What Was Missing From the Theranos Machine?

Tyler Shultz was 22 when he finally saw the Theranos device in a validation lab, and the promised technology was not there. The open reader, the machine without its shell, was an eight channel pipette on a robotic arm. It was not a standalone platform. It tested only one thing at a time, ran only one type of test, and was poorly engineered, so it did not run even that one test very well.

His manager had worked at Theranos for several years, had a PhD and a postdoc in molecular biology, and was seeing the device for the first time too. The woman running the demonstration shrugged when asked whether the machine was cool, said they could decide for themselves, and walked away. No centrifuges were inside it. Liquid handling was not accurate enough for the initial dilution out of the nanotainer. A worker manually put the nanotainer into a centrifuge, spun it, manually pipetted the serum into a different nanotainer, and put the nanotainer into a pipetting robot. The robot took a few microliters out and put them into a Theranos cartridge for the initial dilution. The cartridge then went into the Theranos product, which ran only one test.

He still hoped a locked door hid the real technology that he and his colleagues were not allowed to see, and he treated the machine as a temporary fix. The longer he stayed, he heard only problems about the future version, and he thought that version was never going to come. He could not see how it would run hundreds of tests from a single drop of blood, or how the pipetting robot would go up in a medevac helicopter.