anonymous. The email was from Stephanie Shulman, director of the
Clinical Laboratory Evaluation Program at the New York State
Department of Health. She was responding to a query Tyler had
submitted the previous Friday under the cover of his new fictional
identity.
Tyler had reached out to the New York health department because it
ran one of the proficiency-testing programs Theranos had participated
in. He still suspected that the way the company conducted proficiency
testing was improper and he wanted an expert opinion. After
exchanging a few emails with Shulman, Tyler had his answer. In
response to a description he gave her of Theranos’s practices, she
wrote back that they amounted to “a form of PT cheating” and were “in
violation of the state and federal requirements.” Shulman gave Tyler
two options: he could give her the name of the offending laboratory, or
he could file an anonymous complaint with New York State’s
Laboratory Investigative Unit. He chose to do the latter.
Armed with the knowledge that he was correct about his
proficiency-testing suspicions, Tyler went to see his grandfather. They
sat down together in the dining room of George’s big house, and Tyler
tried to explain to the former secretary of state the concepts of
precision, sensitivity, quality control, and proficiency testing and to
show him why he thought Theranos’s approach to each was lacking.
He also revealed that Theranos was using its proprietary device for
only a handful of the more than two hundred blood tests it advertised
on its website. And that before samples could even be processed on the
device, they had to be diluted with a third-party machine six feet long
and two and a half feet wide that cost tens of thousands of dollars.
George took it all in quizzically. Tyler could tell he wasn’t getting
through to him, but he needed him to know as both his grandfather
and a member of the company’s board of directors that he could no
longer be a party to what was going on. He told him he planned to
quit. George asked him to hold off and to give Elizabeth another
chance to address everything. Tyler agreed to do so and tried to set up
another meeting with Elizabeth, but her rising public profile made her
very busy. She asked him to send her an email with his concerns