This is part of a case series. As the Alps disappeared into the darkness through NayaMed’s window, the General Manager Aarnav Sendutta considered how to grow his fledgling unit. It was February 2014, and NayaMed, a unit of medical device giant, Medtronic, was just over two years old. It was formed to distribute Medtronic’s economy range of heart pacemakers and defibrillators, with regional sales and online technical support. Aarnav was facing two key issues. The first was the perception from Medtronic sales reps that NayaMed would cannibalise their offering. The second issue was how to grow the unit, which currently operated from its Lausanne base in Switzerland, targeting only Italy, Germany and Sweden. The business had grown but was still very small, generating US $4 million in its second year of existence. Aarnav’s passion for the NayaMed business was clear, the justification for NayaMed made good business sense, but attempts to grow it were being constrained by organisational issues within the parent company, Medtronic. What could they do?