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S01.E03: Green Juice


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6 hours ago, Rootbeer said:

Elizabeth and Sunny were obsessed with NDA's and everyone who worked at Theranos had to sign them, often multiple times. 

I'm so curious as to how that work. With each contract, each party has to give something. What did they give each time an employee had to sign an NDA?

The first NDA is in exchange for employment. Then what for the next NDA, a raise?

Edited by AntFTW
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54 minutes ago, AntFTW said:

I'm so curious as to how that work. With each contract, each party has to give something. What did they give each time an employee had to sign an NDA?

The first NDA is in exchange for employment. Then what for the next NDA, a raise?

I don’t even think many NDAs are truly enforceable. What has some lowly lab tech got to lose?

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3 minutes ago, Cinnabon said:

I don’t even think many NDAs are truly enforceable. What has some lowly lab tech got to lose?

That’s what I’m thinking.
 

I’m thinking “sue me. I’m out of a job. I have no income. I don’t own my house. My bank account is nearly empty. I have no assets. However, if you want to fire me with no NDA protection, I’d be willing to exchange a nice severance package for my silence.”

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20 minutes ago, AntFTW said:

That’s what I’m thinking.
 

I’m thinking “sue me. I’m out of a job. I have no income. I don’t own my house. My bank account is nearly empty. I have no assets. However, if you want to fire me with no NDA protection, I’d be willing to exchange a nice severance package for my silence.”

Exactly. I got out of potentially being fired from a startup/internet company in 2003 by agreeing to resign and asking for a few months severance pay. I also got unemployment. They only gave it to me because I asked. 

Edited by Cinnabon
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1 hour ago, AntFTW said:

I'm so curious as to how that work. With each contract, each party has to give something. What did they give each time an employee had to sign an NDA?

The first NDA is in exchange for employment. Then what for the next NDA, a raise?

I think the subsequent NDAs came with an implicit (or not so implicit) threat that those who refused to sign them would lose their jobs. California is an at-will employment state, so employers are able to make the signing of NDAs a condition of employment even if the NDAs themselves are unenforceable. And the employees, just like the clients and investors, were gaslit to believe that Theranos was the next mega-unicorn, and that if they stayed long enough to fully vest their stock options (usually a four-year period), they would all get rich when the company went public. So it wasn't just a threat of losing *a* job, there was a sort of FOMO of losing the most important job of one's career.

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The fear over the NDAs also was because everyone knew Theranos had much feared David Boies as its attorney.  Both Sunny and Elizabeth were obsessive in their paranoia.  They also monitored the employee computers and fired/threatened former employees with lawsuits after some forwarded work emails to their personal emails.  The windows to her office were even bulletproof!  Sunny and Elizabeth ran the company with nothing but intimidation and fear.  

Richard and his family are pieces of work too. I wonder how much detail they go into with his family.  There is just so much to cover!

Edited by KLJ
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11 hours ago, AntFTW said:

That’s what I’m thinking.
 

I’m thinking “sue me. I’m out of a job. I have no income. I don’t own my house. My bank account is nearly empty. I have no assets. However, if you want to fire me with no NDA protection, I’d be willing to exchange a nice severance package for my silence.”

That is why NDA's are so effective when the employer has been shown to have the will to enforce them legally.  Theranos had one of the top law firms in the country for this sort of litigation.  They can and did sue former employees for violating their NDA.  Once you get served with the suit, it requires a response, usually pages and pages of legal gobbledegook that is not possible for a non-lawyer to produce.  So, you go to a law firm that specializes in civil litigation.  They will want a retainer; $10,000 cash upfront would be in the ballpark, to defend you against this corporation with bottomless pockets.  If the thing progresses beyond the initial stages, those fees are going to go up and up.  Anything that gets to the court stage is going to be $30,000 in legal fees easy.  And, if the corporation isn't interested in collecting from you (they're not, they want you to retract prior statements and shut up); their fancy lawyers will file motion after motion, all of which require a response and you are in triple digits pronto.

For example:

Spoiler

Tyler Schultz, who spoke to the Wall Street Journal reporter anonymously, was served with suits from Theranos for doing so.  Prior to that, they used his grandfather to intimidate him and try to get him to retract his previous statements and sign another NDA.  When he refused, they went to court.  Tyler said his parents paid out over $500,000 to defend him against the suits rather than concede and retract his interview with the WSJ.

 

Edited by Rootbeer
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6 hours ago, Rootbeer said:

That is why NDA's are so effective when the employer has been shown to have the will to enforce them legally.  Theranos had one of the top law firms in the country for this sort of litigation.  They can and did sue former employees for violating their NDA.  Once you get served with the suit, it requires a response, usually pages and pages of legal gobbledegook that is not possible for a non-lawyer to produce.  So, you go to a law firm that specializes in civil litigation.  They will want a retainer; $10,000 cash upfront would be in the ballpark, to defend you against this corporation with bottomless pockets.  If the thing progresses beyond the initial stages, those fees are going to go up and up.  Anything that gets to the court stage is going to be $30,000 in legal fees easy.  And, if the corporation isn't interested in collecting from you (they're not, they want you to retract prior statements and shut up); their fancy lawyers will file motion after motion, all of which require a response and you are in triple digits pronto.

For example:

  Hide contents

Tyler Schultz, who spoke to the Wall Street Journal reporter anonymously, was served with suits from Theranos for doing so.  Prior to that, they used his grandfather to intimidate him and try to get him to retract his previous statements and sign another NDA.  When he refused, they went to court.  Tyler said his parents paid out over $500,000 to defend him against the suits rather than concede and retract his interview with the WSJ.

 

That poor kid! If he had already signed the first NDA, why did they insist he sign another? To my knowledge, employers can’t force anyone to sign anything when they quit/get fired from a job. They may ask/demand that they sign, and make any severance dependent on signing, but employees still have the right to refuse. I actually quit one job by email - I wrote it from home and never set foot in the office again, and they couldn’t do anything about it legally. 

Edited by Cinnabon
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1 hour ago, Cinnabon said:

That poor kid! If he had already signed the first NDA, why did they insist he sign another? To my knowledge, employers can’t force anyone to sign anything when they quit/get fired from a job. They may ask/demand that they sign, and make any severance dependent on signing, but employees still have the right to refuse. I actually quit one job by email - I wrote it from home and never set foot in the office again, and they couldn’t do anything about it legally. 

I believe they didn't just want another NDA, they wanted him to recant his interview with the WSJ reporter, to deny that he ever said the things that were quoted or to say he was angry about being fired and fabricated it all, They were in full damage control mode at that point.  I presume the additional NDA was to prevent him from discussing anything about the agreement to recant since he was no longer an employee and the original didn't cover him anymore.

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On 3/7/2022 at 11:19 AM, bluegirl147 said:

I just know from having so much blood work that a drop of blood isn't going to do everything they said it could do.

ER nurse here.

When I first heard of Theranos’s “technology” 10 or 15 years ago, I was utterly mystified as to how it was supposed to work.

Because when you draw blood with a pinprick, red blood cells lyse!

Which means they release potassium.

Wouldn’t those elevated potassium levels throw off most diagnostic assays?

Oh well, I thought at the time. Smarter people than you have found the workaround.

Except, as it turns out, they hadn’t.

They weren’t smarter than me.

Just better scammers.  😀

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4 hours ago, Maximona said:

ER nurse here.

When I first heard of Theranos’s “technology” 10 or 15 years ago, I was utterly mystified as to how it was supposed to work.

Because when you draw blood with a pinprick, red blood cells lyse!

Which means they release potassium.

Wouldn’t those elevated potassium levels throw off most diagnostic assays?

Oh well, I thought at the time. Smarter people than you have found the workaround.

Except, as it turns out, they hadn’t.

They weren’t smarter than me.

Just better scammers.  😀

And, with this post, you prove that you know more than Elizabeth Holmes about lab technology.

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4 hours ago, Maximona said:

ER nurse here.

When I first heard of Theranos’s “technology” 10 or 15 years ago, I was utterly mystified as to how it was supposed to work.

Because when you draw blood with a pinprick, red blood cells lyse!

Which means they release potassium.

Wouldn’t those elevated potassium levels throw off most diagnostic assays?

Oh well, I thought at the time. Smarter people than you have found the workaround.

Except, as it turns out, they hadn’t.

They weren’t smarter than me.

Just better scammers.  😀

Exactly. When you prick a finger and squeeze the blood out, the red blood cells pop and make it impossible to get an accurate potassium reading.

I’m reading Carreyrou’s “Bad Blood” book right now, and anyone who showed any skepticism or “negativity” was immediately shut down and usually fired. 

It’s absolutely flabbergasting that the farce went on as long as it did. Even IF the machines had worked as promised, it still wouldn’t have “saved lives” by diagnosing diseases early. Regular old venipuncture blood draws were already available, if doctors thought they were warranted based on a patient’s symptoms. While finger stick tests would make it easier and less stressful for some patients, doctors would still have to order and interpret the results. What would really save lives is a universal healthcare system, so that the 28 million uninsured Americans can get access to any kind of early testing and medical care. These are the people who don’t get tested until it’s too late. 
 

 

Edited by Cinnabon
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21 hours ago, Cinnabon said:

Even IF the machines had worked as promised, it still wouldn’t have “saved lives” by diagnosing diseases early

Kinda have to disagree with you there.  Delayed diagnosis isn't evidence of medical malpractice per se, true, but a presumptively accurate blood test early in the game would enhance the process of differential diagnosis considerably.

Plus, you know, in the time of the Internet, the entire relationship between MDs and patients is evolving (even if the AMA is such a powerful trade organization that it will take decades for laws to reflect that.)  If—as seems likely in the aftermath of the COVID-19 pandemic—increasing numbers of physician/patient encounters are taking place remotely—why should physicians remain the agents of services you are purchasing from them?  Why not let patients decide what medical services they want?  

Of course, most patients are more comfortable letting physicians make such decisions for them because illness is infantilizing that way—when you're sick, you want someone to take over and make you well.

But it wasn't handed down on stone tablets that it has to be that way.  😀

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23 minutes ago, Maximona said:

Kinda have to disagree with you there.  Delayed diagnosis isn't evidence of medical malpractice per se, true, but a presumptively accurate blood test early in the game would enhance the process of differential diagnosis considerably.

Plus, you know, in the time of the Internet, the entire relationship between MDs and patients is evolving (even if the AMA is such a powerful trade organization that it will take decades for laws to reflect that.)  If—as seems likely in the aftermath of the COVID-19 pandemic—increasing numbers of physician/patient encounters are taking place remotely—why should physicians remain the agents of services you are purchasing from them?  Why not let patients decide what medical services they want?  

Of course, most patients are more comfortable letting physicians make such decisions for them because illness is infantilizing that way—when you're sick, you want someone to take over and make you well.

But it wasn't handed down on stone tablets that it has to be that way.  😀

Insurance companies aren’t likely to cover blood tests not ordered by a doctor. 

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4 hours ago, Maximona said:

Why not let patients decide what medical services they want?  

I absolutely believe a patient should be involved in their health and decide how to proceed with their own care.  Diagnostics, however, are a different matter.  Most of us aren't doctors with the training needed to know what tests should be ordered.  I don't think the patient should be calling that shot.  Especially if their expertise is solely from Dr. Google.  If they don't want to take the test, that's on them.

I would also worry about the value of patient interpretation of test results.  I prefer to leave my health to professionals, not dropouts with a dream to make billions.

 

 

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3 minutes ago, MollyB said:

I absolutely believe a patient should be involved in their health and decide how to proceed with their own care.  Diagnostics, however, are a different matter.  Most of us aren't doctors with the training needed to know what tests should be ordered.  I don't think the patient should be calling that shot.  Especially if their expertise is solely from Dr. Google.  If they don't want to take the test, that's on them.

I would also worry about the value of patient interpretation of test results.  I prefer to leave my health to professionals, not dropouts with a dream to make billions.

 

 

Exactly. It would be a nightmare if patients just started ordering their own tests. How could most possibly know the specific tests and blood panels to request? Those lab requisition forms are tricky. I’ve worked in many healthcare settings, and (some)patients already call their doctors’ offices frequently. I can only imagine the number of patients calling freaking out about test results if they all just went to the lab and ordered their own tests, lol. And what about the millions of uninsured? They order some random tests, and then what?                  

The exception to this is STD testing. There are labs in my area that test for all common STDS, no doctor’s order needed. You just walk in, get blood drawn, pay, and they email the results to you within a day or 2. Many cities have public clinics that do these tests.         

 

 


 

 

 

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4 hours ago, Maximona said:

Kinda have to disagree with you there.  Delayed diagnosis isn't evidence of medical malpractice per se, true, but a presumptively accurate blood test early in the game would enhance the process of differential diagnosis considerably.

Plus, you know, in the time of the Internet, the entire relationship between MDs and patients is evolving (even if the AMA is such a powerful trade organization that it will take decades for laws to reflect that.)  If—as seems likely in the aftermath of the COVID-19 pandemic—increasing numbers of physician/patient encounters are taking place remotely—why should physicians remain the agents of services you are purchasing from them?  Why not let patients decide what medical services they want?  

Of course, most patients are more comfortable letting physicians make such decisions for them because illness is infantilizing that way—when you're sick, you want someone to take over and make you well.

But it wasn't handed down on stone tablets that it has to be that way.  😀

There are very few illnesses that can be diagnosed from a simple random bloodtest.  Someone has to take the patient's history, symptoms, family history, etc into account before ordering the test and then, once the result is back, put it into the framework of that individual patient and their situation in order to determine the next best step.  There are many blood assays that cost hundreds of dollars apiece to perform.  Having patients order from a menu like MacDonald's is not going to be cost effective at all and our healthcare system is already faltering at the high cost of care. Having people order their own bloodwork based on their own agenda is not good medicine.

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4 hours ago, Maximona said:

Kinda have to disagree with you there.  Delayed diagnosis isn't evidence of medical malpractice per se, true, but a presumptively accurate blood test early in the game would enhance the process of differential diagnosis considerably.

Plus, you know, in the time of the Internet, the entire relationship between MDs and patients is evolving (even if the AMA is such a powerful trade organization that it will take decades for laws to reflect that.)  If—as seems likely in the aftermath of the COVID-19 pandemic—increasing numbers of physician/patient encounters are taking place remotely—why should physicians remain the agents of services you are purchasing from them?  Why not let patients decide what medical services they want?  

Of course, most patients are more comfortable letting physicians make such decisions for them because illness is infantilizing that way—when you're sick, you want someone to take over and make you well.

But it wasn't handed down on stone tablets that it has to be that way.  😀

A few more thoughts on this. Elizabeth often used the story of her uncle who died of cancer, claiming that the availability of Theranos testing would have somehow contributed to a longer life for him. But her uncle DID see his doctor early on and the doctor sent him to get the appropriate blood tests done .Theranos was just another lab (and an extremely inaccurate one), so how would its existence have helped her uncle? His doctor ordered his tests, interpreted them, and sent him for treatment. It’s just flabbergasting that so many fell for her stories.

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30 minutes ago, Rootbeer said:

There are very few illnesses that can be diagnosed from a simple random bloodtest.  Someone has to take the patient's history, symptoms, family history, etc into account before ordering the test and then, once the result is back, put it into the framework of that individual patient and their situation in order to determine the next best step.  There are many blood assays that cost hundreds of dollars apiece to perform.  Having patients order from a menu like MacDonald's is not going to be cost effective at all and our healthcare system is already faltering at the high cost of care. Having people order their own bloodwork based on their own agenda is not good medicine.

Seriously, can you imagine the volume of frantic patient calls if they were ordering their own tests?  I worked for 2 internists in the mid-90s, and they saw mostly HIV+/AIDS patients. At that time, antiretrovirals were brand new, and they were still constantly experimenting with different combinations, dosages, etc. Sometimes there were a lot of unexpected side effects. It was my job to come into the office early every morning and listen to the many, many voice mail messages that patients and their partners and friends left every night after the office closed. Sometimes this took me hours there were so many frantic messages. Then I had to triage with the doctors, getting their input on each and return the calls with next steps. It would be absolutely overwhelming if patients were out there ordering their own blood tests, not knowing how to interpret them and calling in panicked. And doctors wouldn’t even know which tests patients had done, since they didn’t place the orders. Complete chaos, lol.

Edited by Cinnabon
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