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They had a fully functional lab though, it just wasn't using Theranos' devices. This is what they did to Wallgreens, they sold them on the idea that they would

They had a fully functional lab though, it just wasn't using Theranos' devices. This is what they did to Wallgreens, they sold them on the idea that they would have theranos machines in-store, but instead what they did was do IV blood draws (calling it a comparison check) .. and then would just process the samples the same way as everyone else using standard equipment. People were getting good results because Theranos was using machines from Siemens in their hidden lab.

justinator 5y ago
I believe they also reverse engineered a lot of the third party machines, in an attempt to make them work the way they wanted to. That's... that's bad.
- keypusher 5y ago
  But not illegal, except under very specific circumstances.
- ghshephard 5y ago
  I think that's entirely fine - both for patients and investors (Siemens might be a bit Irate, but I don't know if I would put that in the "Bad" category). The issue would be if they informed their investors that tests were being done on Theranos technology, but were actually using siemens technology. With regards to the patients - all they should care about is accuracy of test results - whether Theranos was doing it with Theranos tech, Siemens Tech, Reverse Engineered Siemens Tech + dilution of the blood to get enough volume is mostly irrelevant to a patient - they just want to get the highest quality information possible, regardless of the route taken.
  - jmcgough 5y ago
    > Reverse Engineered Siemens Tech + dilution of the blood to get enough volume is mostly irrelevant to a patient Those machines weren't designed to work that way though, so the test results were wildly inaccurate when they did dilutions. And they fired people who wanted to delay rollout in order to ensure that they had consistently accurate results.
    - ghshephard 5y ago
      The point I was making was that it was irrelevant how the original designs were intended - if Theranos had been able to successfully reverse engineers the tests, and determine a way to make them work reliably, while it would have made those of us who believed Theranos had some incredible new technology, and that Elizabeth Holmes was the next coming, no patients need to have been concerned. It was the fact that the tests were unreliable, that made Theranos guilty. Lying about it to the Investors, and possible intellectual/contract issues with Siemens are another issue.
      - josefx 5y ago
        > It was the fact that the tests were unreliable, that made Theranos guilty. Very few tests are 100% reliable, so I would expect that Theranos claims about how the tests where performed would play a significant role in determining the guilt. People where told they would get the perfect magic pixy dust test that worked on one drop of blood instead they got one of the early covid tests that needed at least four repeats to give a "most likely negative" result, unsurprisingly the covid tests also resulted in confused tweets by the one or other VC.
        ghshephard 5y ago
        Well - some of the tests have to be 100% reliable, because medication decisions are made on them, and the incorrect dosage can be harmful. It's not like a cheap $10 antigen tests that has sub 100% specificity and sensitivity - a bunch of the tests were trying to measure particular levels. Theranos was just overall horrible. They were trying to do some tests that were impossible based on the physics of what can be measured by pinprick blood.
      - jmcgough 5y ago
        Yeah, I think we're actually in agreement here. Sometimes I think about how, if Theranos had figured out how to make things work over the last year before the WSJ article, all of their horrible and unethical practices would have been swept under the rug even if they were essentially lying for years to investors and patients. Unfortunately, it turns out that "fake it til you make it" doesn't work with some problems that are seemingly unsolvable (at least by the approach they took).
- kragen 5y ago
  Reverse engineering is an important right that is protected by centuries of patent and trade secret law in the US and many other countries. It's fundamental to innovation, even though non-innovative bad people like Theranos also do it. Reverse engineering is not bad, and it is dismaying that someone posting on a site called "Hacker News" would think so.
  - darkerside 5y ago
    Reverse engineering for shits and giggles, good. Reverse engineering for profit by modifying a device regulated by the FDA, bad.
    - lai-yin 5y ago
      I think you mean, reverse engineering to create new, better machines: good. Reverse engineering to game a medical testing device: bad.
  - justinator 5y ago
    Reverse engineering is not bad, and it is dismaying that someone posting on a site called "Hacker News" would think so. Personal attacks aside, I'm just saying that if I get a blood test and it says I've got AIDS and I actually don't - and that's all because some sociopath grifter with less of an education than what's been proven with my own Bachelors of Fine Arts realized that to swindle millions of more dollars from her geriatric backers she's been manipulating (and ruining the lives of their own family members), she needs to fake the test results from an impossible dream machine that does NOT exist and couldn't ever - because it defies the laws of physics, and does this by running modified machines of her competitors that are now basically broken, in secret rooms she doesn't tell journalists or inspectors about, well: that's truly fucked.
    - WillPostForFood 5y ago
      Yes! And reverse engineering is not bad. Everything else you mention is bad.
- protastus 5y ago
  Emphasis on attempt. After failing to produce their own reagents and hardware, Theranos pivoted to using off-the-shelf Siemens hardware and reagents (purchased through a shell company) and dramatically diluting the blood samples to make good on the "single drop of blood" customer promise. This would've been an impressive feat of reverse engineering, software eating the world, IF IT WORKED. But it didn't. Results couldn't even pass internal audits and the FDA forced Theranos to invalidate ~1 million test results when they found what was going on.
Flammy 5y ago
My understanding is they took much smaller samples of blood which lead to lots of reproducibility problems. The standard machines they were using were being fed with up-sampled blood because Theranos didn't have the normal sample size. > People were getting good results because Theranos was using machines from Siemens in their hidden lab. Thus the tests sometimes were good, and sometimes bad. Some patients underwent unnecessary medical treatments and procedures based on bad tests.
jmcgough 5y ago
They were using traditional siemens for most tests but were doing some tests with a fingerprick that they diluted - like their PSA test sometimes coming back super high for cis women, indicating that they had prostate cancer.
- kjaftaedi 5y ago
  Agreed, but the line of thinking is to try and prosecute this. You'd have to prove to the court that theranos used their bad techniques instead of their good ones. I am not as optimistic they kept such detailed records of their crimes, and feel this would be a tough angle to successfully prosecute.

justinator 5y ago

I believe they also reverse engineered a lot of the third party machines, in an attempt to make them work the way they wanted to. That's... that's bad.

keypusher 5y ago
But not illegal, except under very specific circumstances.
ghshephard 5y ago
I think that's entirely fine - both for patients and investors (Siemens might be a bit Irate, but I don't know if I would put that in the "Bad" category). The issue would be if they informed their investors that tests were being done on Theranos technology, but were actually using siemens technology. With regards to the patients - all they should care about is accuracy of test results - whether Theranos was doing it with Theranos tech, Siemens Tech, Reverse Engineered Siemens Tech + dilution of the blood to get enough volume is mostly irrelevant to a patient - they just want to get the highest quality information possible, regardless of the route taken.
- jmcgough 5y ago
  > Reverse Engineered Siemens Tech + dilution of the blood to get enough volume is mostly irrelevant to a patient Those machines weren't designed to work that way though, so the test results were wildly inaccurate when they did dilutions. And they fired people who wanted to delay rollout in order to ensure that they had consistently accurate results.
  - ghshephard 5y ago
    The point I was making was that it was irrelevant how the original designs were intended - if Theranos had been able to successfully reverse engineers the tests, and determine a way to make them work reliably, while it would have made those of us who believed Theranos had some incredible new technology, and that Elizabeth Holmes was the next coming, no patients need to have been concerned. It was the fact that the tests were unreliable, that made Theranos guilty. Lying about it to the Investors, and possible intellectual/contract issues with Siemens are another issue.
    - josefx 5y ago
      > It was the fact that the tests were unreliable, that made Theranos guilty. Very few tests are 100% reliable, so I would expect that Theranos claims about how the tests where performed would play a significant role in determining the guilt. People where told they would get the perfect magic pixy dust test that worked on one drop of blood instead they got one of the early covid tests that needed at least four repeats to give a "most likely negative" result, unsurprisingly the covid tests also resulted in confused tweets by the one or other VC.
      - ghshephard 5y ago
        Well - some of the tests have to be 100% reliable, because medication decisions are made on them, and the incorrect dosage can be harmful. It's not like a cheap $10 antigen tests that has sub 100% specificity and sensitivity - a bunch of the tests were trying to measure particular levels. Theranos was just overall horrible. They were trying to do some tests that were impossible based on the physics of what can be measured by pinprick blood.
    - jmcgough 5y ago
      Yeah, I think we're actually in agreement here. Sometimes I think about how, if Theranos had figured out how to make things work over the last year before the WSJ article, all of their horrible and unethical practices would have been swept under the rug even if they were essentially lying for years to investors and patients. Unfortunately, it turns out that "fake it til you make it" doesn't work with some problems that are seemingly unsolvable (at least by the approach they took).
kragen 5y ago
Reverse engineering is an important right that is protected by centuries of patent and trade secret law in the US and many other countries. It's fundamental to innovation, even though non-innovative bad people like Theranos also do it. Reverse engineering is not bad, and it is dismaying that someone posting on a site called "Hacker News" would think so.
- darkerside 5y ago
  Reverse engineering for shits and giggles, good. Reverse engineering for profit by modifying a device regulated by the FDA, bad.
  - lai-yin 5y ago
    I think you mean, reverse engineering to create new, better machines: good. Reverse engineering to game a medical testing device: bad.
- justinator 5y ago
  Reverse engineering is not bad, and it is dismaying that someone posting on a site called "Hacker News" would think so. Personal attacks aside, I'm just saying that if I get a blood test and it says I've got AIDS and I actually don't - and that's all because some sociopath grifter with less of an education than what's been proven with my own Bachelors of Fine Arts realized that to swindle millions of more dollars from her geriatric backers she's been manipulating (and ruining the lives of their own family members), she needs to fake the test results from an impossible dream machine that does NOT exist and couldn't ever - because it defies the laws of physics, and does this by running modified machines of her competitors that are now basically broken, in secret rooms she doesn't tell journalists or inspectors about, well: that's truly fucked.
  - WillPostForFood 5y ago
    Yes! And reverse engineering is not bad. Everything else you mention is bad.
protastus 5y ago
Emphasis on attempt. After failing to produce their own reagents and hardware, Theranos pivoted to using off-the-shelf Siemens hardware and reagents (purchased through a shell company) and dramatically diluting the blood samples to make good on the "single drop of blood" customer promise. This would've been an impressive feat of reverse engineering, software eating the world, IF IT WORKED. But it didn't. Results couldn't even pass internal audits and the FDA forced Theranos to invalidate ~1 million test results when they found what was going on.

Flammy 5y ago

My understanding is they took much smaller samples of blood which lead to lots of reproducibility problems. The standard machines they were using were being fed with up-sampled blood because Theranos didn't have the normal sample size. > People were getting good results because Theranos was using machines from Siemens in their hidden lab. Thus the tests sometimes were good, and sometimes bad. Some patients underwent unnecessary medical treatments and procedures based on bad tests.

jmcgough 5y ago

They were using traditional siemens for most tests but were doing some tests with a fingerprick that they diluted - like their PSA test sometimes coming back super high for cis women, indicating that they had prostate cancer.

kjaftaedi 5y ago
Agreed, but the line of thinking is to try and prosecute this. You'd have to prove to the court that theranos used their bad techniques instead of their good ones. I am not as optimistic they kept such detailed records of their crimes, and feel this would be a tough angle to successfully prosecute.