When activist investor Kenneth Orr first heard about Rua Diagnostics, he didn’t believe it. A breath test that has the potential to detect lung cancer and sepsis sounded like something out of a Silicon Valley pitch deck: ambitious, maybe even fantastical.
But instead of walking away, he got on a plane. Orr and his team flew to Ann Arbor, Michigan, to meet the researchers at the University of Michigan and the tech transfer team managing the project. He asked tough questions. He studied the data. What he saw didn’t just impress him—it changed everything.
“I was so impressed, I was tempted to close the deal right then and there,” Orr said. “We flew out to Ann Arbor to meet with the doctors and the licensing team at the University of Michigan. It still took a couple of weeks to finalize everything, but I knew after that visit I was in. No question.”
Rua Diagnostics is building a breath-based diagnostic platform that uses gas chromatography and advanced machine learning to detect disease. A patient breathes into the device for two minutes, and in under 30 minutes, the system analyzes volatile organic compounds (VOCs)—tiny chemical markers in the breath that change when illness disrupts the body’s metabolism. Rua’s system detects those changes at the molecular level.
The science behind this technology isn’t new. Gas chromatography has been around since the 1950s, and analyzing VOCs in breath has long been used in environmental testing. What makes Rua different is how it brings that technology into real-time, point-of-care healthcare. The platform is compact and non-invasive. It doesn’t require bloodwork, biopsies, or lab-sent samples. It’s designed to deliver results quickly, right where the patient is.
For Orr, the appeal wasn’t just in the innovation—it was in the validation. The University of Michigan had already proven the technology in its hospital system through their own studies. And the doctors believed in it so strongly that they, along with the University of Michigan, became co-founders of the company. In addition, a non-profit affiliated with UCI Research Park had also invested hundreds of thousands in Rua and similar companies through an initiative investing in cutting-edge medical technology.
“You hear that it’s based on the same principle as dogs being able to smell cancer.” Orr said. “It’s not just about smell. It’s about chemistry, machine learning, and pattern recognition. The university’s involved, the NIH is involved, and it’s already been tested in real hospitals. This isn’t some wild startup idea. This is the real thing.”
Rua also represents something personal for Orr. He’s lost friends and family members to cancer, including one friend’s wife, who might still be alive had her illness been caught earlier. Another close friend, his best friend from childhood, nearly died of sepsis. That experience was terrifying, made worse by the uncertainty of whether treatments were working. Orr believes that if Rua’s technology had been available then, the outcomes could have been different.
That belief fuels his conviction in the company’s potential. Catch lung cancer at stage two, and the survival rate is around 80 percent. Catch it at stage four, and the odds drop dramatically to under 20 percent. Closing that gap is what Rua is positioned to do.
The potential for Rua Diagnostics may stretch well beyond lung cancer and sepsis. Orr and the team believe the same breath-based technology can be applied to detect a range of conditions, including colon cancer and ARDS. Eventually, they believe that it could help clinicians track treatment effectiveness in real time. With Rua’s platform, early detection is only part of the story. The broader vision is continuous insight into a patient’s health, all through a simple breath test.
“It’s not just diagnostics,” Orr said. “It’s continuous monitoring. Imagine testing someone on a ventilator with sepsis every hour, every two hours, or however often the healthcare provider wants. We can actually test whether or not the medications are helping. That’s a game changer.”
To reach that vision, Rua still needs to clear key regulatory hurdles, the most significant being FDA approval. Fortunately, the team is confident that their collective experience in prior med tech ventures will assist in navigating any challenges that may arise throughout this process.
Rua’s leadership includes industry veterans and academic partners, from machine learning engineers and University of Michigan researchers to Teresa Carlson, the former head of Amazon Web Services’ government division. The company is also exploring an innovative pricing model: a flat monthly fee instead of charging per test. The goal is to help hospitals adopt the technology at scale, without prohibitive per-test costs.
“I didn’t invent this, and I’m not the management executing it,” Orr said. “I’m just looking to help bring it to market. And I’d be really proud to be able to say that I was involved. To me, that will be enough—to be able to say I helped make that happen.”
