The Innovator's Credo: Fail Early and Often

Abstract

Editorial| June 2021 The Innovator's Credo: Fail Early and Often Steven L. Shafer, MD Steven L. Shafer, MD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor June 2021, Vol. 85, 5. https://doi.org/10.1097/01.ASM.0000754184.26241.a4 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Steven L. Shafer; The Innovator's Credo: Fail Early and Often. ASA Monitor 2021; 85:5 doi: https://doi.org/10.1097/01.ASM.0000754184.26241.a4 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAll PublicationsASA Monitor Search Advanced Search Topics: sharks, surgical procedures, operative, swimming, propofol, fospropofol, entrepreneurs, software, prodrugs I was in tears laughing as I read the investigator's brochure for fospropofol on a flight to Baltimore. Fospropofol was a water-soluble prodrug of propofol, rapidly metabolized into phosphate and propofol. Fospropofol was being developed, in part, to eliminate propofol pain on injection. Unfortunately, phosphate makes your genitals burn, as every anesthesiologist who has given a bolus of I.V. dexamethasone phosphate or codeine phosphate to an awake patient knows (no anesthesiologist ever does this twice). It struck me as an uneven trade. What, exactly, is one supposed to tell the patient before inducing with fospropofol? During the presentation I had been asked to give, I explained that the perceived benefits (slower onset and offset) were not benefits at all. I also shared my view that genital burning was a showstopper. To my amazement, and against both the available evidence and scientific first principles, the company leadership was convinced that fospropofol... You do not currently have access to this content.