These past several months, we tested a device called the Marrow Cellutions (MC). While the manufacturers had claimed through various white papers and physician endorsements that the device was able to obtain dramatically more stem cells, our tests and those of another physician didn’t support those claims. Hence, time to move on, right? I guess not, as the sales reps that work for the company are now in full mudslinging mode. This blog is a response to a recent bizarre e-mail from one such sales rep sent to me by a colleague.
Medicine is more like playing a Stratocaster guitar than playing a music file on your computer or phone. Meaning, it takes time, education, and experience to learn how to perform any medical procedure, including a bone marrow aspiration (the procedure where stem cells are harvested). However, the concept behind the MC device was that it was a like a high-end guitar (e.g., Fender Stratocaster) that, if you followed the instructions, would virtually play itself. Basically, the device and its design would be better than a doctor who used an inexpensive trocar and then used a bedside machine or lab protocol to concentrate stem cells. This was a tall order, a bit like saying that you had designed a special rock guitar that could send signals to your brain to move your fingers and body so that for all intents and purposes, you were Pete Townsend. In the end, that didn’t happen. Our data showed what we all know is likely true at face value—that Pete Townsend playing a cheap dime-store guitar still sounds better than you or I playing a hundred-thousand-dollar Fender Stratocaster.
If you’re a sales rep, it’s your job to sell the product you’re representing. I’ve seen some good sales reps in my days, but most have told me stuff that later turned out not to be true. Hence, I’m always a bit wary when talking to a sales rep.
The manufacturer of MC has hired a small army of orthopedic device sales reps. As you might imagine, because of the tests that we did and those performed by another physician, both showing that the MC device wasn’t the automatic Stratocaster and instead didn’t perform any better than the dime-store guitar (despite the high price for MC), the sales reps for MC are freaking out. I suppose, in the long run, more studies paid for by the manufacturer will be commissioned, but in the meantime, there are sales to make and tall tales to tell about why the MC device failed. Hence, I’d like to share an e-mail sent by an MC rep to a colleague.
As I write this blog, I’m on vacation in Italy this week and sitting outside with the birds chirping. Hence, it’s pretty hard to get upset in an amazingly beautiful place like this. However, yesterday, a physician colleague sent me an e-mail sent to him by an MC sales rep. I’ll copy and paste it below to give you some sense of how the sales reps for MC are freaking out:
“Yes, Centeno is (deleted insults)… We’ve reached out to him on several occasion’s for an independent lab comparing his technique to Marrow Cellution. And the answer is always NO! …The technique involves 12 pokes in the iliac for a procedural time of two hours…borderline barbaric!
More importantly, if his OWN lab results are correct… then everyone on the listed thought leaders below are completely wrong. I find that hard to swallow….”
Hmmm…. Let’s dig a bit deeper:
—”We’ve reached out to him on several occasion’s for an independent lab comparing his technique to Marrow Cellution.”
As I have blogged before, I reached out to the MC manufacturer and told them that we wanted to test their device with our advanced lab facility. I also wrote to them that we would be happy to send our samples to an independent university lab. There are numerous within driving distance of our main office at the University of Colorado and CSU. The whole thing seemed to break down when I discussed that our tests were about using the device to maximize a bone marrow aspiration for later concentration, hence, we would be drawing a higher volume of bone marrow in total than the 8 ml they recommended. However, the company was also informed that we would also test the first 8 ml drawn with the MC device for comparison to the first 8 ml drawn using our technique with an inexpensive trocar. After that, the participation of the MC manufacturer was withdrawn. In fact, when I asked to have our local MC rep at the tests, I was told by the rep that he couldn’t be there. Finally, when we went to purchase three units to perform the test, we were told no. Finally, I had to buy them through a third-party surrogate. Why? I’ll let you speculate. For anyone interested, here are the details of my back and forth emails with the Marrow Cellutions device manufacturer.
—”The technique involves 12 pokes in the iliac for a procedural time of two hours…borderline barbaric!” Here, the rep is talking about our multi site technique that beat the MC device in every patient we tested. In fact, we performed 5–7 draw-site punctures through the same site in the skin on our side—the video is here. I always book 40 minutes for a marrow draw, so I have no idea where the two hours was plucked from. As far as the MC device, it not only took more time to use than our standard draw but was uniformly more painful during and after the procedure in ALL patients tested. Why? I can numb the back of the hip area I’m drawing from, but I can’t numb the deep marrow space as the MC device travels through it, hence the MC device caused more pain. So, from the patient’s perspective, the only thing that felt “barbaric” about the BMAs I did with our technique and MC, was the side on which I used the MC device.
What is a thought leader? This is a medical sales industry term for doctors who are compensated to support the use of a product. Sometimes they get speakers fees; other times they get free product, money for research, stock, and so on. Do the payments bias these providers? You decide.
We paid to test the MC device (we even bought the devices) because we wanted to see if it worked well enough to warrant buying and using. So we have no dog in this fight, even though the reps are growling now.
The upshot? Sales reps sell stuff. That’s their job. It’s usually all about making the sale. For my part, after spending several months and many thousands of dollars testing MC to see if we wanted to use the device, I was hoping to never have to write about it again as there are many important topics and research projects waiting! However, this quote from The Godfather is how I feel about right now:
So if you’re an MC sales rep, get over it, and keep it factual! We’re moving on!
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…