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In early 2014, recent Stanford University graduate Tyler Shultz was in a quandary. He had been working at Theranos, a blood-diagnostic company founded by Elizabeth Holmes, a Stanford-dropout wunderkind, for almost a year. Shultz had learned enough about the company to realize that its practices and the efficacy of its much-touted finger-prick blood-testing technology were questionable and that the company was going to great lengths to hide this fact from the public and from regulators.

Theranos and Holmes were Silicon Valley darlings, enjoying positive press and lavish attention from potential investors and technology titans alike. Just as companies like PayPal had revolutionized the stagnant payments industry and Uber had upended the for-hire transportation sector, Theranos had been positioned as the latest technology firm to substantially disrupt yet another mature sector: the medical laboratory business. By the start of 2014, the company had raised more than $400 million in funding, and had an estimated market valuation of $9 billion.

Shultz's situation was exacerbated by the fact that his grandfather, the highly respected former US Secretary of State George Shultz, was on the Theranos board and was one of Elizabeth Holmes's biggest supporters.

But Tyler Shultz worried about the customers he was convinced were receiving highly unreliable and often inaccurate blood-test results. With so much at stake, Shultz wondered how he should proceed. Should he raise his concerns with the firm's investors? Blow the whistle externally? Report to industry regulators? Go away quietly?

This case and its subsequent four brief follow-up cases are based largely on interviews with Tyler Shultz, and outline the dilemma he faced and the various steps he would take both to extricate himself from his unsavory position and let the public know the full extent of the deception at Theranos.

Five optional handouts are available to instructors to further discussion after the case has been debriefed. The handouts serve as additional decision points for the students if your class time permits.

The aim of this paper is to improve the understanding of strategies for how established companies can respond to disruptive innovation, handle increasing complexity, facilitate entrepreneurial culture and processes and successfully manage organizational ambidexterity.

A qualitative multiple-case study was conducted to explore successful practices of innovation ambidexterity (IA) and their organizational design, entrepreneurial culture and mindset, processes and leadership. Two internationally established firms that have launched and established IA programs provided deep insight, revealing their strategy and learning on the path toward effective IA.

The findings show that accepting and managing the inherent complexity increases within an ambidextrous organization strategy is a decisive factor in achieving effective IA. As a result, segmenting small organizational units and granting them extensive autonomy is proposed for managing the complexity of an organization while increasing its effectiveness. Furthermore, it is shown that this helps foster entrepreneurial culture, mindsets and processes as additional mediators for achieving effective IA. Coaching, empowerment and trust were identified as key factors of ambidextrous leadership values that encourage entrepreneurial behavior and decision-making.

To the best of the authors knowledge the first study connecting the research fields of complexity management, organizational ambidexterity theory and entrepreneurial culture while applying the fundamentals of systems theory to propose a practical management framework for successfully responding to disruptive innovation.

Drawing on the social presence theory, this study aims to explore how supplier–customer social media interactions influence supplier observers’ trust in the customers and what mechanisms contribute to variation in trust experience.

A total of 36 semi-structured interviews were conducted with Chinese suppliers using WeChat for business-to-business interactions. Data were analyzed in three steps: open coding, axial coding and selective coding.

Findings reveal that varied trust is based not only on the categories of social presence of interaction – whether social presence is embedded in informative interactions – but also on the perceived selectivity in social presence. Observer suppliers who experience selectivity during social and affective interactions create a perception of hidden information and an unhealthy relationship atmosphere, and report a sense of emotional vulnerability, thus eroding cognitive and affective trust.

The findings contribute new understandings to social presence theory by exploring the social presence of interactions in a supplier–supplier–customer triad and offer valuable insights into business-to-business social media literature by adopting a suppliers’ viewpoint to unpack the mechanisms of how social presence of interaction positively and negatively influences suppliers’ trust and behavioral responses.