What Happens to Your Brain Implant If the Company Goes Bankrupt? The Question No One Wants to Answer
The neurotech industry has a documented history of abandoning patients mid-treatment — and as brain implants scale from dozens to thousands of users, the stakes are getting impossible to ignore.
Nobody in the brain implant business wants to talk about this. The conference presentations focus on neural decoding, surgical robotics, and the extraordinary things paralyzed patients can do when a chip talks directly to their motor cortex. The press releases announce funding rounds. The clinical coordinators explain informed consent. But somewhere in the fine print of every patient agreement, in the risk disclosures nobody fully reads, there’s a question that the whole field is quietly hoping not to answer: what happens to the person wearing this thing if the company building it runs out of money?
It’s not a hypothetical. It has already happened, more than once, to devices that sit in people’s skulls and retinas and spinal cords right now. The bodies are in the ground — or more accurately, the defunct devices are in people’s bodies — and the regulatory framework still hasn’t caught up. As companies like Neuralink talk about high-volume production and thousands of annual implants, and as smaller startups race to reach patients with devices for depression, paralysis, and epilepsy, the failure scenario is moving from an edge case to a structural probability. Some of these companies will go under. That’s not cynicism. That’s statistics.
I think this is the most underreported risk in neurotech, and it’s not even close.
The cautionary tales already on the books
The history here is short but consequential. Nuvectra, a manufacturer of a spinal cord stimulator for chronic pain, filed for bankruptcy in 2019. That same year, Second Sight, an artificial-vision company, began hemorrhaging money and advised its implantees that it was stopping production of retinal implants. In early 2020, the CEO and director of R&D exited suddenly, most employees were laid off, and the company started auctioning its physical assets, leaving approximately 350 people fitted with a Second Sight implant to wonder what was happening.
The Second Sight case is the one that should keep every neurotech investor and regulator up at night. After Second Sight abandoned the Argus II retinal prosthesis, users not only lost their regained vision but were left with an obsolete device implanted in their bodies, forced to decide between the risks of leaving it in or the risk and cost of having it removed. One patient, Terry Byland, who was the only person ever implanted with Second Sight devices in both eyes, found out secondhand through press coverage that the company was collapsing. Nobody called him. The device that had given him back his ability to see the world was now a permanent, inert foreign object in his face, with no technical support, no replacement parts, and no one left who knew its proprietary components well enough to help a surgeon safely remove it.
And the cruel irony: despite its treatment of those users, Second Sight subsequently received a new round of NIH funding to support research and testing of a different neural prosthesis.
The pattern doesn’t stop with commercial bankruptcy. Sometimes the killer is simply funding running out. Ian Burkhart, who in 2014 became the first paralyzed person in history to regain hand movement using a brain-computer interface, used his device through the Ohio State University trial for seven and a half years. After funding for the trial ran out, he had to have the device removed in 2021. “It definitely was a sad time,” Burkhart said. “I was able to restore that function, and then lose it once again. That was really tough.” 💔
He’s now the founder of the BCI Pioneers Coalition, an advocacy group pushing for the industry to get its act together on patient protections. His core proposal is simple and has apparently been impossible to implement: companies should be required to set aside funds covering ongoing device maintenance and removal on the patient’s timeline, not the company’s.
The abandonment risk looks like this in practice:
Commercial bankruptcy: company folds, no successor, device becomes an unsupported orphan with no parts supply, no technical support, and documentation locked inside a liquidated IP portfolio
Strategic pivot: company stops supporting an older device to focus resources on a newer product, as Second Sight did when it abandoned the Argus II to chase the Orion
Trial funding ends: publicly funded research concludes, patients lose access regardless of whether the device is still working
NIH or government funding cuts: federal support evaporates mid-trial, as hundreds of participants discovered in 2025 when NIH funding cuts disrupted experimental treatments for depression and quadriplegia
Explantation: the option that isn’t really an option
When the company disappears, patients face a choice that the medical community frames as binary but is really just two versions of bad.
Option one: leave the device in. A defunct implant isn’t necessarily dangerous on its own. When companies go under, the implants they created are typically left in place — surgery to remove them is often too expensive, too risky, or simply deemed unnecessary. An inert electrode array sitting in your motor cortex isn’t going to kill you. But it might complicate an MRI, interfere with other procedures, degrade over time in unpredictable ways, and — in the case of devices that were actually working — leave you with the permanent psychological weight of carrying something that used to restore a function you’ve now lost again. A patient named Carol Seeger, who treated her severe depression with an experimental deep brain stimulation device, described what happened when her device’s batteries failed and insurance refused to cover repairs: she sank back into dangerous darkness and worried for her life. “If this turns off, I get sick again. Like, I’m not cured. This is a treatment that absolutely works, but only as long as I’ve got a working device.”
Option two: have it removed. Replacing an obsolete implant like Nuvectra’s spinal cord stimulator requires surgery that takes weeks to recover from and costs around $40,000. And that assumes a replacement device is available. For brain implants specifically, the removal risk is higher and the costs steeper, because you’re asking a surgeon to undo something that required extreme precision to install, using documentation that may no longer exist if the company’s IP has been liquidated. Insurance programs generally have no legal obligation to cover device removal unless it is deemed medically necessary for physical reasons, such as infection or device failure. Removal for psychological distress or strong personal preference is not typically considered medically necessary, meaning patients may have to cover the cost themselves — approximately $11,500 for DBS device explantation in some estimates.
Frederic Gilbert, an associate professor at the University of Tasmania who specializes in neurotech ethics, has made the point that removing a device can be tantamount to withdrawing treatment, because these devices can profoundly affect a patient’s identity — and the distress caused by removal may be directly proportional to how effective the device was. That’s an observation that hasn’t yet worked its way into how companies think about their obligations, or how regulators frame their requirements. 🧠
The situations patients can find themselves in:
Device still physically functional but software unsupported and unable to receive updates
Device hardware failing with no replacement parts available
Technical documentation locked inside a company’s proprietary system, inaccessible to any surgeon or support team
Insurance refusing to cover removal because the indication isn’t “medically necessary”
No identifiable legal entity to hold accountable for the abandonment
The regulatory gap that shouldn’t exist
Here’s what’s genuinely maddening about this situation: there is no federal requirement in the United States that forces a medical device company to designate a successor entity, fund a maintenance reserve, or guarantee long-term support for patients carrying their devices. The FDA’s post-market surveillance requirements for Class III devices focus on safety reporting and performance monitoring. They do not require companies to plan for their own failure.
The FDA does require device tracking for certain high-risk implantables, meaning manufacturers must know who has their device so they can issue recalls or field safety notices quickly. That’s useful for hardware defects. It is completely silent on what happens when the company stops existing. As researchers writing in STAT News argued, regulators should require that companies developing technologies that become integrated into patients’ bodies and brains have a duty of care, be liable for negligence or malpractice like medical professionals, and designate a successor in the event of failure or bankruptcy so users are ensured indefinite support. That proposal has been on the table since 2022. Nothing has moved on it. ⚡
One meaningful partial solution would be open-sourcing device documentation. With open-source information about proprietary medical devices, a third party would be able to access what it needs to take on the complex responsibilities of supporting implant users in the event of business failure. Burkhart himself has pushed for industry-wide component standards, noting that if batteries were interoperable across devices the way phone chargers eventually became, maintaining a device after the original company folds would be dramatically more feasible.
The advocacy community is trying to move the needle. The BCI Pioneers Coalition has been pushing companies and regulators to hear directly from trial participants, and Burkhart’s recognition on MIT Technology Review’s 2025 Innovators Under 35 list has given the issue some profile. But patient advocacy has yet to translate into enforceable regulatory requirements. 🔬
Meanwhile, the scale problem is growing in one direction only. Neuralink has publicly stated plans to move toward high-volume production, with thousands of implants annually as the near-term target and a long-term vision of tens of millions. The current neurotech startup field attracted approximately $2.1 billion in venture investment in 2025, a 62% increase from 2023 — a funding surge that will produce not just successful companies, but also, statistically, a significant number of failed ones. Some of those companies will have devices in people’s heads when they go under.
What a responsible framework would actually require
The structural fix here isn’t complicated in concept. It’s just politically and commercially inconvenient, which is why it hasn’t happened.
A responsible framework for long-term device support would include: 💡
Mandatory succession planning: as a condition of FDA approval for any long-term implantable neural device, companies must designate a named successor entity or establish a maintenance trust before the first device is implanted
Escrow requirements: companies must fund a maintenance reserve proportional to their implanted patient population, calculated to cover device support and explantation costs for the expected device lifetime
Open documentation requirements: technical documentation sufficient for a qualified third party to maintain or explant a device must be held in escrow and released automatically if the company becomes insolvent
Insurance coverage mandates: the “not medically necessary” exclusion cannot apply to explantation when the necessity arises from corporate abandonment rather than clinical indications
There’s a broader question about whether venture-backed startups are the right legal structures to be putting permanent devices in people’s brains at all — not because the science is wrong, but because the incentive structures don’t line up well with indefinite patient obligations. A venture fund expecting a 10-year return horizon and an implant patient expecting lifetime support are operating on completely incompatible timelines.
The NeurotechMag piece on how neurotech is quietly replacing antidepressants for some patients makes the case that this space is genuinely moving toward mainstream adoption — which makes the governance question not more abstract but more urgent. The same thing is true across the wider equity and access questions that come with brain implants scaling up, which we’ve covered separately on how mainstream brain implants could widen the inequality gap.
The question worth asking out loud: if a company can’t credibly guarantee it will support the devices it puts in people’s heads for the lifetime of those people, should it be permitted to implant them in the first place? That might sound radical. But the alternative — the status quo where Second Sight patients discover their vision is going dark because a startup pivoted — is not a hypothetical risk scenario. It already happened. It will happen again. The only question is whether we build the infrastructure to handle it before the next time, or after. 🚀