Concussion Inc.: CTE Expert Robert Cantu Has Confused Relationship With Xenith Helmet Company

Having lambasted Dr. Joseph Maroon for his sundry commercial associations, I cannot fail to explore a controversy last week sparked by articles in the Boston business press reporting that Dr. Robert Cantu had some kind of advisory status with the innovative Xenith helmet company.

Cantu of Boston University, the physician who diagnosed Chris Nowinski’s concussions prior to the launch of his Sports Legacy Institute, is one of the leading lights in chronic traumatic encephalopathy research. He was quoted widely in the coverage of the latest Boston U./SLI finding of CTE in a deceased athlete: hockey player Bob Probert. In coming days I’ll try to add a little to the public conversation about the Probert case.

Meanwhile, fasten your chin straps for a complicated tale of hype in the world of venture capital.

I am not alleging here the kind of blatant corruption suggested by the deep-seated symbiosis of Maroon with the Pittsburgh Steelers, the National Football League, World Wrestling Entertainment, the University of Pittsburgh Medical Center, the imPACT testing program, the unregulated supplements Vindure and Sports Brain Guard, and the Riddell “Revolution” helmet. That particular custodian of the Hippocratic Oath has turned himself into a walking infomercial.

On the other hand, do Cantu and Xenith themselves pass the “Caesar’s wife” test of discouraging even the appearance of impropriety? You decide.

Xenith, LLC is a Lowell, Massachusetts-based company started by Vincent Ferrara, who played quarterback at Harvard in the 1990s and, indeed, lost most or all of one season to a concussion. (He happened to be four years ahead of Nowinski at Harvard.) Ferrara then got his M.D. and, upon finding himself most interested in the business side of health care, his MBA at Columbia.

I am not an expert and I have no opinion on the benefits of Xenith’s helmet model. If it has the potential to prevent injuries and save lives, then great. In a phone conversation with me last Thursday, Vin Ferrara said all the right things about the primacy of education – how no piece of head hardware can substitute for safer playing technique and a smarter athletic mindset.

In a 2007 New York Times story on Ferrara’s company – written by concussion beat writer Alan Schwarz – Dr. Cantu said a good bit more.

Schwarz’s article asserted that the Ferrara helmet’s 18 thermoplastic shock absorbers filled with air “can accept a wide range of forces and still moderate the sudden jarring of the head that causes concussion.” In addition, unlike traditional foam helmet lining, the disks do not degrade after hundreds of impacts, according to laboratory tests.

Cantu told The Times this was “the greatest advance in helmet design in at least 30 years.” He was identified as an informal adviser during the helmet’s development with “no financial relationship with the product.”

In September 2010, Xenith issued a press release announcing it had raised $10.5 million in equity financing. The release cited the marketing inroads of the company’s X1 football helmet. Dr. Cantu was nowhere mentioned. (The document can be viewed at http://muchnick.net/xenithpr.pdf.)

However, until very recently – that is, some time past the September round of PR – Cantu was still on the Xenith website (http://xenith.com). Ferrara told me that Cantu had asked for the removal of the references to him several months ago.

By law, Xenith was required to submit paperwork to the Securities and Exchange Commission about its $10 million financing threshold; the filing became public on February 25. Three days later – a week ago Monday – a spate of articles about Xenith appeared in online versions of Boston business magazines. Citybizlist.com, for example, wrote:

Xenith helmets have been recorded to reduce the risk of concussion by as much as 60%, and players have reported a 70% reduction in the incidence of headaches. Xenith advisor Dr. Robert Cantu, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine and one of the nation’s leading experts in concussion management, called it “the greatest advance in helmet design in at least 30 years.”

The Boston Business Journal and its offshoots also erroneously reported (and subsequently retracted) NFL Hall of Fame quarterback Warren Moon’s participation in the Xenith investment group.

Ferrara shared with me his email to the leadership of the National Operating Committee on Standards of Athletic Equipment, in which he said he had “absolutely no idea why anything came out today, and Xenith had no involvement in this whatsoever…. [Xenith’s September press release] in no way mentions concussions, concussion reduction, the NFL, Warren Moon, Bob Cantu, or anything else that is being printed in these recent posts. I have received numerous calls, emails, etc about these releases, and I am truly baffled as to how this transpired. I have already emailed Jeff Pash [NFL attorney] to inform him of this as well.”

I also spoke last Thursday with Cantu, who reinforced that he has never been a paid advisor for Xenith. “Have I talked with people from that company about their products? Yes. I do that with a lot of companies,” Cantu said. “But I have not received money from any of them.”

I’m not sure what to make of all this. In my experience, business journalists don’t ordinarily have the enterprise to research and publish deep backgrounders with short turnarounds – let alone inaccurate ones – every time a company makes a routine SEC filing.

I also think that, while the root 2007 Times article carefully disclaimed Cantu’s equity interest in Xenith, the story as a whole smells of social networking in the old-fashioned sense – the kind involving Ivy League elites well practiced in planting high-toned hype in the Newspaper of Record. Would a startup elsewhere located and with a worse-connected CEO have been able to get this kind of ink?

It was wrong for Riddell Helmets, aided by NFL-funded research conducted by Joseph Maroon, to be making the kinds of statistical safety claims now under investigation by the Federal Trade Commission.

It was also wrong for Robert Cantu and Xenith to have gotten mixed up in their own brand of fledgling and unverifiable braggadocio.

As the public witnesses a statistically significant population of athletes dying young, often by their own hands, leading doctors cautiously emphasize how much is yet to be understood about the scope and magnitude of traumatic brain injury in contact sports. I just wish the same doctors would be correspondingly modest about the commercial products designed to mitigate it.

Tomorrow: My review of the new article for Neurosurgery by Dr. Bennet Omalu, the “conscience of CTE research.”

Irv Muchnick