When your insulin pump connects to your phone or your glucose monitor shares data with the cloud, is it secure? And what does "secure" even mean?

In this episode of Inside MedTech Innovation, Shannon Lantzy sits down with Jacob Combs, Chief Information Security Officer and VP of Cybersecurity at Tandem Diabetes Care. Jacob brings deep expertise from across telecom, defense, financial services, and healthcare—and now protects connected devices that deliver life-sustaining insulin therapy to people with diabetes.

This conversation explores the unique challenges of medical device cybersecurity: the tension between usability and security, the reality of legacy systems and security debt, how to scale security by design across engineering teams, and why regulatory requirements can actually be a competitive advantage.

Jacob and Shannon discuss:

• Why medical device security is fundamentally different from enterprise IT security

• The critical balance between safety risk and security risk in insulin delivery systems

• How threat modeling becomes a verb that transforms engineering culture

• The challenge of maintaining security across interoperable diabetes management ecosystems

• Why "secure enough" requires sophisticated risk management, not just risk assessment

• How compensating controls and lifecycle management address security debt in fielded devices

• The role of FDA guidance in driving security programs forward

• What it takes to push software updates quickly while maintaining quality and regulatory compliance

Timestamps

• 00:00 Introduction to Medical Device Cybersecurity

• 01:03 Meet Jacob Combs: Expert in Medical Device Cybersecurity

• 02:12 The Mission-Driven Approach to Cybersecurity

• 03:16 Balancing Safety and Security in Medical Devices

• 05:18 Challenges in Medical Device Cybersecurity

• 09:57 The Role of a CISO in Medical Device Companies

• 13:55 Risk Management and Cybersecurity in Medical Devices

• 17:17 Interoperability and Complexity in Medical Devices

• 26:55 Future of Cybersecurity in Medical Devices

• 36:08 Cybersecurity in Med Tech: A Non-Competitive Necessity

• 36:30 The Ethical Dilemma of Charging for Security

• 37:25 Product Security as a Growth Engine

• 38:50 Marketing Security: A Competitive Edge

• 39:32 Quality and Security: A Symbiotic Relationship

• 41:08 Regulatory Challenges and Operational Efficiency

• 42:36 Measuring Cybersecurity Quality

• 43:57 Navigating Regulatory Requirements

• 51:23 Innovating with AI in Security Documentation

• 55:25 Threat Modeling: A Cultural Shift

• 59:23 Legacy Devices and Security Debt

• 01:06:03 Balancing Security and Innovation

• 01:09:08 Rapid Fire Questions and Closing Thoughts

Follow Shannon and Jacob:

Connect with Shannon : 

LinkedIn: https://www.linkedin.com/in/shannonlantzy/

Website: https://www.shannonlantzy.com/

Connect with Jacob: 

LinkedIn: https://www.linkedin.com/in/jacobcombs/

Website: Left to Our Own Devices Podcast