Capitalism[Part 2]

January 12, 2012 

Envoy Medical Business Plan

I have always supported local businesses and have been a local Chamber of Commerce member wherever I have worked or served..  Whether it is a medical practice, an ice cream store or a print shop, I think about their business plan, their market, their appearance, their attitude, their advertising and their product.  When Bank of America announced debit card fees last year, I watched the papers for the small banks to run ads of no fees or to post banner signs—nothing!  Eventually B of A dropped the fees but it was a missed opportunity for the small banks to gain new customers.  Our community recently opened a 22 field soccer and lacrosse complex in the middle of nowhere (The NFL Combine and the US Soccer Women’s Olympic team are both there this month).  One strip mall with a pizza shop is the only retail within a mile.  Over 78 teams from 20 states as well as France, Turkey and Brazil were here for a competition last month.  Did the pizza guy bring in extra supplies and help? Did he distribute coupons and deals to the thousands attending?  I hope so as I want every entrepreneur to do well, big and small.

I investigated my consumer investment in Envoy Medical’s product for 18 months prior to paying the $30,000, I wanted to be sure they were well financed and would be around if problems occurred and I investigated their business plan.

It is estimated that 31.5 million people in the United States have at least some hearing loss. Of those people, more than 90 percent suffer from sensorineural hearing loss which results from problems that originate in the inner ear, the auditory nerve (which runs from the inner ear to the brain) or in the brain itself.

Envoy Medical’s target market comprises people with moderate to severe sensorineural hearing loss—about 18.5 million people, or more than half of all people with sensorineural hearing loss.

At the time of submission to the FDA in December, 2009, Envoy Medical has spent over $150,000,000!  I was shocked to read that the Rush Limbaugh airtime is billed out at $250,000 a month.   Fine for me but how do they reach my liberal friends.  I hear their commercials with talk hosts Glen Beck and Laura Ingraham as well.  I guess they figure the folks with $30,000 to spend are conservatives.

Investor Glen Taylor has admitted that the implant is expensive but said: “We have to learn how to drive down costs.” CEO Patrick Spearman said two years ago that in order to hold costs down, “We brought everything in house that we could to keep costs down, quality up, and ensure product availability,”   Envoy Medical manufactures the device at its White Bear Lake headquarters, where it employs 50 people. (Rhetorical Query—do the OWS alleged 99% hire and employ folks)


To help overcome the lack of insurance coverage, Envoy Medical offers its own financing.  Investor Roger Lucas was quoted as saying, “Just last week, I got a call from a waitress making less than $40,000 a year-- when she found out we’d finance it and what the payment would be, she said, ‘That’s my car payment. I’ll just hang onto my car a while longer.’”

I found it interesting that they have forged ahead with little expectation of insurance coverage for the implant happening anytime soon.  Their materials and agreements clearly lower this expectation.  I have submitted a claim for reimbursement as a “medical necessity” which it is as I can no longer function at meetings and events due to my severe hearing loss.  I did not send in the agreements with my claim as there was so much pessimism for insurance.





I do like the fact that Envoy Medical will not deal with insurance companies in setting arbitrary rates.  They will let the market, the folks that can afford the implant, decide if it is a good medical investment for them.  Med City News quoted Patrick Spearman last year saying, “The patient will decide whether this works or not, not the medical community.” Envoy will not even bother to apply for reimbursement.



Last year, Spearman estimated Envoy Medical’s 2010 revenue at $10 million and 2011 revenue at $50 million. As of yet, no other company has started to develop a technology to compete with Esteem.



Competition may change, too. “It’s inevitable that we will get competition, because this development is profound,” the late Ken Dahlberg (founder of Miracle Ear) said in 2010. He added, “It is an absolute threat to the hearing aid industry”.  Normally, medical device companies market their technology to doctors, with hopes they will recommend them to patients. However, Envoy will take its message directly to the consumer through mass radio and TV ads.



It was reported last year that about 90-to-100 surgeons are training to implant the device, including doctors from Mayo Clinic, Harvard University and Yale University,   To my knowledge, my doctor has always met the four hour goal (based on the fact I am online with half of his patients) as the patient is under anesthesia. Just like I told my kids, “nothing good happens after midnight”, nothing good happens after four hours of anesthesia either.  I have heard of many cases with other physicians running from 6 to 9 hours.  I know that Envoy Medical will not continue to approve of doctors who consistently exceed that time frame.

In Medical Device Daily, April, 2009 some insight to the business plan was given by CEO Patrick Spearman., he said, "We have a lot of money and keep putting in money ourselves...To raise $25 million to $30 million should be a slam-dunk. We have such a high value, it makes raising money easy. We believe the company can be sold, after FDA approval of Esteem”.  The goal, he has said, is to go public and then create a surgical franchise.

"It takes a skilled surgeon to implant the Esteem and we want to make sure they are properly trained and we want control of it all," he said. "There's a steep learning curve. Our marketing strategy will be completely different. We're not going to hospitals and doctors. We're going to launch our own surgical centers and use direct-to-consumer advertising. If you use a hospital, the cost of surgery is $30 to $40 a minute. If you have your own center, it's $6 to $10 per minute, like a plastic surgeon."

Spearman has been further quoted as saying, "Initially, there are enough people who can afford this...we're not going to be at the beck and call of the medical community on what we can charge. When they see the success, they'll come to us. The public will sell this product. If a pacemaker is put in, how can you tell if it's working? Only the doctor can tell. With our device, the patient can tell if it works or not. This product is a public interest story and we're going to devote tens of millions to advertising."  He believes the volume of sales will reduce the overall cost of Esteem.

It appears the Envoy Medical is on course to an IPO.  They filed with the SEC for a $20,000,000 security offering on November 17, 2011.  The FDA approval, the trained physicians and word of mouth of successfully implanted patients may make this another successful American story of reinvestment, the essence of capitalism. 

[Attribution and Disclaimer-- Sources used for this post were: Twin Cities Business, Hearing Aid Home, Med City News, Forbes, Medical Device Daily, Fox 26 Houston. The information herein is from reliable sources and deemed to be accurate. If any information is believed to be inaccurate, please notify and corrections will be made]

Envoy Esteem, Story of American Capitalism [Part 1]

January 11, 2012

Perhaps this post should be titled, “Bob Dylan, Occupy Wall Street and the Envoy Medical Business Plan”.  It is a story of smalltown Americans whose efforts to achieve success and help others are on the road to success.

Bob Dylan

Hibbing Minnesota, a city of less than 20,000 along the Mesabi Iron Range in northern Minnesota is most famous for being the hometown of Robert Zimmerman, better known as Bob Dylan.  I had Hibbing business acquaintances from The Ryan Companies They built 15 million square feet of Targets, Best Buys, Kohl’s and others including a 12,000 seat arena, the Sears Centre, in the city I represented for 35 years.  They still have summer homes there.  Hibbing athletes?  How about Roger Maris and Kevin McHale!

McHale married his high school sweetheart, Lynn Spearman.  Lynn’s brother, Patrick Spearman,  is the CEO of Envoy Medical. Another brother Michael is CEO of Ototronix and an investor in Envoy Medical.  Ototronix is another non-microphone hearing system and the home office is in the Woodlands in Houston.  Not surprisingly, Envoy Medical has established “the premier international center for the implantation of the Esteem hearing restoration technology” in the Woodlands.

Patrick, Michael, and a third brother Daniel had $5.25 million invested in the company as reported a year ago. The Spearmans are veteran entrepreneurs who sold their first company, filter maker Porous Media, to Minneapolis-based Pentair for $225 million in 2007. Their second, Lexion Medical, has 100 employees and shares a building with Envoy Medical, the more universal-sounding name that St. Croix Medical assumed in 2006.

Houston media says: “The Spearman brothers work to bring the world of sound to those who have difficulty hearing, using remarkable technology that exists no where else in the world.”

They said when McHale was named coach of the Houston Rockets: “It seems Hibbing, Minn. has a habit of producing one-of-a kind individuals, whether it is legendary musician Bob Dylan or Kevin McHale, a tremendous big man who made it all the way to the Naismith Hall of Fame...the move to Houston to begin his new job as head coach of the Rockets will be a little like coming home away from home for he and his wife Lynn.”

It is reported that the Spearman families split time between Minnesota and Houston. I would bet Houston is the home of all during the winter.


Occupy Wall Street



The folks down at Zucotti Park decry the 1% and espouse redistribution of wealth.  Most millionaires in this country, the one percent, were not born into wealth.  They worked hard and took risks.  Some fail but those who succeed receive great rewards due in part to a tax system that does not penalize success.  We would not have Envoy Esteem but for a system that rewards entrepreneurship. The Envoy Medical story is a continuing one—a lot of capital is invested and rewards have not yet come to them but the investors believe they will.  The investors would not invest unless they were assured they could keep a fair amount of return for the risk taken.

Before the Spearmans, there was Roger Lucas.  Lucas is currently Chairman of the Board of Directors of Envoy Esteem. He is also currently Vice Chairman and Chief Scientific Advisor to the Board of Techne Corp. (NASDAQ:TECH and  a Forbes top 100 mid-cap), a biotechnology company that he co-founded in 1985 and developed into one of the world’s largest suppliers of genetically engineered immuno-modulatory molecules. The story goes (from Twin Cities Business) that Lucas, “stumbled across the company and its technology while looking for something else. In November 1995, he was chatting with an independent technology broker working for the University of Minnesota. That discussion was interrupted by an incoming call that Lucas needed to take. The next day, when Lucas called to continue the conversation, the broker mentioned he had just returned from showing office space to Ted Adams and Bruce Brillhart, two former Medtronic employees who had founded a new company called St. Croix Medical. Adams and Brillhart told the broker they owned a technology that could restore hearing.


Intrigued, Lucas got in touch with the start-up’s founders. ‘They had this device, and they drew it out on the back of the proverbial napkin,” he recalls. Lucas was impressed and says that he ‘kept falling more and more in love with the company.” He kept pouring more and more money into it. Today, he owns about 18 percent of the company,”

Other investors include Minnesota Timberwolves owner and billionaire Glen Taylor with 15 percent of Envoy; former Medtronic Inc. vice chairman Glen Nelson, a prolific investor, owns a little under 1 percent. The late Ken Dahlberg, founder of Miracle Ear and inventor of the first in-the-ear hearing aids was an early investor with 3%. Dahlberg said “I think [this technology] will replace a substantial share of the hearing aid market, but it will be gradual...once people buy this, they are off the hearing aid market forever”. It has been reported that Starkey Laboratories have invested $10,000,000 last year and that Allen Lensmeier, former Vice Chairman of Best Buy has also made a substantial investment. in this hearing aid alternative. Patrick, Michael, and Daniel Spearman have, at last report, 34%.. Cofounder Adamshas cashed out, while Brillhart retains a small stake.

In August of 2010, Twin Cities Business reported that “in May 2000, McHale invested $200,000, then watched as the company faltered the next few years. “I thought, ‘There’s some good money that went bad,’” he recalls. “But I knew the technology was still good.”  He kept his shares. He and his immediate family now own about 1.5 percent of the company”. 



Glen Taylor was reported as saying: “It tickles my heart emotionally to hear the stories of people who have been helped by the technology...It is life-changing for people.”   Taylor also was impressed with the other investors: “The three Spearman brothers were nuts-and-bolts type of people. They watched expenses. They thought long-run, and there was a place and a need for someone like myself. I could help in the business practices.”

MedCity News reported in 2010 that Roger Lucas, said he believes Envoy will go public in two years and reach a $3 billion to $5 billion market cap.  As the Esteem reports more success and the economy improves, an IPO may be on the market this year or next.

Another Google or Apple?  No, but an endgame of three billion dollars would not have happened if our capitalistic system followed the European model to redistribute investor gains.  American capitalism is not political, it is American!

[Attribution and Disclaimer-- Sources used for this post were: Twin Cities Business, Hearing Aid Home, Med City News, Forbes, Medical Device Daily, Fox 26 Houston. The information herein is from reliable sources and deemed to be accurate.  If any information is believed to be inaccurate, please notify and corrections will be made]

Activation January 23--Life Changing Experience?

January 4, 2012

The folks at Envoy Esteem market the implant as a “life changing experience”. I buy into this to a point.  One published testimonial by Envoy Medical says “It’s like Jesus came down and touched my ear and said ‘be healed’”.   That may be a little over the top!  I was blessed with good hearing for my first 52 years.  Many patients have never heard well and their experience may be more exciting to them.  The device is intended for those with moderate to severe sensorineural hearing loss and not for the deaf or those suffering other sources of hearing loss.

Activation is a major step on the journey to hearing improvement.  I have been notified that the Envoy Medical technician, Allison, will meet with me on January 23 at 9 A.M. The technicians travel throughout the U.S. as well as Europe and South America.  A technician is always present during surgery to assure that the device is working properly. If I had remained in the post FDA approval testing group (see Dec. 1 blog), I would have gone to my surgeon’s office in Chicago for the activation.  Since this is not required, Allison will come from Atlanta to a Tampa medical office in the Outback Steakhouse home office building next to my wife’s favorite upscale mall, International Mall.  This could be an expensive trip.

I am in the fifth week of temporary total loss in the left ear and severe loss in the right ear.  My hearing aid has gone out a few times in reaction to loud sounds and I have an appointment to address this. When the lone hearing aid is off or removed, I literally cannot hear my razor, a blender five feet away or the vacuum.  A blessing sometimes as I removed the hearing aid a few times over the holidays when the grandchildren were roughhousing in the pool.

Due to fluid in the ear from the surgery, tests have shown that feedback problems occur if activation occurs too early.  Eight weeks is a prudent timeframe to limit such problems.  Earlier experience showed that the fluid could infiltrate the “wires” between the implanted Sound Processor and the incus and stapes bones. This has been corrected.  I have reviewed issues that occurred prior to the FDA approval and found that smokers have problems healing, that the batteries have improved, that the surgeon/technician teamwork is better, that surgeons who cannot meet the timeframes (time under anesthetic) have not been certified and other implant issues have been resolved.

Many persons interested in the Envoy Esteem implant have seen Sarah Churman’s activation appointment.  It is on YouTube at http://www.youtube.com/watch?v=LsOo3jzkhYA

She has been inspiring to the Envoy Esteem patients who share a Facebook group with her.  She keeps a blog which can be accessed at http://sarahchurman.blogspot.com/.

I will NOT be taping my activation nor do I expect to be quite as emotional.  Nonetheless, after waiting eight weeks, one hopes it works.  Expectations are kept low as several post activation follow up appointments are required.

The device will be set with minimal gain as one begins to hear again.  A “personal programmer” remote device can move around tiers of settings to find comfort zones and optimal hearing situations. Many patients have found no reason to change settings once such a zone is identified.

I really have missed not being able to respond to my grandchildren who would repeat three times before I would have to give up—we made a game of it.   My golfing friends are veterans of elective surgery for knees and hips and have been understanding.  My wife somehow never raises her voice in frustration to my inability to understand (sometimes purposeful, shhh). At professional meetings, my input has been limited as I can nod to what has been said but since I am not sure what was said, I cannot contribute.

I look forward to this (drum roll please) life changing experience on January 23.

The Latin Beat

January 3, 2012

I like the Latin culture.  I have enjoyed time in Chile and have travelled to Peru, Columbia, Ecuador and South Beach.  For years, I did police seminars in Miami and Miami Beach and was a regular at the outdoor restaurants on Ocean Drive.  Seems to me the ambience for Latin culture is as great in South Beach as in Latin America. 

Unfortunately, today’s title reference is not to the great Latin culture but to the dead language, Latin. 

Some have asked what the blog title, OYEZ means.  It comes from the Latin word “audire” which in French became “oir” which both mean “hear”.  It became the call to public meetings and courts similar to “Hear Ye, Hear Ye”.  The U. S. Supreme Court continues the tradition with the “Oyez, Oyez” call that the Court is coming to order. 

In fact, the Chicago Kent Law School has compiled all oral arguments of the Supreme Court since recording at the Court began in 1955 in a project entitled, The Oyez Project.  My 1981 oral argument is found at http://www.oyez.org/cases/1980-1989/1981/1981_80_1681, a case we won unanimously. I wrote and defended an ordinance that effectively banned the retail sale of drug paraphernalia (even though the items themselves are legal) and the opinion effectively closed “head shops” in the USA.

 In a second case, my co-counsel argued for an expansion of the Federal Rules of Evidence to allow the conversations of a police officer involved in a shooting death to her psycho-therapist be privileged.  That argument is found at http://www.oyez.org/cases/1990-1999/1995/1995_95_266.  The Court ruled 7-2 in our favor and said that “those who serve and protect should be protected.”  

The other Latin term that has become my mantra is “pro bono”.  This is a Latin phrase more formally stated as “pro bono publico” and means professional services dispensed on a voluntary basis for the public good at no cost to the recipient.  Many state bar associations require attorneys to provide a minimum amount of free services. 

I have taken the “publico” literally and applied it to the greater public good..  In law school, students were required to work with Legal Aid to assist those in need.  Pro bono generally is thought of as assisting the needy. This is not my calling. 

Upon semi- retirement in 2008, I determined to provide free services for the public good and have never billed an hour or received a W-2 since then.  I have reported over 800 hours a year to the Florida Bar for pro bono services.  Most of the hours were spent in the effort to incorporate our region of about 20,000 residents as a municipality.  It required meeting twice a week and evening citizen meetings for 27 months, but more than that, tremendous hours of research in drafting and debating charter provisions, meeting with state and local elected officials, dealing with lobbyists and putting together a campaign.

The work was a great retirement transition.  Ultimately the citizens preferred the comfort of the way things are to forging forward with a “contract city” as we envisioned. See:  http://www.lwrincorporation.com/documents.html 

 I now serve, with pay waived, as an elected “Supervisor” for our local taxing district and also work with the Chamber of Commerce to promote local businesses. I was a Political Science major and had run for state office in Ohio in 1972 and worked for many campaigns since then.  I remain active in political matters and assist some of the local campaigns. I am becoming more active in Hearing Loss Association endeavors and hope to contribute my skills as needed.  I serve on several 501 (c) 3 Boards as well as law enforcement related Boards of Directors. 

I love my golf and family but the need to offer pro bono service is something I cannot give up despite the hearing modifications necessary to do this.