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New University of Michigan Tinnitus Discovery — Signal Timing

This is all really disheartening stuff to read as I'm really pinning my hopes on Dr. Shore's device, which is not a good thing to do.

I guess one must take a step back and try to come to mentality of aiming to cope better and if the device comes out sooner than two years, it's a bonus.
 
Maybe @Hazel can reach out for another update from Dr. Shore after some appropriate time period has elapsed since the last one?

It might also be worth reaching out to Neuromod. They're enjoying considerable success right now and, from looking at their company profile and hiring activities, seem to be investing back into further R&D. Maybe there's a 'next-gen' device in the works. As mentioned before, the best possible outcome for us would be for them to license the UoM technology - UoM still make money without all the risk and downsides of trying to bring a product to market (90% of start-ups fail even when the product is good).
 
This is all really disheartening stuff to read as I'm really pinning my hopes on Dr. Shore's device, which is not a good thing to do.

I guess one must take a step back and try to come to mentality of aiming to cope better and if the device comes out sooner than two years, it's a bonus.
Nobody knows anything about Auricle. We don't know if they're contract manufacturing or doing it in-house. We don't know what supply agreements they already have. We don't know what funding they have.

Everything here is speculation.
 
It's just speculation to be honest, I wouldn't put any stock into it.

For obvious reasons people want the FDA acceptance to occur immediately after submission, which was only tentatively scheduled for the end of the month. This is a lot of doom/gloom with little verified reason.
 
There must be a dozen or so devices knocking around at UoM from the clinical trials. Surely they will be sold at a deal to some private audiologists if the device is approved.
 
The software is just one element of the larger picture. The larger picture is we are nowhere near a commercial product.

The company has no employees per LinkedIn. Just founders: CEO - Pearson, CSO (Chief Science Officer) - Dr. Shore and VP - Dr. Martel. Dr. Shore clearly is not spending full time effort with the company, the fact she started the new job at UC Irvine suggests Auricle is not a priority for her (for whatever reason). They only got the 2nd round of funding from the university incubator. I doubt it is in the 10s of millions of dollars which would be required to get the ball rolling. Accelerate Blue Fund only raised a total of $2M by 2021 (see here). They don't even have a webpage. Zero PR/marketing efforts, beyond a couple of articles.

So Dr. Martel tinkering with the old code on GitHub just shows this is not a business that's moving full steam ahead yet. Sorry, no way.

I also add the fact they are not in one physical location does not bode well. Taking a new company off the ground is a LOT of work. I am a big fan of remote work, but if I were starting a new company (and did not have tinnitus and hyperacusis...) I'd definitely would want to be working close with my folks. Dr. Shore is in Irvine, CA, maybe splitting time between there and Ann Arbor, MI. Dr. Martel seems to be in Ann Arbor, and Pearson is located San Francisco. He incorporated the company in California in the fall of last year (the company was registered in Delaware in 2019), indicating that perhaps this will be their primary location. Who knows.

Compare this to the timeline and progression of Neuromod. They have got roughly over 50 million EUR in funding over the years.

I have no doubt Auricle has a superior solution, but the (sad) reality is they are moving slower than we would like, and I don't think it is realistic to expect the product any time soon. A year from now would be too optimistic. Two years? Maybe.
I agree things are moving slowly. But the speculation about the company employees, or Dr. Shore's relocation mean nothing in terms of project delay. If anything, her relocation to UC Irvine indicates the move into the next phase of the process, which would naturally minimize her direct role. I seriously doubt what's been her life's work is no longer a priority for her.

The immediate negative dissection of any news about this is just perplexing. Waiting for some real news instead of making assumptions based on the quality of code, is a much healthier approach. And unfortunately, you're going to have to wait for any real news.
 
As a programmer, I've worked on some of the biggest systems for some of the biggest companies and the code is always messy.

Messy code works. The markup is the last thing I'm worried about. But I would expect them to be making changes as they move towards FDA submission and production.

None of this equates to additional years added to the release date of the product.
I think that once a medical device is submitted to the FDA for approval, any updates to the code is a change and is required to be resubmitted.

Anyone know for sure?
 
I think that once a medical device is submitted to the FDA for approval, any updates to the code is a change and is required to be resubmitted.

Anyone know for sure?
From my understanding, the software is an external tool used to tune the device. It technically has nothing to do with the device itself and probably won't have much impact on the FDA approval. Despite how messy the code looks, we can assume it does what it's supposed to since the trial was successful.
 
I think that once a medical device is submitted to the FDA for approval, any updates to the code is a change and is required to be resubmitted.

Anyone know for sure?
That would not scale. Re-submission is required when "Changes made with intent to significantly affect safety or effectiveness of a device".

(Source)
Good thing @gameover doesn't know anything about Auricle or their timelines. No need to be all doom and gloom about them not having a website, or about them not having people on LinkedIn, lol. Nothing has changed.
True, I don't. But I have some idea about starting a company, what it takes, and how it looks like, and the idea is from an experience in tech industry that did not require any government approvals or even manufacturing.

I will happily eat crow if Auricle delivers a product to a patient within a year, but in my humble opinion, they are far from it.
 
I think that once a medical device is submitted to the FDA for approval, any updates to the code is a change and is required to be resubmitted.

Anyone know for sure?
Not all updates to the code of medical devices require a new FDA submission. The need for re-submission depends on the nature of the update and its impact on device safety and effectiveness. The FDA provides guidelines to help manufacturers determine if a software change necessitates a new submission:

https://www.fda.gov/media/99785/download?attachment

Routine cybersecurity updates may not require re-submission if they don't adversely affect safety or effectiveness. But, from what I understand, anything that changes the core functionality of the device would require a re-submission.

If we assume the TinnTester software on GitHub is the actual software used by Auricle, and seeing that David Martel hasn't made any core changes to the repository in over 3 months, we can assume that they might have submitted already. But again, that's purely speculation.
 
I think that once a medical device is submitted to the FDA for approval, any updates to the code is a change and is required to be resubmitted.

Anyone know for sure?
Depends on severity.

If a major change, it may need re-submission. If it's generally bug fixes and improvements that don't affect the functionality of the device, there's a route of a 30-day submission process to get smaller changes through. This route exists so that companies don't delay potentially critical software updates because they don't want to re-submit.
 
I will happily eat crow if Auricle delivers a product to a patient within a year, but in my humble opinion, they are far from it.
Why would they have a product ready to go in a year? They don't even have FDA approval yet, and it's likely to take up to a year just to obtain that. In the interim they would have to build a massive amount of biz relationships before even conceiving of manufacturing. I get people wanting it to happen as soon as possible, but acting like the device is a failure even if their original schedule for FDA approval gets delayed is just setting yourself up for failure and is honestly probably a sign that some are a bit too invested in this product than warranted.

I'd be happy if the device is available within two years.
 
Why would they have a product ready to go in a year? They don't even have FDA approval yet, and it's likely to take up to a year just to obtain that. In the interim they would have to build a massive amount of biz relationships before even conceiving of manufacturing. I get people wanting it to happen as soon as possible, but acting like the device is a failure even if their original schedule for FDA approval gets delayed is just setting yourself up for failure and is honestly probably a sign that some are a bit too invested in this product than warranted.

I'd be happy if the device is available within two years.
If they're submitting as a 510(k), the FDA tries to have a decision in 90 days, give or take. That can be affected by staffing levels, and if the FDA has questions called "AI requests" or additional info requests back to the submitter. That can add time and is not a sign of anything wrong; it's an accepted part of the process. Then it could be a little longer but it shouldn't be much more than a few months total time. It's very likely that they'll submit as a 510(k). I've already explained this a few times in this thread!
 
If they're submitting as a 510(k), the FDA tries to have a decision in 90 days, give or take. That can be affected by staffing levels, and if the FDA has questions called "AI requests" or additional info requests back to the submitter. That can add time and is not a sign of anything wrong; it's an accepted part of the process. Then it could be a little longer but it shouldn't be much more than a few months total time. It's very likely that they'll submit as a 510(k). I've already explained this a few times in this thread!
And per Gene Parunak from in2being.com, who is very likely (speculation) handling their submission, recent actual approval times for 510(k) is ~140 days.

The speculation is based on the fact they built the trial device and can be seen in photos with Jon Pearson, Auricle CEO. A public photo from LinkedIn is attached. Gene is first from the left, Jon next to him.

I think these two guys may have the key to our better future...

Screenshot 2024-03-06 at 17.40.29.png
 
Maybe @Hazel can reach out for another update from Dr. Shore after some appropriate time period has elapsed since the last one?
This is their stance, from Jon Pearson, CEO of Auricle:
Susan and I have nearly always responded to the many people that have—and continue to—write to us, but it's not appropriate that we continue to do so. In fact, responding to people occasionally backfires when our responses generate additional information requests which then lead to disappointment. For example, one individual writes and insists on 'simply wanting to know if you have, or have not, submitted to FDA,' and is upset that we 'refuse' to answer this 'simple' question.

Here's the problem in providing any kind of 'answer' or guidance: if we answer 'Yes, we have submitted,' then uninformed and inexperienced individuals will immediately reach out on internet communities to begin a process of poorly informed speculation. For example: 'Auricle just confirmed that they have submitted to FDA! Hooray! I just asked my brother's aunt's nephew's wife, who is knowledgeable about FDA things, and she said that the company can expect an answer in 60 days. Isn't that wonderful? That means that there will be an approval by summer!'

Perhaps you can see where this all leads… more disappointment. There are various FDA medical device submissions, and none are slam dunks with guaranteed review cycles that result in automatic clearances. Moreover, post-submission, the FDA often imposes additional requirements or data which the sponsor must respond to—and to the satisfaction of the FDA review team. This back and forth process can be time consuming. As such, it is folly to think that one can forecast or predict the timing window of any FDA clearance. Furthermore, and just as importantly, uninformed and inexperienced laypersons understand 'FDA clearance date' to be equivalent to 'the day that the device will be available at the Walgreen's near me.' Inexperienced laypersons do not realize that regulatory timelines are completely and entirely separate from commercial timelines. In other words, a company may receive a regulatory clearance, but only commercialize the drug or device at a much later date.

I hope that this elaboration is helpful in understanding why we do not and will not provide information concerning either our regulatory or commercialization timelines and plans. We hope that interested people focus on the good news: The Shore Lab spent decades researching a novel tinnitus therapy, concluded two human studies which revealed promising outcomes, and a private company that is the exclusive licensee of the patents pertaining to the therapy has been formed and funded to pursue clearance and commercialization.
Basically, I would not hold my breath. They are working on it, they are doing their best (I sincerely believe so based on my interactions with Jon and Susan), but this can take some time still. We just need to be patient and understanding.
 
If they're submitting as a 510(k), the FDA tries to have a decision in 90 days, give or take. That can be affected by staffing levels, and if the FDA has questions called "AI requests" or additional info requests back to the submitter. That can add time and is not a sign of anything wrong; it's an accepted part of the process. Then it could be a little longer but it shouldn't be much more than a few months total time. It's very likely that they'll submit as a 510(k). I've already explained this a few times in this thread!
This is still at its core an assumption though. Realistically no one knows what they are doing, how they're submitting, nor what hiccups or delays in the process on their end or the FDA's might occur.

Your speculation might even be right IF everything goes great. I'm much more a believer in Murphy's law. I'd much rather be pleasantly surprised than hanging on every guesstimated milestone on the way to production and commercial rollout, as if stressing about it it had any impact on the availability of the device.
 
Realistically it's hard to see how approval will not happen this year, unless there are major unforeseen circumstances. I'm still going for this summer. Wider approval seems years away.

Commercialisation is anyone's guess but I would shoot for next spring.
 
Realistically it's hard to see how approval will not happen this year, unless there are major unforeseen circumstances. I'm still going for this summer. Wider approval seems years away.

Commercialisation is anyone's guess but I would shoot for next spring.
Why would EU approval be years away? The FDA is stricter than the EU usually.
 
Thanks for taking the time to reach out @Markku. Like someone else already mentioned, this group was in need of a reality check. Let's just wait for future updates and try our best to go about our day without thinking about this device.
 
Dr. Shore said in the Q&A that she has no intention of even looking at EU approval until it's established in America.
I would be surprised at that, to be honest. It is one thing saying it, but money talks. And the copycat devices will start to pop up soon.
 

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