1. California

The Golden Gate Bridge in San Francisco [Image from Unsplash]
Medical device industry employment (2019): 72,471
Medical device industry establishments (2019): 2,131
Major medical device company headquarters (2019): 19
Medical device patents (2019): 1,764
Medical device VC investments (2019): $1.249B
Medical device VC deals (2019): 72
Best States for Business ranking (2019): 31
Despite complaints about the high costs of doing business, California is unrivaled when it comes to the size of its medical device industry — not to mention the range of innovations. From medtech employment to patent numbers to the amount of venture capital investment, California is well ahead of other states. It accounted for nearly a fourth of the U.S. medical device industry’s revenue in 2017, according to IBISWorld.
The Golden State’s medical device industry is actually made up of a number of major hubs running down the length of the state:
North Bay
The North Bay region outside San Francisco is an important medical device manufacturing hub. Two of Medtronic’s business units — Aortic and Peripheral Disease Management and Coronary and Structural Heart Disease Management — are based in Santa Rosa.
Silicon Valley
Silicon Valley includes the dominant player in robotic surgery, Sunnyvale-based Intuitive Surgical. Cancer treatment innovator Varian Medical Systems is headquartered in Palo Alto, and invisible, customized orthodontics maker Align Technology is based in San Jose.
Mobile and digital health remain hot areas for the high-tech industry, with 546 digital health and 635 wearables exhibitors at this year’s CES show in Las Vegas. Cooperation between medical device companies and consumer technology companies, including Apple and Google’s life sciences sister company Verily, is increasing as more products roll out to monitor people’s health and catch problems early.
The region is also home to Carbon, a major 3D printing innovator that is forging partnerships with medical device companies including Johnson & Johnson and BD. In Milpitas, upstart Bigfoot Biomedical has a partnership with Abbott as it seeks to create an improved automated insulin delivery system for diabetes treatment. The Fogarty Institute for medical device innovation is based in Mountain View.
Orange County
Orange County exported more than $4 billion worth of life science exports in 2015 alone — about three-fourths involving medical device and diagnostic equipment shipments, according to trade group Biocom. The medtech industry in the county as of 2016 included 23,673 workers, a headcount larger than most U.S. states’ medical device workforces.
The hundreds of firms in the county include Irvine-based Edwards Lifesciences, a major player in the cardiovascular devices space, and San Clemente-based ICU Medical, provider of IV-based therapies, systems and services. Johnson & Johnson’s vision surgical business, formerly part of Abbott, is based in Santa Ana.
Besides Biocom, local industry boosters include OCTANe and the Device Alliance.
The Alfred E. Mann Foundation for Scientific Research is based nearby in Valencia, and Medtronic’s diabetes business is based in the Northridge section of Los Angeles.
San Diego
San Diego is home to a number of companies pushing the boundaries when it comes to packaging digital health with medical devices, including Dexcom and its continuous glucose monitoring systems for diabetes management and ResMed and its CPAP equipment for treating sleep-related breathing disorders. Spine technology company NuVasive is also based there.
The medical device industry in San Diego County employed 9,770 people at 211 companies as of 2016, according to Biocom.
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Notable medical device industry suppliers
Freudenberg Medical (Carpinteria & Baldwin Park) boasts technical capabilities ranging from the design and manufacture of minimally invasive, catheter and handheld technology to the development and production of medical components through advanced materials and processes.
Confluent Technologies (Scottsdale, Ariz.) — which works on everthing from catheter delvery systems to Nitinol guides and frames — has locations in Fremont, Campbell and Laguna Niguel.
Green Hills Software (Santa Barbara) says its products allow for faster medical device development.
Flex (Singapore; U.S. Headquarters in San Jose) offers design, engineering, manufacturing, real-time supply chain insight and logistics services.
IDEX Health & Science (Rohnert Park) focuses on advanced optofluidic technologies.
Medical Extrusion Technologies (Murrieta) has been providing custom medical tubing extrusions for more than 20 years.
Traco Power North America (San Jose) provides customers with optimal power supply solutions.
Wright Engineered Plastics (Santa Rosa) is a San Francisco Bay Area plastic injection molder and contract manufacturer.