Welcome to the 21st century, where paradigms are shifting, roles are reversing, and changes in workflow influence-perhaps even dictate-new patterns of thought. If that sounds new age to you, then you might be onto something, because this is a new age, and new rules apply. We can no longer succeed by sitting atop a power hierarchy and bending others to our will; instead, we must step into the flow of others' work. This applies to every field, including biomedical engineering, where every inventor has a story about groundbreaking technology that never reached its target market. To what extent does changing our mindset for the 21st century influence the success of a device? To answer this question, we need to know the following: when useful technology, invented by the greatest minds in science, fails, what went wrong? And more importantly, when it succeeded-both from a medical and financial point of view-what went right, and how do we replicate that?