Dear Reader: While this article focuses upon avoiding the common pitfalls of the start-up entrepreneurial company, there are lessons here that anyone working in any company can benefit from, since at the end of the day we are really all entrepreneurs, and work in an increasingly competitive world. When we think like entrepreneurs and take ownership of our own success, and work to build innovative value at whatever type of company we are at, everyone benefits. -TK
Typically, any successful venture follows a path that in hindsight seemed the only reasonable path to success. This path, however, was likely not known when the journey started. The journey forward was similar to driving down a foggy winding road, at night, with only dim headlights. There were any number of ways to go off the road, and only one way that eventually led to the destination.
A common aphorism states that walking is falling forward and catching yourself before you fall. There is a well-known maxim known as the Anna Karenina Principle which states that there are many ways to fail, few to succeed, and if you eliminate the greatest risks for failure, hopefully, the principles for success remain. 
“Happy families are all alike; every unhappy family is unhappy in its own way.”–Leo Tolstoy, Anna Karenina
During World War II, the British examined battle-damaged bombers that managed to return from raids. They would note where the bullet holes and flak damage were, and then look for ways to armor the sections of the plane without bullet holes. The theory was that if the plane returned with a hole, it was assumed that damage was survivable. If it got a hole elsewhere, that is what brought down the planes that did not return. This was a clever way to discover and reduce the risks of failing to return from a mission.
This restates the principle mentioned at the beginning, that there are many ways to fail, and few to succeed. The goal is to be in the “happy family” of successful entrepreneurs.
Some of the principles of success are few and deceptively simple: purpose, focus, persistence, planning and a bit of providence. Myers and Hurley state, “The three pillars of bioentrepreneurship are scientific and managerial talent, technology and money.” Others have stated this as the various Ps of entrepreneurship: passion, persuasiveness, persistence, priorities, and “pain threshold.” In this essay are some of the “broad ways” that can lead to entrepreneurial failure. The idea is to identify these potential problems and address them before you sink years of your life into the venture, and a bunch of money into patents and product development.
What follows is a list of things that I have personally seen lead to entrepreneurial failure in the medical device space. It is hardly exhaustive; however, these are distressingly common.