Using a case study of Acclarent, a medical device company, this paper attempts to propose a framework to further illustrate the process of open innovation in the medical device industry. We examined five elements in the mechanism of the open innovation process. Our paper shows how the success of Acclarent — a medical device start-up — depends on effective management of the flow of knowledge to satisfy unmet needs, while integrating in-depth knowledge of FDA regulations and third-party payers' reimbursement policies into the product innovation process. Read More: http://www.worldscientific.com/doi/abs/10.1142/S0219877014500321