John Simpson never set out to be a physician and still does not consider himself a businessman; yet he is a leading interventional cardiologist and has launched more than a half dozen successful device companies. Simpson takes pride in building successful teams, enabling him to delegate the engineering and business responsibilities to others, while focusing on what he does best: figuring out how to better treat the patient. He is perhaps best known for developing over-the-wire angioplasty through his first company, ACS, and has followed that with companies involved with ultrasound (CVIS), atherectomy (DVI and Fox Hollow), vascular closure (Perclose), and chronic total occlusions (LuMend). Simpson remains iconoclastic when it comes to patient care issues. So although angioplasty is where he made his name, he remains suspicious of stents and hopes through his current venture, Fox Hollow, to minimize their use.

Atrial fibrillation patients are at risk of stroke because their atria, the heart's upper chambers, can't pump blood effectively. In 1998, MV Medical Devices Inc. was founded to tackle the problem with a device-oriented approach that would eliminate the need for life-long Coumadin administration.

The desire of managed care customers and group purchasing organizations to be serviced by large distributors is limiting the ability of small- and mid-sized device companies to access customers directly. Smaller companies have responded with reliable service and quality, cost-effective products. In most niche markets, customers have temporarily accepted the small-company argument. But all suppliers expect increased consolidation by customers, suggesting more alliances will be required to sustain innovation and quality throughout the marketplace.