Bad Blood by John Carreyrou

Author:John Carreyrou
Language: eng
Format: epub, mobi, azw3
Publisher: Knopf Doubleday Publishing Group
Published: 2018-05-21T04:00:00+00:00

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IN JUNE, Daniel Young, the brainy MIT Ph.D. who headed Theranos’s biomath team, came to see Alan Beam in Jurassic Park with a subordinate named Xinwei Gong in tow. In the five years since he’d joined Theranos, Daniel had risen up the ranks to become the company’s de facto number-three executive. He had Elizabeth and Sunny’s ear, and they often deferred to him to solve nettlesome technical problems.

In his first few years at Theranos, Daniel had seemed every bit the family man, leaving the office at six every evening to have dinner with his wife and kids. This routine had drawn snickers behind his back from some colleagues. But after being promoted to vice president, Daniel had become a different person. He worked longer hours and stayed at the office later. He got very drunk at company parties, which was jarring because he was always quiet and inscrutable at work. And there were whispers of a flirtation with a coworker.

Daniel told Alan that he and Gong, who went by Sam, were going to tinker with the ADVIA 1800, one of the lab’s commercial analyzers. The ADVIA was a hulking 1,320-pound machine the size of two large office copiers put together that was made by Siemens Healthcare, the German conglomerate’s medical-products subsidiary.

Over the next few weeks, Alan observed Sam spend hours opening the machine up and filming its innards with his iPhone camera. He was hacking into it to try to make it compatible with small finger-stick blood samples, Alan realized. It seemed like confirmation of what Paul Patel had told him: the 4S must not be working, otherwise why resort to such desperate measures? Alan knew the Edison could only perform immunoassays, so it made sense that Daniel and Sam would choose the ADVIA, which specialized in general chemistry assays.

One of the panels of blood tests most commonly ordered by physicians was known as the “chem 18” panel. Its components, which ranged from tests to measure electrolytes such as sodium, potassium, and chloride to tests used to monitor patients’ kidney and liver function, were all general chemistry assays. Launching in Walgreens stores with a menu of blood tests that didn’t include these tests would have been pointless. They accounted for about two-thirds of doctors’ orders.

But the ADVIA was designed to handle a larger quantity of blood than you could obtain by pricking a finger. So Daniel and Sam thought up a series of steps to adapt the Siemens analyzer to smaller samples. Chief among these was the use of a big robotic liquid handler called the Tecan to dilute the little blood samples collected in the nanotainers with a saline solution. Another was to transfer the diluted blood into custom-designed cups half the size of the ones that normally went into the ADVIA.

The combination of these two steps solved a problem known as “dead volume.” Like many commercial analyzers, the ADVIA featured a probe that dropped down into the blood sample and aspirated it. Although it aspirated most of the sample, there was always some unused liquid left at the bottom.

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