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50 Innovative Companies to Watch 2020

OtoNexus eliminates the need for unnecessary antibacterial therapy and provides accurate assessment of otitis media


Ear infection occurs when bacteria or viruses get into the middle ear, the space present behind the eardrum. When a child has an ear infection (also known as otitis media), the middle ear fills with infected fluid (pus). The fluid will push on the eardrum, which can cause immense pain. One of the main sign of middle ear infection is ear pain, but the kids might also have trouble eating, sleeping, chewing, fever, lying down, and sucking due to painful pressure in the middle ear. If the pressure buildup reaches extreme level, then it can rupture the eardrum. A child with a ruptured eardrum might feel nauseated or dizzy, and have buzzing or ringing in the ear.

OtoNexus has created a simple, affordable, hand-held, lightweight, non-invasive tool for the accurate diagnosis of middle ear infections, which provides data in less than two seconds so that clinicians can accurately determine the four disease states of middle ear infections and accurately determine when antibiotics are appropriate. Clinicians want an objective test to determine the presence of bacterial infection vs. a viral infection, so they know when to prescribe antibiotics. A simple and elegant solution, the device applies a well-known medical technology, ultrasound, in a completely novel way to achieve a fundamental advance in the detection of middle ear infections. This is a win-win for patients, clinicians, hospital systems, insurance companies, and government medical agencies. OtoNexus Medical Technologies was founded in 2010, and it is based in Seattle, Washington.

In conversation with Caitlin Cameron, Chair of the Board and CEO of OtoNexus

Q. Signs and symptoms of an ear infection can indicate a number of conditions. How do you manage to get an accurate diagnosis to prompt treatment?

The OtoNexus device uses ultrasound technology to analyze the presence and type of fluid behind the eardrum, along with other diagnostic data. It provides a simple metric to share with patients and parents and communicate the appropriate course of therapy. The character of the fluid behind the eardrum is analyzed to categorize the disease as no infection, primarily viral, primarily bacterial or glue ear.

Q. How do your solutions affect the healthcare costs?

  • Accurate diagnosis by the first care-giver seen
  • Reduce unnecessary antibiotics prescriptions
  • Reduce doctor visit for antibiotic side effects
  • Reduce unnecessary referrals to specialists
  • Reduce surgeries (there are approximately 1 million tympanostomy tube surgeries performed per year in the US)
  • Care can be managed by least-cost provider with increased accuracy

Q. What are the challenges addressed by OtoNexus Medical Technologies?

There is a substantial unmet need for the accurate diagnosis of middle ear infections. Clinical studies show that using current tools results in a 50% error rate, particularly in differentiating viral vs. bacterial infections. The CDC estimates antibiotics are prescribed in ~85% of cases but only appropriate in just 15%-20% of cases. Middle ear infections are the #1 reason for antibiotics and #1 reason for surgery in children. The estimated cost to the US healthcare system is $8-$15B per year. Clinicians need an accurate tool to determine when or when not to prescribe antibiotics. With the OtoNexus device, we help clinicians confidently diagnose Otitis Media by providing quantitative data regarding the type of infection so they may plan and communicate the appropriate therapy.

Q. How does your solution align with the existing medical practice?

When we spoke with pediatricians during our market research, it was clear they needed a tool that fits into their busy schedules. On average, pediatricians may see between 25-30 children per day. With this in mind, we created a device that has a familiar look and feel of the otoscope they use every day and follows exactly their current workflow and processes. The only difference now is they push a button to measure in less than two seconds. With that information, they can determine the four disease states of a middle ear infection – no infection, primarily viral, primarily bacterial and glue ear. Using the OtoNexus device, they obtain quantitative and visual data they can share with the patient and parents to communicate the appropriate treatment, while actually reducing time to diagnosis. This device was designed for primary care providers from the ground up with their input into the development process.

Q. Do you have any new services ready to be launched?

We are finalizing the development and testing of our product and expect to bring this to the market soon after we receive our FDA clearance. Additional models and devices will follow.

Q. What are your trajectories for the next 5 years?

We want to bring the product to market and work with children’s hospitals and professional medical organizations to standardize the use of this device for the evaluation of middle ear infections. In the future, we also plan to integrate machine learning algorithms into this device so it can be simplified even further for home use.

Meet the leader behind the success of OtoNexus

Ms. Cameron is the Chair of the Board and CEO of OtoNexus. She is a highly accomplished senior executive with 30 years’ cross-industry expertise in the life sciences, biotech, technology, and IT industries. She is a specialist in building high-performing start-up companies. OtoNexus is her sixth startup company. Previously, she held Chair and CEO positions at several life sciences and IT companies, building successful businesses and organizations, creating value and maximizing potential in a very short period. In addition, she has built organizations known for employee satisfaction, including being selected for the 100 Best places to work in Washington.

“This inexpensive ultrasound device provides data in seconds and is easy to use by physicians or non-physician personnel worldwide.”