Friday 23 August 2019

Heart pioneers pump life into Ireland

Nathan Tenzer of Edwards Lifesciences has moved to the midwest to lead its $160m investment here, writes Fearghal O'Connor

Nathan Tenzer, general manager of Edwards Lifesciences, Shannon, Co Clare. Photo: Don Moloney
Nathan Tenzer, general manager of Edwards Lifesciences, Shannon, Co Clare. Photo: Don Moloney


Nathan Tenzer




Plant General Manager, Edwards Lifesciences, Ireland


Irish mid-west but from Bakersfield, California


University of California, San Diego - bachelors and master's degrees in biomedical engineering

Previous experience

Senior Director of Engineering at Edwards Lifesciences facility in Draper Utah


Married to Nicole. Children Jackson (13), Abigail (11) and Samantha (9)


Hobbies revolve around what his children do: computer coding, basketball, track and field, ice hockey

Favourite book

The Speed of Trust by Stephen MR Covey

Favourite Movie

The Usual Suspects. "I love that movie. It teaches us that our perception is sometimes helping us and is sometimes blinding us"

Favourite holiday

Stirling, Scotland. Connemara. Paris.

The floor-to-ceiling finished-goods racks in the new Edwards Lifesciences facility at Shannon are empty - for now. Just a year ago this high-tech pristine facility was a dated warehouse in the Shannon Free Zone. Its facade has since been given a 21st century makeover and the car park is full with vehicles from across the mid-west and beyond.

Inside, Californian Nathan Tenzer - plant general manager for Edwards Lifesciences Ireland - proudly shows off the transformation that he has led with a new and growing Irish workforce since his arrival here 12 months ago.

"This was an empty warehouse and here we are now with a highly advanced medical device factory," says Tenzer. Edwards - with $3.4bn in turnover and 13,000 employees in the US - plans to employ 600 Irish workers at a major new medical devices facility. Tenzer is here to lay the groundwork.

He has fitted in with ease, as comfortable discussing the intricacies of the human heart as he now seems talking about hurling - a game his ice hockey-playing teenage son has taken up since moving here: "Did you see the Waterford-Limerick game yesterday?" he says. "Very exciting."

He proudly shows off high-tech work stations - more than $7m worth of equipment - pristine behind the glass of a new cleanroom that keeps them hermetically sealed from the outside world.

"There's just a couple of us here [from the US] to bring the Edwards patient-first culture that is so central to what we do. Everyone else that we're hiring here is Irish and at a certain point it'll be time to hand over the reins and head back to the States myself. That is the long-term plan."

The new production lines will soon be buzzing, with skilled engineering staff assembling catheters that are inserted into the veins and arteries of patients. Edwards stands up to demonstrate the journey of the catheter as it is pushed up from where it is inserted in the groin, up to the top of the heart where it delivers the trans aortic valve implant (TAVI) that can greatly improve - or often save - the life of a patient without the need for difficult surgery to open the chest cavity.

"It's amazing. With open-heart surgery you spend six months in recovery as your rib cage heals. But with this you instantaneously feel better and can go home the next day," Tenzer says.

The 28,000 sq ft interim Shannon facility is just the first step for Tenzer and the Edwards team in Ireland. Work has just started on a much bigger plant - 280,000 sq ft - at Castletroy, Co Limerick, due for completion in 2020. The Californian company has now decided to double its capital investment in Ireland, from €80m to €160m.

"A lot of that extra investment will go into enlarging the facility to accommodate future growth, but the company has also purchased land that it believes it will need for future expansion," he says.

"Right now it's 600 employees... there's a lot for us to chew on so we're going to give ourselves a little bit of run time on that. But we wouldn't be too surprised if we had an opportunity to share an increase in job numbers in the future."

Edwards will build two 10,000 sq ft cleanrooms at Castletroy initially, not including storage, gowning areas and other facilities.

"We'll have provision to increase that by 50pc to build a third cleanroom and the expansion of the project will allow for a fourth clean room."

"It's a great future-proofing move. The challenge in our world is that the growth of the products that we're working on has been so explosive that our most conservative estimates have been too low. The future is very, very bright."

The company reinvests 17pc of gross revenue - roughly €600m every year - into new product development. Edwards is "going to leave the door open for future announcements" about jobs above the 600 already announced. This could see it increase the number of jobs, he says. The Castletroy facility, with extra room for expansion now secured, could become "the launchpad" for a new product or technology, he says.

"But we want to make sure that we deliver on the promises that we have already made before we start to make more. When we say we are going to do something, we are going to do it. I'm extremely comfortable with 600 jobs. I don't think that is going to be a problem for us at all. And if our seven-year projections are even close then we'll have some more news to share. The future looks very bright. We have new technology to treat groups of patients that are under-served at the moment."

The company's story began 60 years ago in the Oregon garage of retired engineer Mike 'Lowell' Edwards, who had spent his life developing patents for pumps. A rheumatic fever sufferer as a child - with a damaged heart valve - Edwards decided in retirement to make the world's first artificial heart, partnering with a local physician.

"Up until then a problem with a heart valve was a death sentence," says Tenzer. "And then these two gentlemen come along and change the world forever with their mechanical ball and cage valve. That valve became the gold standard for treating diseases associated with the heart valve."

Edwards has since become a world leader in surgical valves and its transcatheter valve replacement implant (TAVI) treats aortic stenosis - one of the most common and most serious heart valve diseases - without the need for major surgery.

"There's over 600,000 people worldwide that have benefited from this technology but aortic stenosis is still widely under-diagnosed," he says.

"Aortic stenosis is a thief. It starts to steal our energy and vitality. Over 7pc of the elderly population suffer from this, but it comes on slowly. Somebody who used to walk miles finds walking from the house to the mailbox a chore. They tell themselves 'I'm just getting old'."

Many only find about the condition when they need a life-saving operation for which they may have already become too ill. Tenzer's own grandmother was in just that situation three years ago, too ill for open heart surgery. The episode gave him a deeply personal insight into the huge relief the technology can bring. "I found myself in the waiting room surrounded by my loved ones, holding hands, telling stories and trying to be strong, waiting to hear the doctor come out to tell us that everything was OK."

The doctor was Dr Raj Makkar at Cedars Sinai Hospital in Los Angeles, one of the most accomplished practitioners of the techniques made possible by the Edwards technology.

"It was an amazing experience because it was my factory that had made these devices and here I was sitting across from my family explaining exactly what was going to happen."

The doctor finally asked for Tenzer by name.

"He comes right over to me, grabs my hand and before I can say anything he says 'thank you'."

"How did it go? Is everything OK?" responded Tenzer. "It went great. Textbook. She'll be back home tomorrow," he answered. The doctor continued: "Thank you. For years we had to send people home or give them an invasive process that they were really too frail to survive. And because of the amazing things that you're doing there in Edwards we get to send them home healthy."

It is not unusual for patients who get a new heart valve of this sort to replace an old blocked one to very quickly feel years younger.

"Instantly their oxygen supply is back. They can think more clearly, get back into their old routine, get out for a walk, be there for the birth of a grandchild. This isn't the type of technology that just give years. It gives quality years."

Tenzer has a tendency to speak of Edwards as a cause rather than a $40bn company.

"There's no person who's closer to the patient than the person who's putting that device together," he says, gesturing to the new cleanroom. "It's their eyes and it's their hands that determine whether or not it is going to work the way it is supposed to. And if we do this well we save someone's life. If we don't we could just as easily be ending someone's life prematurely."

Taxation and proximity to the European market are reasons that the company chose Ireland for its European base but ultimately the key reason, he says, is the availability of a quality workforce.

"Ireland is such a great fit for us because of its educated workforce. The people we have hired understand the gravity of what they're doing. They value it. They treat it with respect. And you know, that's not the case everywhere. This can't just be a job. It is a cause. When we do this well we have a huge impact."

Of course, sometimes things do get lost in the cultural translation: "You want to bring a strong corporate culture but you have to leave room for a local culture too." The company's digital recognition board - which scrolls through praise of individual staff members for tasks well performed or other achievements - showed how Irish workers can react differently to American workers.

"A recognition board is a place where we have to be a little bit softer and, culturally, maybe people are a little bit more uncomfortable with receiving praise. You have to make sure one person doesn't feel singled out.

"They're being singled out for the right reasons but they might feel like it puts them in an awkward position. We want people to feel appreciated but we were taking maybe an American-centric view and we had to adapt it."

There are many such details for Tenzer to work though - technically, culturally - before Tenzer and his family will return to the US.

"I'm not really too worried about what the next step holds. But I would say my role here is done when the team has the ability to take the reins and I've passed on all the information that I possibly can and I'm duplicative to what the capability here has developed to."

Ultimately he expects his new Irish team to push him out of the way: "'We've got it from here,' they will say. 'You can go back to the States now'."


Name: Nathan Tenzer


Age: 39

Position: Plant General Manager, Edwards Lifesciences, Ireland

Lives: Irish mid-west but from Bakersfield, California

Education: University of California, San Diego - bachelors and master's degrees in biomedical engineering

Previous experience: Senior Director of Engineering at Edwards Lifesciences facility in Draper Utah

Family: Married to Nicole. Children Jackson (13), Abigail (11) and Samantha (9)

Pastimes: Hobbies revolve around what his children do: computer coding, basketball, track and field, ice hockey

Favourite book: The Speed of Trust by Stephen MR Covey

Favourite Movie: The Usual Suspects. "I love that movie. It teaches us that our perception is sometimes helping us and is sometimes blinding us"

Favourite holiday: Stirling, Scotland. Connemara. Paris.



What piece of advice would you give to someone starting out on their career?

Never stop learning. There is a difference between having 10 years of your first year’s experience or having 10 years’ experience.

The difference is active learning and making sure every day you are taking home something new, you are pushing the boundaries, challenging yourself.


How challenging is it to relocate a young family to a new country?

We love it here. One of Ireland’s best charms is the community-based culture. People are very warm, very welcoming.

Obviously there are days that are difficult, especially the first six months, when you’re trying to figure out where to get a car serviced or how to get to a doctor.

I remember one Friday that was tough for each one of us in different ways. You just go home and put your arms around the whole family and say: “Listen, tonight is a pizza night and we are going to rent a movie.”

We piled pillows on the ground and like a dog pack we took comfort in each other. You wouldn’t believe it, but by Monday every one of those items had cleared.

Sunday Indo Business

Also in Business