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Dec 21 2023 KFF Health News

Living with diabetes, Carlton "PeeWee" Gautney Jr. relied on a digital device about the size of a deck of playing cards to pump insulin into his bloodstream.

The pump, manufactured by device maker Medtronic, connected plastic tubing to an insulin reservoir, which Gautney set to release doses of the vital hormone over the course of the day. Gautney, a motorcycle enthusiast, worked as a dispatcher with the police department in Opp, Alabama.

The 59-year-old died suddenly on May 17, 2020, because — his family believes — the pump malfunctioned and delivered a fatal overdose of insulin.

"There's a big hole left where he was," said Gautney's daughter, Carla Wiggins, who is suing the manufacturer. "A big part of me is missing."

The wrongful-death lawsuit alleges the pump was "defective and unreasonably dangerous." Medtronic has denied the pump caused Gautney's death and filed a court motion for summary judgment, which is pending.

The pump Gautney depended on was among more than 400,000 Medtronic devices recalled, starting in November 2019, after the company said in a recall notice that damage to a retainer ring on the pump could "lead to an over or under delivery of insulin," which could "be life threatening or may result in death."

As the recall played out, federal regulators discovered that Medtronic had delayed acting — and warning patients of possible hazards with the pumps — despite amassing tens of thousands of complaints about the rings, government records show.

Over the past year, KFF Health News has investigated medical device malfunctions including: Artificial knees manufactured by a Gainesville, Florida, company that remained on the market for more than 15 years despite packaging issues that the company said could have caused more than 140,000 of the implants to wear out prematurely. Metal hip implants that snapped in two inside patients who said in lawsuits that they required urgent surgery. Last-resort heart pumps that FDA records state may have caused or contributed to thousands of patient deaths. And even a dental device, used on patients without FDA review, that lawsuits alleged has caused catastrophic harm to teeth and jawbones. CBS News co-reported and aired TV stories about the hip and dental devices.

The investigation has found that most medical devices, including many implants, are now cleared for sale by the FDA without tests for safety or effectiveness. Instead, manufacturers must simply show they have "substantial equivalence" to a product already in the marketplace — an approval process some experts view as vastly overused and fraught with risks.

"Patients believe they are getting an implant that's been proven safe," said Joshua Sharlin, a former FDA official who now is a consultant and expert witness in drug and medical device regulation. "No, it hasn't," Sharlin said.

And once those devices reach the marketplace, the FDA struggles to track malfunctions, including deaths and injuries — while injured patients face legal barriers trying to hold manufacturers accountable for product defects.

In a statement to KFF Health News, the FDA said it "has a scientifically rigorous process to evaluate the safety and effectiveness of medical devices." 'Too little, too late'

The FDA approved the MiniMed 670G insulin pump on Sept. 28, 2016, after its most stringent safety review, a little-used process known as premarket approval.

In a news release that day, Jeffrey Shuren, who directs the FDA's Center for Devices and Radiological Health, lauded the device as a "first-of-its-kind technology" that would give patients "greater freedom to live their lives" and to monitor and dispense insulin as needed. The pump was tested on 123 patients in a clinical trial over several months with "no serious adverse events," the release said. Shuren declined to be interviewed.

The FDA's enthusiasm didn't last. In November 2019, Medtronic, citing the ring problem, launched an "urgent medical device recall" of the pumps, which it expanded in late 2021.

During an inspection at Medtronic's plant in Northridge, California, FDA officials learned the company had logged more than 74,000 ring complaints between 2016 and the November 2019 recall. More than 800 complaints weren't investigated at all, according to the FDA, which sharply criticized the company in a December 2021 warning letter.

Medtronic is facing more than 60 lawsuits filed by injured patients and their families and the company believes it may be hit with claims for damages from thousands more patients, the company disclosed in an August Securities and Exchange Commission filing.

Medtronic pumps that allegedly dispensed too much, or too little, insulin have been blamed for contributing to at least a dozen patient deaths, according to lawsuits filed since 2019. Some cases have been settled under confidential terms, while others are pending or have been dismissed. Medtronic has denied any responsibility in response to the lawsuits.

In one pending case, a Las Vegas man using the pump allegedly fell into an "insulin-induced coma" that led to his death in 2020. In another 2020 case, a 67-year-old New Jersey resident collapsed at her home, dying later the same day at a local hospital.

The recall notice Medtronic sent to a 43-year-old Missouri man's home arrived a few days after police found him dead on his bedroom floor, his family alleged in a lawsuit filed in August. "Simply too little, too late," the suit reads. The case is pending, and Medtronic has yet to file an answer in court.

Medtronic declined to answer written questions from KFF Health News about the pumps and court cases. In an emailed statement, the company said it replaced pump rings with new ones "redesigned to reduce the risk of damage" and "fulfilled all pump replacement requests at no cost to customers."

In April, Medtronic announced that the FDA had lifted the warning letter a few days after it approved a new version of the MiniMed pump system. Shortcut to market

The 1976 federal law that mandated safety testing for high-risk medical devices also created a far easier — and less costly — pathway to the marketplace. This process, known as a 510(k) clearance, requires manufacturers to show a new device they plan to sell has "substantial equivalence" to one already on the market, even if the prior product has been recalled.

Critics have worried for years that the 510(k)-approval scenario is too industry-friendly to protect patients from harm.

In July 2011, an Institute of Medicine report concluded that 510(k) was "not intended to evaluate the safety and effectiveness of medical devices" and said "a move away from the 510(k) clearance process should occur as soon as reasonably possible."

More than a decade later, that hasn't happened, even amid mounting controversy over the clearance of hundreds of devices that employ artificial intelligence.

The FDA now clears about 3,000 low- to moderate-risk devices every year through 510(k) review, which costs the device maker a standard FDA fee of about $22,000. That compares with about 30 approvals a year through the stricter premarketing requirements, which cost nearly $500,000 per device, according to FDA data. Diana Zuckerman, president of the National Center for Health Research, said even many doctors don't realize devices cleared for sale typically have not undergone clinical trials to establish their safety.

"Doctors are shocked to learn this," she said. "Patients aren't going to know it when their doctors don't."

In response to written questions from KFF Health News, the FDA said it "continues to believe in the merits of the 510(k) program and will continue to work to identify program improvements that strengthen the safety and effectiveness of 510(k) cleared devices." The FDA keeps a tight lid on data showing which devices manufacturers choose to demonstrate substantial equivalence — what the agency refers to as "predicate" devices.

"We can't get detailed data," said Sandra Rothenberg, a researcher at the Rochester Institute of Technology. "It's very hard for researchers to determine the basis on which substantial equivalence is being made and to analyze if there are problems."

Rothenberg cited the history of "metal-on-metal" artificial hip implants, which under 510(k) spawned many new brands — along with a disastrous toll of patient injuries. The implants could release metal particles that damaged bone and led to premature removal and replacement, a painful operation. Just four of these hip devices have been the target of more than 25,000 lawsuits seeking damages, court records show. In early 2016, the FDA issued an order requiring safety testing before approving new metal-on-metal hip devices. Alarm bells

Two former Medtronic sales executives in California argue in a whistleblower lawsuit that the 510(k) process can be abused.

According to the whistleblowers, the FDA approved the Puritan Bennett 980, or PB 980, ventilator in 2014 based on the assertion it was substantially equivalent to the PB 840, an earlier mechanical ventilator long viewed as the workhorse of the industry.

Medtronic's subsidiary company Covidien made its claim even though the device has completely different "guts" and operates using software and other "substantially different" mechanisms, according to the whistleblowers' suit.

In response, Medtronic said it "believes the allegations are without merit and has moved to dismiss the case." The case is pending.

The whistleblowers argue the PB 980 ventilator was plagued by dangerous malfunctions for years before its recall in late 2021.

One ventilator billowed smoke in an intensive care unit while the whistleblowers were told by one hospital that "the wheels for the ventilator cart may actually fall off the ventilator during transport," according to the suit.

Batteries could die without warning, kicking off a scramble to keep patients alive; monitor screens froze up repeatedly or otherwise went on the blink; and, in several cases, alarm bells warning of a patient emergency rang continuously and could be quieted only by unplugging the unit from the wall socket and pulling out its batteries, according to the suit.

The December 2021 recall of the PB 980 cited a "manufacturing assembly error" that the company said may cause the ventilator to become "inoperable."

Medtronic said in an email that the ventilator "has helped thousands of patients around the world," including playing a "critical role in the global response to the COVID-19 pandemic." Late warnings

The FDA operates a massive database, called MAUDE, to alert regulators and the public to emerging device dangers. The FDA requires manufacturers to advise the agency when they learn their device may have caused or contributed to a death or serious injury, or malfunctioned in a way that might recur and cause harm. These reports must be submitted within 30 days unless a special exemption is granted.

But FDA officials acknowledge that many serious adverse events go unreported — just how many is anybody's guess.

Since 2010, the FDA has cited companies more than 5,000 times for not handling, reviewing, or investigating complaints properly, or for not reporting adverse events on time. For instance, the FDA cited an Ohio company that made electric beds and other devices more than 15 times for failing to properly scrutinize complaints or report adverse events, including the death of a patient who allegedly became trapped between a bedrail and mattress, agency records show.

In about 10% of reports, more than a year or two elapsed from when a death or serious injury occurred and when the FDA received the reports, a KFF Health News analysis found. That works out to nearly 60,000 delayed reports a year.

Experts and lawmakers say the FDA needs to find a way to detect safety problems quicker.

Sens. Chuck Grassley (R-Iowa) and Elizabeth Warren (D-Mass.) have tried for years to persuade the agency to add unique device identifiers to Medicare payment claim forms to help track products that fail. In an email statement to KFF Health News, Grassley called that a "commonsense step we can take up front to mitigate risk, improve certainty and save money later." Related StoriesStem cell therapy trial shows promise for regenerative treatment of heart failureFetal hormone GDF15 linked to nausea and vomiting in pregnancyIncreased internet use linked to higher anxiety in teens, research shows

The FDA said it is working to "strike the right balance between assuring safety and fostering device innovation and patient access." Yet it noted: "Additional resources are required to establish a fully functioning active surveillance system for medical devices." For now, injured patients suing device companies often cite the volume of adverse event reports to MAUDE, or FDA citations for failing to report them, to bolster claims that the company knew about product malfunctions but failed to correct them.

In one case, a New York man is suing manufacturer Boston Scientific, claiming injuries from a device called the AMS 800 that is used to treat stress urinary incontinence.

Though Boston Scientific says on its website that 200,000 men have been treated successfully, the lawsuit argues complaints piled up in MAUDE year after year and no action was taken — by the company or by regulators.

The number of complaints filed soared from six in 2016 to 2,753 in 2019, according to the suit. By far, the largest category involved incontinence, the condition the device was supposed to fix, according to the suit. Boston Scientific did not respond to a request for comment. The company has filed a motion to dismiss the case, which is pending.

By the FDA's own count, more than 57,000 of some 74,000 complaints Medtronic received about the MiniMed insulin pump's retainer rings were reported to the agency. The FDA said the complaints "were part of the information that led to the compliance actions." The agency said it "approved design and manufacturing changes to the retainer ring to correct this issue" and "has reviewed information confirming the effectiveness of the modification."

"What is the threshold for the FDA to step in and do something?" said Mara Schwartz, who is a nurse, diabetes educator, and pump user. "How many deaths or adverse events does there have to be?"

In 2020, she sued Medtronic, alleging she suffered seizures when the pump mistakenly delivered an overdose of insulin. Medtronic denied her claims, and the case has since been settled under confidential terms.

Private eyes

Some countries don't trust the device industry to play such a key role in oversight.

Australia and about a dozen other nations maintain registries that measure the performance of medical devices against competitors, with an eye toward not paying for care for a substandard device.

That's not likely to happen in the United States, where no device or drug manufacturer must demonstrate its new product is better than what's already for sale.

Product liability lawsuits in the U.S. often cite troubling findings from overseas. For instance, registries in Australia and other countries pinpointed durability problems with the Optetrak knee implants manufactured by Florida device company Exactech years before a major recall. Exactech has declined comment.

The Australian surveillance network also detected deficiencies with the Medtronic PB 980 ventilator, prompting the country's health authority to suspend its use for six months until Medtronic completed training for health care workers and took other steps to improve it, court records show. Medtronic told KFF Health News that it had "worked closely" with the Australian group to resolve the problems. "We take patient safety very seriously and have processes to identify quality issues and determine appropriate actions," Medtronic said.

Registries have gained some traction in America. But so far, they typically have been controlled, and sometimes funded, by industry and medical specialty groups that share their findings only with doctors.

One private registry managed by the Society of Thoracic Surgeons, called Intermacs, tracks death and injury rates at 180 hospitals in the United States certified to implant a mechanical heart pump known as an LVAD. Some patients might find that information helpful, but it's not available to them. 'Exciting features'

While the FDA clears thousands of devices for use based on the "substantial equivalence" premise, manufacturers often tout "new and exciting features" in their advertising and other marketing, said Alexander Everhart, a researcher at the Washington University School of Medicine in St. Louis.

These marketing campaigns have long been controversial, especially when they rely partly on wining and dining surgeons and other medical professionals to gain new business, or when surgeons have financial ties to manufacturers whose products they use. Orthopedic device makers have funneled billions of dollars to surgeons, including fees for consulting, doing medical research, or royalties for their role in fine-tuning surgical tools and techniques, even promoting the products to their peers.

Marketing campaigns directed at prospective patients may receive little scrutiny. The FDA has "limited resources to actively monitor the volume of direct-to-consumer advertising," according to a Government Accountability Office report issued in September. From 2018 to 2022, the FDA took 255 enforcement actions involving advertising claims made for devices, according to the GAO report. Legal barriers

While manufacturers can advertise devices directly to patients, courts may not hold them accountable for communicating possible risks to patients.

Consider the case of Richard Greisberg, a retired electronics business owner in New Jersey. He sued Boston Scientific in 2019, years after having a Greenfield vena cava filter implanted. The device is intended to prevent blood clots that develop in the lower body from traveling into the lungs, which can be deadly.

Greisberg argued that the device had migrated in his body, causing pain and other symptoms and damage that took years to identify. Representing himself in court, he tried to argue that nobody had told him that could happen and that if they had done so he wouldn't have agreed to the procedure.

He lost when the judge cited a legal doctrine called "learned intermediary." The doctrine, which is recognized in many states, holds that manufacturers must warn only physicians, who are presumed to have the knowledge to understand a medical device's risks and relay them to patients.

The court ruled that a 27-page manual the manufacturer sent to the physician who implanted it, which included details about possible risks, was adequate and tossed the case.

Greisberg, 81, felt sucker-punched. "They never gave me any warning about what could happen down the road," he said in an interview. "I never had a chance to have my day in court."

The family of PeeWee Gautney also faces challenges pursuing the insulin pump lawsuit.

Gautney died in a motel room in Destin, Florida, a day after riding his Harley-Davidson to the Panhandle beach town on a weekend jaunt. The MiniMed pump was still strapped to his body, according to a police report.

Medtronic had sent Gautney a form letter in late March 2020, less than two months before he died, advising him to make sure the ring was locking in place correctly. A week later, he wrote back, telling the company: "It's fine right now," court records show.

Wiggins, 33, his daughter, who is also a neonatal respiratory therapist, said she believes a crack in the retainer ring caused it to release too much insulin, which her dad may not have recognized.

"It should never be put on the patient to determine if there is a problem," Wiggins said.

Medtronic has denied the pump failed and caused Gautney's death. The FDA approved the device knowing patients faced the risk of it administering wrong doses, but believed the benefits outweighed these risks, Medtronic argued in a motion for summary judgment in September. The motion is pending.

Medtronic also cited a legal doctrine holding that Congress granted the FDA sole oversight authority over devices receiving premarket approval, which preempts any product defect claims brought under state laws. Manufacturers have drawn on the preemption defense to sidestep liability for patient injuries, and often win dismissal, though federal courts are split in applying the doctrine.

Wiggins hopes to beat those odds, arguing that the December 2021 FDA warning letter reveals that Medtronic violated safety and manufacturing standards.

Her lawyer, Scott Murphy, said that insulin pumps are "really wonderful" devices for people with diabetes when they work right. He argues that the FDA records confirm that Medtronic significantly downplayed its pump's hazards.

"The risks get minimized and the benefits exaggerated," he said.

This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism. Source:

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From health to depth to the entire offense: One thing that must change for all 30 MLB teams

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May 5, 2025

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From health to depth to the entire offense: One thing that must change for all 30 MLB teams

  • Bradford DoolittleMay 5, 2025, 07:00 AM ET

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      • MLB writer and analyst for ESPN.com
      • Former NBA writer and analyst for ESPN.com
      • Been with ESPN since 2013

Something has to change.

Of course, much has already changed since we last convened with our final preseason projections. But for each MLB team, playing five weeks of a new season will inevitably expose additional shifts that are needed. Every team, no matter how splendid or how dreadful the start, has something.

One thing the forecasts suggested that has borne out so far is the relative levels of stratification between the leagues. The National League, led by the champion Dodgers, looked top-heavy, and while not all of the teams we thought would make up that elite tier are a perfect match with the forecasts, the overall dynamic is very much one of dominance. Meanwhile, the American League figured to be a whole bunch of teams in spitting distance of break even, with little separation among the top 12-13 teams in the circuit.

How will these dynamics hold up until we Stock Watch again in June?

Each team’s ability, or lack thereof, to make the following changes might determine that.

Win average: 104.5 (Last: 102.4, 1st)
In the playoffs: 98.8% (Last: 97.7%)
Champions: 28.5% (Last: 28.4%)

What must change: Rotation health

There were actually some bumpy moments in the early weeks of the season for the Dodgers but nothing has happened to really knock them out of the favorite’s perch as we think ahead to late October. One thing that could change that is L.A.’s ever-growing injured list, especially its collection of 60-day IL assignments. For all the depth the Dodgers seemed to build up in their rotation over the winter, they’ve still gone with two bullpen games already. And this doesn’t even include Shohei Ohtani, who’s still building up so he can take his turns in the rotation. Given their recent history of starter injuries … maybe he shouldn’t? Including the two openers, the Dodgers have already had 10 different pitchers start games.

Win average: 96.0 (Last: 90.2, 3rd)
In the playoffs: 88.6% (Last: 73.5%)
Champions: 10.5% (Last: 6.0%)

What must change: Middle relief instability

There hasn’t been much to complain about with the Mets. Though New York hasn’t overtaken the Dodgers in the simulations from a going-forward perspective, the Mets have probably been the better team to this point. The Dodgers have the better winning percentage, but the Mets’ Pythagorean pace (109.7) is the National League’s best. With not much to nitpick about, the relief contingent in front of Edwin Diaz needs to coalesce a little more. Ryne Stanek has the pen’s second-highest average leverage index but has struggled, and the two top lefties (A.J. Minter and Danny Young) have already been lost to injury. Still, if this is a team’s biggest worry at the beginning of May, it’s in a good place.

Win average: 95.8 (Last: 84.3, 13th)
In the playoffs: 92.7% (Last: 51.2%)
Champions: 7.8% (Last: 1.5%)

What must change: Ninth-inning drama

The Cubs have mostly bludgeoned their opposition so far with a breakout offense that ranks among baseball’s best in pretty much every major category. Assuming Chicago won’t average over six runs per game all season, eventually its thin bullpen is going to move into the spotlight. The Cubs have blown seven of their first 15 save opportunities. Closer Ryan Pressly has managed to white-knuckle his way through most of his outings but has struck out fewer than four batters per nine innings, with more walks than K’s. Overall, Chicago’s relievers rank 28th in swing-and-miss percentage, underscoring the general lack of dominance in that unit. The Cubs have been strong in every other facet but for them to establish themselves as a true front-runner, the relief leaks will need to be shored up.

Win average: 93.7 (Last: 83.0, 16th)
In the playoffs: 91.7% (Last: 41.2%)
Champions: 10.1% (Last: 1.8%)

What must change: Shortstop play

You hate to pick on Trey Sweeney, who accounts for most of Detroit’s starts at shortstop, but there just aren’t many shortcomings for the Tigers so far. No team has improved its forecast more since the start of the season. Detroit is now landing a No. 1 playoff seed more often than any other AL team in the simulations, though the Yankees’ pennant odds are still a tick better because of a higher baseline. (New York has a lower regular-season win forecast because of schedule differences.) Sweeney hasn’t hit (.234/.317/.355)* and the Tigers’ shortstop defensive rating, per FanGraphs, ranks 20th. It’s the most obvious blemish on what is shaping up as a pristine season in Detroit.

* These numbers were .202/.282/.303 entering Sunday, but Sweeney must have had spies watching over my shoulder. Against the Angels, he went 4-for-5 with a homer and six RBIs. That’s more like it.

Win average: 92.9 (Last: 84.5, 12th)
In the playoffs: 76.9% (Last: 44.4%)
Champions: 4.0% (Last: 1.8%)

What must change: Lineup depth

The Padres are off to a great start, largely on the strength of a bullpen that has been off the charts. The relievers have racked up 14 saves (they’ve blown only one) and 27 holds while compiling a collective 1.73 ERA. Those numbers are both unbelievable and unsustainable. When some regression sets in, a top-heavy lineup will need to get production from spots like catcher (21st in OPS) and left field (27th) to offset the difference. We kind of knew this was how the Padres were constructed, but still — San Diego has given too many plate appearances to too many players in what we’ll call the post-productive phases of their careers.

Win average: 91.4 (Last: 84.3, 13th)
In the playoffs: 85.4% (Last: 46.8%)
Champions: 8.1% (Last: 2.5%)

What must change: First base production

Generally speaking, the more specific the issue we choose to worry about, the better off the team. For Seattle, the primary concern the past couple of years has been more wide-lens than specific: offense. For now, that problem has apparently been largely solved. The Mariners’ offense has been one of the hottest in baseball and over the past couple of weeks, with its hitters even managing to mash at T-Mobile Park. So rather than worrying about the offense, writ large, we can point out that at first base, the Rowdy Tellez–Donovan Solano combo is mostly responsible for Seattle’s .518 OPS (tied for 29th in MLB) at the position. This projected to be a major hole before the season, so the chances of self-correction are limited. Now, the stakes are higher to shore up the weak spots, since the Mariners have emerged as the early front-runner to win the AL West.

Win average: 90.8 (Last: 88.7, 5th)
In the playoffs: 84.5% (Last: 68.3%)
Champions: 9.3% (Last: 6.5%)

What must change: Rotation depth chart

For a first-place team, there is plenty to worry about when it comes to the Yankees. They’ve had the best position player (Aaron Judge, by far) and arguably the best pitcher (Max Fried) in baseball. The relief staff has dealt with the struggles of demoted closer Devin Williams, but the bullpen still ranks sixth in relief ERA and with only 14% of inherited runners scoring. But the rotation has been below average (4.07 ERA and only eight quality starts) despite Fried’s great beginning. Even worse, with Gerrit Cole out for the season and Luis Gil and Marcus Stroman currently on the shelf, it’s not immediately clear how this is going to get better. This issue might really start to mushroom if and when Fried regresses from his hot start.

Win average: 90.3 (Last: 89.2, 4th)
In the playoffs: 66.2% (Last: 68.9%)
Champions: 4.1% (Last: 4.8%)

What must change: Slumping stalwarts

The Phillies’ roster was constructed on star power, not depth, and while that has worked well enough the past few years, they need the stars to produce. The “it’s still early” caveat applies, but so far, Bryce Harper hasn’t hit like Bryce Harper, Alec Bohm‘s production has gone missing, Aaron Nola just earned his first win but remains under league average (91 ERA+) and key bullpen acquisition Jordan Romano has gotten shelled. If the Phillies don’t want to lose sight of the front-running Mets in the NL East race, they’ll need their main cogs to start firing.

Win average: 89.7 (Last: 79.9, 20th)
In the playoffs: 59.7% (Last: 24.6%)
Champions: 2.5% (Last: 0.6%)

What must change: Team batting average

The Giants have inserted themselves into a top-heavy NL postseason chase that they didn’t figure to be a part of when the season began. The pitching and defense has been stellar, but the offense hasn’t kept up. San Francisco ranks eighth in walks percentage but 24th in batting average. That can work in a take-and-rake general approach to offense, but the Giants are only middle of the pack in homers. Since they aren’t very athletic and rarely steal bases, this leads to uneven production. The Giants can hang in contention with a league-level batting average, but they simply don’t hit enough homers to do so if they continue to hover around .230. That puts the onus on low-average hitters such as Matt Chapman (.198), LaMonte Wade Jr. (.141, ouch) and Willy Adames (.230 and now four homers after hitting two on Sunday) to up the ante.

Win average: 87.1 (Last: 87.1, 8th)
In the playoffs: 44.2% (Last: 58.4%)
Champions: 1.7% (Last: 3.0%)

What must change: Bullpen health

In what’s shaping up as a historically good NL West (save for the Rockies), little problems can quickly become big ones. For the Diamondbacks, a shiny start has lost its luster a bit as they have battled bullpen problems in both the performance and health categories. The unit scuffled badly during a 5-9 stretch, posting a 5.61 collective ERA while blowing six of 10 save opportunities. Closer A.J. Puk (elbow) is on the 60-day IL and Justin Martinez (shoulder) hit the 15-day IL after two concerning outings with diminished velocity. Both are expected to help later this season but for that to matter, the likes of Kevin Ginkel, Shelby Miller and Ryan Thompson need to step up in high-leverage spots.

Win average: 86.8(Last: 88.7, 5th)
In the playoffs: 66.6% (Last: 68.7%)
Champions: 3.7% (Last: 5.4%)

What must change: Homer count

It has been a mixed bag for the Astros. Hunter Brown has been one of the game’s best pitchers and Josh Hader is having a vintage season at the back of the bullpen. The relief staff, in general, has been strong. But the lineup has been below average with a lack of power at the root of the issue. No Astro has homered more than four times and Houston ranks 21st in home run and overall slugging percentage. It’s an issue up and down the lineup but things would look a lot more promising if Christian Walker and Yordan Alvarez were going deep at their usual rates.

Win average: 86.7 (Last: 96.5, 2nd)
In the playoffs: 43.5% (Last: 91.1%)
Champions: 2.2% (Last: 14.4%)

What must change: IL roster

An 0-7 start threatened to sink the Braves’ season before it began. They recovered — nearly climbing to .500 at one point — but they have a lot of work to do. Hopes that the Braves can still reach their ceiling hinge on the longed-for returns of Spencer Strider and Ronald Acuña Jr. In the meantime, they need underperforming stalwarts such as Matt Olson, Michael Harris II, Chris Sale and Raisel Iglesias to hit their stride. Atlanta can’t keep plodding along under .500 in this year’s NL while waiting for its stars to get healthy, but if the Braves can stay above water until then, they might be able to really take off. Considering what we’ve seen so far, the fact that they won’t see the Dodgers again during the regular season certainly helps.

Win average: 83.6 (Last: 84.6, 11th)
In the playoffs: 47.4% (Last: 48.8%)
Champions: 1.3% (Last: 2.3%)

What must change: Outfield production

The Royals’ offense, in general, has been missing, with only Bobby Witt Jr. producing all season. But the outfield ranks 29th in bWAR as a group — the continuation of a problem that hovered over the roster last season. MJ Melendez was sent to the minors to find himself. His initial results in Omaha suggest he’ll be searching for some time. Hunter Renfroe has produced less than a good-hitting pitcher. Mark Canha has helped in a big role and Drew Waters has had some nice moments. But the Royals need some stable offense from the corner outfielders, making this a must-get as the trade deadline starts to loom.

Win average: 82.9 (Last: 77.7, 22nd)
In the playoffs: 40.9% (Last: 19.0%)
Champions: 0.9% (Last: 0.5%)

What must change: Emmanuel Clase

You figured the Guardians’ bullpen would fall off a bit after last season’s off-the-charts showing. That has happened even though set-up relievers Cade Smith and Hunter Gaddis have been every bit as good as they were in 2024. No, the problem has been a mystifying start by Clase, who has already given up more runs (11) than he did all of last season (10). He already has won four games, matching a career high, but of course that’s not necessarily a good sign for a closer. Clase’s dominance was the biggest differentiator on last year’s team. The 2025 squad, which has been outscored by 23 runs despite a 20-14 record, needs him to approximate that performance.

Win average: 82.8 (Last: 84.1, 15th)
In the playoffs: 43.6% (Last: 45.6%)
Champions: 1.8% (Last: 2.5%)

What must change: Bullpen depth

Despite an elite offense, the Red Sox have hovered around .500 because of a thin bullpen. The relievers have blown as many saves (eight) as they’ve converted and only one team has seen a higher rate of inherited runners score. Closer Aroldis Chapman has been fine, but he hasn’t had enough situational help. Boston ranks in the middle of the pack with a 4.11 relief ERA and its 10 holds are tied for the fewest of any bullpen. The rotation has been solid, but it’ll need more support to remain that way.

Win average: 81.9 (Last: 87.1, 8th)
In the playoffs: 38.1% (Last: 61.0%)
Champions: 1.1% (Last: 5.2%)

What must change: The offense

Even after an eight-run outburst against the division-leading Mariners on Sunday, Texas ranks 29th in run scoring. Only the Rockies have scored fewer. It’s a stunning turnaround for an offense that kept scoreboards spinning in 2023 on the way to a World Series title. Last year’s falloff was steep, and based on what we’ve seen so far, hopes for positive regression are fading. Adolis Garcia is having another down season. Marcus Semien is below replacement. And the key additions from the winter — Joc Pederson and Jake Burger — have hurt more than they’ve helped. Pederson is hitting a remarkable .094 with a .334 OPS, and Burger (.561) was sent to the minors. Not good. The Rangers’ brass has taken note: Offensive coordinator Donnie Ecker, who was with the club during its 2023 run, was fired after Sunday’s game.

Win average: 79.5 (Last: 85.1, 10th)
In the playoffs: 25.7% (Last: 52.4%)
Champions: 0.7% (Last: 2.7%)

What must change: Carlos Correa

For once, we don’t have to cite the availability of the Twins’ stars as their primary problem. That’s still an issue, too, as Royce Lewis has yet to make his season debut — but the larger problem has been the star who has stayed on the field, Correa, is off to a miserable start. He’s hitting .216 with a lone homer and a .560 OPS to begin the season, hamstringing a Twins lineup that has struggled. Everything is off, even Correa’s plate discipline, as he has walked at a rate less than half his career norm. The Twins need more to turn around than just Correa, but no one else on the roster has fallen as far below expectation as he has.

Win average: 79.4 (Last: 82.9, 17th)
In the playoffs: 25.0% (Last: 39.2%)
Champions: 0.6% (Last: 1.6%)

What must change: Powerless stars

After the formerly punchless Royals hammered seven homers in Baltimore on Sunday, the Blue Jays sank to last in the majors with 23 homers. The power trio of Vladimir Guerrero Jr., Anthony Santander and Bo Bichette have hit nine of those dingers between them — and that’s just not enough. Guerrero will be fine. Bichette has recovered most of the batting average he lost during last year’s .225 season, but he has homered only once. This is a player in his age-27 season who topped 20 homers in each season from 2021 to 2023. Finally, Santander has flailed during his first Toronto season, hitting four homers with a 67 OPS+. This can’t continue if the Jays are to contend.

Win average: 79.1 (Last: 79.9, 20th)
In the playoffs: 11.4% (Last: 28.9%)
Champions: 0.1% (Last: 0.5%)

What must change: The pitching

The Brewers are built to win on pitching and defense. Every year, they overperform their projections because of an organizational ability to find, or produce, quality pitchers. But so far, they just haven’t found enough of them in 2025. The overall run prevention has been off. In the first season after Willy Adames’ departure, the team defense has been more decent than elite. The rotation has received good work from Freddy Peralta, Jose Quintana and upstart Chad Patrick, but the falloff after that has been steep. Brandon Woodruff might return to the mix soon and that will certainly help. More troubling is Milwaukee’s normally airtight relief staff, which has struggled to finish games and strand inherited runners.

This all needs to turn around — and fast. With the Cubs emerging as a potential powerhouse in the NL Central, being an above-average team is no longer the bar to clear in the division. And it’s unlikely the Central’s second-place club is going to have a chance at a wild-card slot — not in this league.

Win average: 78.8 (Last: 80.3, 19th)
In the playoffs: 22.3% (Last: 27.1%)
Champions: 0.5% (Last: 0.8%)

What must change: Home-field disadvantage

No matter what happened, this was going to be a strange season for the Rays. Playing in a minor league facility owned by a division rival was going to take some getting used to. The problem for the Rays is that they need to get used to it quickly, because of a schedule heavy on early home games. When the Rays depart for a six-game trip on June 8, they will have played nearly twice as many games in Tampa (43) as on the road (22). That means, of course, that the Rays will have a road-heavy schedule after that, which would be fine if the Rays were playing well at George M. Steinbrenner Field — but they aren’t. When the Rays return to Florida on Tuesday, they’ll be 9-13 at their temporary venue. With a lot more games in Tampa coming up, it’s an issue they need to fix fast. If they don’t, they’ll be looking at an uphill battle for playoff contention, and most of those hills will be confronted away from home.

Win average: 78.8 (Last: 75.9, 23rd)
In the playoffs: 10.6% (Last: 14.6%)
Champions: 0.2% (Last: 0.2%)

What must change: Lead protection

The Reds might be good. The pitching staff (122 ERA+) ranks third in the NL. The rotation and the bullpen have contributed even though presumed closer Alexis Diaz floundered so badly that he was sent to the minors. Emilio Pagan has been OK in Diaz’s place, but he’s better suited for set-up work. Diaz’s trouble started last season, so it’s hard to say where his trajectory is headed. Recently recalled Luis Mey has electric stuff, but he’s unproven and prone to lapses of command. However it happens, manager Terry Francona needs someone to step up to lock down the ninth because the overall pitching is contention-worthy. The lineup … well, it’s another reason why the Reds can’t afford back-of-the-bullpen inconsistency.

Win average: 77.5 (Last: 73.5, 26th)
In the playoffs: 16.1% (Last: 8.4%)
Champions: 0.2% (Last: 0.1%)

What must change: The defense

This is shaping up as an exciting first season in Sacramento for the Athletics. The offense has been productive and looks legit, especially if rookie Nick Kurtz hits the ground running. The pitching is going to be more of a scramble, but what would help if the Athletics could field. They rank last or second to last in the leading defensive metrics. Only the Red Sox have committed more errors. Some teams can overwhelm opponents by favoring offense over defense at most positions, but the Athletics aren’t likely to be one of them. Key spots to shore up are second base and third base, positions that aren’t producing at the plate, either, so at the very least the Athletics could favor a glove.

Win average: 76.8 (Last: 81.0, 18th)
In the playoffs: 6.4% (Last: 33.9%)
Champions: 0.1% (Last: 0.7%)

What must change: Ryan Helsley

The Cardinals are perfectly mediocre, owning a run differential that has hovered around break even. Their record is a little worse than the expectation the so-so differential portends, largely because of a 4-5 record in one-run games — two of those coming in Sunday’s doubleheader against the Mets. This is not exclusively because of Helsley, but he has not been on his game so far with two blown saves in seven chances and walking nearly as many batters as he has struck out. The strikeout and walk rates are alarming, as they reflect what Helsley was early in his career before he ascended to All-Star status. If the mediocre Cardinals are going to do better than middling, they need their star closer to help them close out more than their share of close games. The kicker, though, is that if the Cardinals go into offload mode, this version of Helsley isn’t going to look nearly as alluring in the trade marketplace.

Win average: 75.7 (Last: 88.0, 7th)
In the playoffs: 11.7% (Last: 64.7%)
Champions: 0.2% (Last: 5.9%)

What must change: Right-handed hitting

No team has lost more from its preseason projection than Baltimore, so it’s very difficult to boil it down to one big thing. The problem with right-handed hitting could also be framed as a problem with hitting left-handed pitchers. The Orioles rank fifth with a .774 OPS against righties but are dead last against lefties (an anemic .502). Their righty hitters (Tyler O’Neill, Jordan Westburg, Gary Sanchez, et al.) are hitting a collective .200/.261/.319. This of course comes after the Orioles moved in the left-field fence at Camden Yards over the winter. How’s that going? Opposing righty hitters have a .972 OPS there, while their Baltimore counterparts are at .586. The visitors have outhomered Baltimore’s righty swingers 20-8 at Oriole Park.

Win average: 70.5 (Last: 67.7, 27th)
In the playoffs: 0.9% (Last: 1.9%)
Champions: 0.0% (Last: 0.0%)

What must change: Dylan Crews

The Nationals are competitive already and often fun to watch. Actual contention seems like a longshot, though, especially given the current state of their bullpen. Still, the more long-term questions the Nationals can answer in the affirmative, the better they will be able to set themselves up for a real push in 2026. At some point, infield prospect Brady House should join the big league fray. Until that happens, eyeballs remain on Crews, the touted second-year player whose MLB career has sputtered at the beginning. Crews looked lost early, going 5-for-47 with zero extra-base hits to start. Then came a two-week splurge with four homers and a 1.026 OPS over 13 outings. He’s 1-for-21 since. More than anything, Crews needs to get off the roller coaster and enjoy a nice, prolonged run of good, solid consistency.

Win average: 66.8 (Last: 73.8, 25th)
In the playoffs: 0.9% (Last: 8.9%)
Champions: 0.0% (Last: 0.1%)

What must change: Roster make-up

What do I mean by “roster make-up”? Remember the glory days of April 12, when L.A. was 9-5 and it seemed its floor-raising project from the winter was going to work? Since then, the Angels have a minus-65 run differential, 14 runs worse than any other team and, yes, that includes the Rockies. And also, Mike Trout is back on the injured list. The Angels are in the bottom five in OPS, ERA and defensive runs saved. This incidentally isn’t a tanking team. So how to change the roster makeup? Maybe just go young and lose big? The losing might happen anyway and, besides, what the Angels are doing now is not working.

Win average: 66.0 (Last: 74.2, 24th)
In the playoffs: 0.2% (Last: 10.4%)
Champions: 0.0% (Last: 0.1%)

What must change: Oneil Cruz‘s defense

According to baseball-reference.com, Cruz’s offense has been nine runs better than average, once you combine his hitting (.243/.377/.505 with eight homers) and baserunning (14 steals). His defensive performance in center field is minus-9 runs, erasing all of that offensive value. His bWAR (0.5) is a product of accounting — positional value and replacement value. Cruz is now minus-12 in fielding runs over the past two seasons in center. His career figure at shortstop was minus-9. Given his speed and arm strength, wherever Cruz plays, this cannot continue to happen. For all that athletic ability and offensive output, to this point he’d have produced almost as much value as a DH.

Win average: 63.6 (Last: 62.9, 28th)
In the playoffs: 0.1% (Last: 0.4%)
Champions: 0.0% (Last: 0.0%)

What must change: Sandy Alcantara‘s command

It’s great to have Alcantara back after Tommy John surgery. But so far, he has been a little tough to watch. It’s often said that command lags behind stuff for many surgery returnees, and that certainly seems to be the case for the 2022 NL Cy Young winner. His walk ratio (5.9 per nine innings) is more than double his career norm and his strikeout rate (15.8%) is the lowest of his career. Alcantara threw strikes nearly 69% of the time during the three years before he was injured; this season he’s at 62%. His velocity isn’t quite all the way back either, but he’s still averaging 97.4 mph with his fastball. He’s just not putting it where it needs to be.

Win average: 54.9 (Last: 54.1, 30th)
In the playoffs: 0.0% (Last: 0.0%)
Champions: 0.0% (Last: 0.0%)

What must change: Fan patience

To paraphrase Timothée Chalamet, now ain’t the time for your tears, Sox fans. That was last year. The White Sox are the team nearest to me — less than two miles from my keyboard — so I get a good sampling of fan feedback as I get out and about, plus plenty from the local media. This isn’t a scientifically-informed observation, but it feels as if many are missing the point. The White Sox tore the team down to the studs — last year — and this is the aftermath. The bounce-back was never going to be immediate. This year’s team stinks, sure, but it’s playing a much better brand of baseball than it did last year. There are players on the roster now who might be around for awhile and more are on the way. The rebuild isn’t even 20% complete and another 100-plus losses is a near certainty, but things are better. They had to be. Watching a team come together required patience, but it’s better than what White Sox fans dealt with a year ago.

Win average: 44.6 (Last: 57.1, 29th)
In the playoffs: 0.0% (Last: 0.1%)
Champions: 0.0% (Last: 0.0%)

What must change: Everything

The Rockies’ saves leader (Zach Agnos with two) has struck out one of the 26 batters he has faced. Their wins leader (Chase Dollander, a legitimately exciting prospect) has a 6.48 ERA. The team OPS+ is 62. Their leader in plate appearances (Ryan McMahon with 136) has an OPS of .574. Did the Rockies tear down? If so, how long have they been rebuilding? It’s really hard to make sense of the last half-decade or so of this franchise, and at this point, there seems to be no relief on the horizon. They did change hitting coaches.

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Technology

From ‘Cockroach Award’ to the Big Board: Hinge Health’s unlikely path to IPO

Published

56 mins ago

on

May 5, 2025

By

From 'Cockroach Award' to the Big Board: Hinge Health's unlikely path to IPO

Hinge Health co-founders Gabriel Mecklenburg (left) and Daniel Perez (right).

Courtesy of Hinge Health

At digital physical therapy startup Hinge Health, CEO Daniel Perez used to recognize hard-working employees with the “Cockroach Award,” a distinction that brought with it a “cockroach squad” t-shirt and a cash payout.

References to the insect were abundant at the company’s old headquarters in London, where a picture of a cockroach was prominently displayed on the wall. For much of Hinge’s 10-year history, the cockroach was the unofficial mascot. Staffers named it Flossy after the viral dance move “the floss.”

Perez relishes the symbolism. In his determination to build a company that will push through adversity, he’s encouraged employees to think of themselves like cockroaches, due to the creature’s grimy resilience and noted ability to survive harsh conditions.

“It was the identity of every individual in the company,” said Joshua Sturm, a vice president at Hinge from 2019 to 2024 and now chief revenue officer at cancer prevention startup Color Health. “We are all in this together, and no matter what happens, we are going to survive together.”

Perez and his 1,400-person workforce now face the ultimate test of their mettle. Hinge, which moved from London to San Francisco in 2017, is trying to go public at a time of such extreme economic uncertainty and market volatility that several companies, including online lender Klarna and ticket marketplace StubHub, have delayed their long-awaited IPOs.

Hinge filed its prospectus on March 10, announcing plans to trade on the New York Stock Exchange under the ticker symbol “HNGE.” Three weeks later, President Donald Trump announced a sweeping tariff policy that plunged U.S. markets into turmoil after tariff concerns had already pushed the Nasdaq to its worst quarter since 2022.

But Hinge. led by its 39-year old co-founder and CEO, appears determined to power through the chaos. Hinge declined to comment or make Perez available for an interview. 

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Going public was already going to be a risky endeavor for Hinge. The IPO market has been mostly dormant since late 2021, when soaring inflation and rising interest rates pushed investors out of risky assets. Within digital health, it’s been almost completely dead.

Health-tech companies have struggled to adapt to a more muted growth environment following the Covid pandemic, and many once promising business models haven’t panned out as planned.

The starkest example is virtual health company Teladoc, which has a market cap of just over $1 billion less than five years after buying digital health provider Livongo in a deal that valued the combined companies at $37 billion. Teladoc’s BetterHelp mental health unit has been a particularly troublesome business as paying users dropped off in the years following the pandemic.

Over time, Hinge’s Cockroach Award transitioned from a monthly prize to a quarterly distinction. The company phased it out entirely about a year ago in preparation for its next public-facing chapter, but the survive-at-all-costs mentality persists, according to current employees. Now, staffers are recognized with the “Movers Awards,” a nod to the company’s focus on movement.

“We have many decades of work ahead,” Perez wrote in a letter to investors in March. “We hope you join us on this journey.”

CNBC spoke to 13 current and former Hinge employees, investors, and people close to Perez for this story, some of whom asked not to be named in order to provide candid commentary.

‘I gave him terrible advice’

Hinge uses software to help patients treat acute musculoskeletal injuries, chronic pain and carry out post-surgery rehabilitation remotely. Large employers like Target and Morgan Stanley cover the costs so their employees can access Hinge’s app-based virtual physical therapy, as well as its wearable electrical nerve stimulation device called Enso. 

The company says its technology can help users manage pain, cut down health-care costs and reduce the need for surgery and opioids. Revenue increased 33% to $390.4 million last year, while its net loss narrowed to $11.9 million from $108.1 million a year earlier, according to the prospectus.

Hinge’s roster of clients expanded by 36% last year to 2,256, and the number of individual members jumped 44% to over 532,300, the filing said.

Hinge has raised more than $1 billion from investors including Tiger Global Management and Coatue Management, and it boasted a $6.2 billion valuation as of October 2021, the last time the company raised outside funding. The biggest institutional shareholders are venture firms Insight Partners and Atomico, which own 19% and 15% of the stock, respectively, according to the filing.

Daniel Perez, CEO of Hinge Health

Courtesy: Hinge Health

Perez and Gabriel Mecklenburg, Hinge’s executive chairman, started the company in 2014. The pair met while they were both pursuing PhDs in the U.K. — Perez at the University of Oxford and Mecklenburg at Imperial College London. They were distracted students, according to Perez’s twin brother, David. 

By the time they launched Hinge, Perez and Mecklenburg had already co-founded two other ventures together. One was the Oxbridge Biotech Roundtable, an organization that connected academics and industry experts. The other was Marblar, which worked to commercialize academic intellectual property.

Perez took a leave of absence from Oxford while working on Marblar and never returned. His brother wasn’t a fan of the decision initially.

“I gave him terrible advice,” said David Perez, a graduate of Yale Law School and partner at Perkins Coie in Seattle. “I was like, ‘I think you’re an idiot, I think you should focus on your PhD. Only an idiot would not finish a PhD at Oxford.'” 

The twins have two older siblings. Their mother immigrated from Cuba in 1968, followed 12 years later by their father. Their parents met in Miami, got married after just three dates, and are still together after more than 40 years. 

The family moved from Miami to Salt Lake City, Utah, in 1990. Perez’s mother was a substitute teacher and his father worked at restaurants as a dishwasher and busboy. David Perez said their father “worked around the clock” and used to call out orders in his sleep. 

“It wasn’t a lot of money, I think combined they made about $19,000 a year,” David Perez said. “But they stitched it together and raised four kids.” 

The twin boys were competitive, particularly when it came to academics and playing basketball in the driveway. David said his brother got “great grades” and always had an inclination toward science and medicine, graduating from high school at age 16 and then starting college at Westminster University, a small liberal arts school in Utah.

“I swear,” David Perez said, “there were times where the only punishment that my mom could issue that would have the sting was restricting our ability to do homework.”

Hit by a car

Perez was a student in the Honors College at Westminster, and he graduated with a degree in biology. Richard Badenhausen, dean of the Honors College, described Perez as an independent thinker and an ambitious student, especially for his age. 

“He didn’t care too much what people thought about him, which is a strength in my book,” Badenhausen said in an interview. 

When Perez was 13, he was hit by a car. He broke an arm and a leg, and had to be airlifted to a nearby hospital. After three surgeries and 12 months of rehab, he had a newfound interest in orthopedics and physical therapy. 

Mecklenburg had a serious injury of his own, tearing his anterior cruciate ligament (ACL) during a judo match, which also required a year of rehab, according to Hinge’s website.

One day in October 2014, the pair put their heads together and outlined the tools they wished were available while undergoing physical therapy. Musculoskeletal conditions affect as many as 1.7 billion people worldwide, according to Hinge’s prospectus, so there was no shortage of opportunities.

They had the early concept of Hinge within hours and a prototype ready by December of that year.

In Hinge’s early days, Perez and Mecklenburg would meet every Saturday morning to talk shop. Now, as they’ve aged and started families, they meet on Wednesday nights, according to colleagues. Perez welcomed his first child with his wife late last year. 

“Seeing the growth over the last six, seven, eight years has just been unbelievable,” said Jon Reynolds, a tech founder who contributed to Hinge’s seed funding round. “That comes down to the quality of Dan and Gabriel as leaders. They complement each other really well, and they’ve obviously got that mutual respect.”

Perez is a hands-on CEO who expects a lot from his staff. 

He’s direct, detail-oriented, opinionated, competitive and can be intense, according to current and former employees. But he’s committed to the mission and the wellbeing of his employees, they said.

“He’s one of those rare founder CEOs who I think can go all the way,” said Paul Kruszewski, a former Hinge employee who joined the company after it acquired his Canadian computer vision startup, Wrnch, in 2021. 

Hinge Health’s Enso product.

Courtesy: Hinge Health

Employees say Perez is a voracious reader, often finishing two to four books a month. That includes books about business and leadership, an important source of information given that Hinge was his first real job. He’s a fan of “The Innovator’s Prescription,” by Clayton Christensen and others, “Crossing the Chasm,” by Geoffrey Moore and “The Long Fix,” by Dr. Vivian Lee.

He also likes his staffers to read. Executives will often prepare to discuss chapters from a book in their meetings. 

“I’d come home and there’d be a package from Dan, and it’s a book,” said Sturm, who led partnerships and new market development at Hinge. “That was just the norm.”

Sturm, who has worked in the health-care and benefits space for around 30 years, said Hinge was very deliberate with hiring, so there wasn’t a lot of turnover among senior executives. He said Hinge’s recruitment process was the hardest he’s ever experienced. 

Another “Dan-ism,” as Sturm called it, is Hinge’s philosophy around writing. Perez has employees write memos, typically up to six pages long, instead of preparing slide decks or other materials ahead of meetings. Perez was inspired by a similar practice at Amazon, according to current and former employees, and sees it as a way to force employees to think through what they want to say instead of hiding behind bullet points.

Hinge’s memo culture can be an adjustment, particularly for new employees. Sturm said he thought the practice was “insane” at first, but ultimately came to appreciate it and said it improved his pitches.

“When you sort of sit back, you go, ‘You know actually, he wasn’t wrong,'” Sturm said. 

Hinge has come a long way since venture firm Atomico led the $8 million Series A investment in 2017. The London-based firm said in a blog post at the time that it was “extremely impressed by Daniel and Gabriel, and their determination to tackle a big problem in society.”

Carolina Brochado led the round, though she left Atomico a year later and now works at investment firm EQT Group. She said that getting Hinge to the brink of an IPO was a “one in a million chance,” but noted that the company has managed to build a sizable business in digital health despite having so many odds stacked against it.

“Lots of learnings along the way, of course, like a big tech correction in the middle,” Brochado said in an interview. “But it really is one of those rare examples of just an enormous market that was under penetrated.”

For David Perez, whose firm now serves as Hinge’s outside counsel, watching the startup grow has been “fascinating,” he said.

“I’m a partner at a major law firm,” he said, “and I am only the second most successful twin. But I think I’m okay with that.”

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The IPO market is likely to pick up near Labor Day, says FirstMark's Rick Heitzmann

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UK

Royal Family watch flypast from Buckingham Palace to mark 80th anniversary of VE Day

Published

57 mins ago

on

May 5, 2025

By

Royal Family watch flypast from Buckingham Palace to mark 80th anniversary of VE Day

The Royal Family watched an RAF flypast from the balcony of Buckingham Palace to mark the start of four days of celebrations for the 80th anniversary of Victory in Europe (VE) Day.

The thousands of people gathered in front of the palace gates and along The Mall cheered, clapped and waved flags as the spectacular Red Arrows red, white and blue display flew overhead.

The King and Queen, who were joined by the Prince and Princess of Wales, their three children Prince George, Princess Charlotte and Prince Louis, and other senior royals waved from the balcony before the band played God Save The King.

Since Queen Elizabeth II’s death in 2022, it is the first landmark VE Day commemoration event without any of the royals who waved to crowds from the balcony in 1945.

The military flypast passes over The Mall and Buckingham Palace. Pic: PA
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The Red Arrows fly over Buckingham Palace. Pic: PA

King Charles, Queen Camilla, the Prince of Wales, Prince George, Prince Louis, the Princess of Wales, and Princess Charlotte on the balcony of Buckingham Palace. Pic: PA
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Members of the Royal Family wave to crowds. Pic: PA

The King earlier stood to salute as personnel from NATO allies, including the US, Germany and France, joined 1,300 members of the UK armed forces in a march towards Buckingham Palace.

Crowds gathered near the Cenotaph – draped in a large Union Flag for the first time since the war memorial was unveiled by King George V more than a century ago in 1920 – fell silent as Big Ben struck 12.

Actor Timothy Spall then read extracts from Sir Winston Churchill’s stirring victory speech on 8 May 1945 as the wartime prime minister told cheering crowds: “This is not victory of a party or of any class. It’s a victory of the great British nation as a whole.”

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King Charles takes the salute from the military procession for the 80th anniversary of VE Day. Pic: PA
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King Charles takes the salute from the military procession for the 80th anniversary of VE Day. Pic: PA

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Actor Timothy Spall has kicked off the VE Day celebrations by reading Winston Churchill’s famous speech, first read on 8 May, 1945.

The military parade was officially started by Normandy RAF veteran Alan Kennett, 100, who was in a cinema in the north German city of Celle when the doors burst open as a soldier drove a jeep into the venue and shouted: “The war is over.”

The King’s Troop Royal Horse Artillery led the march down Whitehall, through Admiralty Arch and up The Mall, while representatives of the Ukrainian military were cheered and clapped by crowds.

More than 30 Second World War veterans are attending celebrations in the capital, which include a tea party inside Buckingham Palace.

William, Prince of Wales, Prince George, Prince Louis and Princess Charlotte. Pic: Reuters
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William, Prince of Wales, Prince George, Prince Louis and Princess Charlotte. Pic: Reuters

King Charles takes the salute from the military procession. Pic: PA
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King Charles takes the salute from the military procession. Pic: PA

The King watched in front of Buckingham Palace along with the Queen, Sir Keir Starmer, other senior royals and Second World War veterans.

It is the monarch’s first public appearance since Prince Harry said his father will not speak to him and he does not know how much longer his father has left.

Members of the Ukrainian military march past the Palace of Westminster, during the VE Day 80th anniversary parade, in London, Monday, May 5, 2025. (James Manning/Pool Photo via AP)
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Crowds cheered members of the Ukrainian military. Pic: AP

The Cenotaph on Whitehall is dressed in the Union flag ahead of a military procession marking the 80th anniversary of VE Day. Pic: PA
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The Cenotaph on Whitehall is draped in the Union flag. Pic: PA

But a Palace aide insisted the Royal Family were “fully focused” on VE Day events after Harry’s shock BBC interview after losing a legal challenge over his security arrangements on Friday.

The King and Queen were said to be “looking forward” to the week’s commemorations and hoped “nothing will detract or distract” from celebrating.

Members of the Household Cavalry Mounted Regiment pass down the Mall ahead of the VE Day 80th anniversary parade in London, Monday, May 5, 2025. (AP Photo/Alberto Pezzali, Pool)
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Members of the Household Cavalry Mounted Regiment pass down The Mall. Pic: AP

Members of the public make their way down The Mall
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Members of the public make their way down The Mall

Prince Louis fiddled with his hair in the breezy conditions, while Kate sat next to veteran Bernard Morgan, who earlier appeared to show her some vintage photographs.

Monday is the first of four days of commemorations of the moment then prime minister Sir Winston declared that all German forces had surrendered at 3pm on 8 May 1945.

A woman wears British flag sunglasses earrings, hat and ribbons as she takes her place on the Mall to wait for the VE Day 80th anniversary parade. PIc: AP
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Thousands of people lined the streets. Pic: AP

A young boy on the Mall.
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A young boy on the Mall


People line the Mall wearing British flags and memorabilia as they wait for the start of the VE Day 80th anniversary parade. Pic: AP
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People line the Mall. Pic: AP

It marked the end of almost six years of war in Europe, in which 384,000 British soldiers and 70,000 civilians were killed, and sparked two days of joyous celebrations in London.

Sir Keir said in an open letter to veterans: “VE Day is a chance to acknowledge, again, that our debt to those who achieved it can never fully be repaid.”

Residents take part in a street party during bank holiday celebrations commemorating the 80th anniversary of Victory in Europe (VE) Day, in Seaford, Britain, May 5, 2025. REUTERS/Carlos Jasso
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A street party in Seaford. Pic: Reuters

Along with the events in the capital, people are celebrating across the UK with street parties, tea parties, 1940s fancy dress-ups and gatherings on board Second World War ships.

The Palace of Westminster, the Shard, Lowther Castle in Penrith, Manchester Printworks, Cardiff Castle and Belfast City Hall are among hundreds of buildings which will be lit up from 9pm on Tuesday.

A new display of almost 30,000 ceramic poppies at the Tower of London will form another tribute.

On Thursday, a service at Westminster Abbey will begin with a national two-minute silence before Horse Guards Parade holds a live celebratory concert to round off the commemorations.

Churches and cathedrals across the country will ring their bells as a collective act of thanksgiving at 6.30pm, echoing the sounds that swept across the country in 1945, the Church of England said.

Pubs and bars have also been granted permission to stay open for longer to mark the anniversary two extra hours past 11pm.

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